WASHINGTON — Even as Republicans rose in a chorus of outrage Thursday over the U.S. Supreme Court’s refusal to gut the unpopular Affordable Care Act (ACA), party leaders were privately breathing a sigh of relief.
Had the court gone the other way, Republicans would have faced their most serious governing challenge since taking control of both houses of Congress earlier this year.
Former Republican National Committee chairman Ed Gillespie called it “a bad legal outcome, but a good political outcome” for Republicans. But he added that it will increase pressure on his party to come up with a specific alternative to the law ahead of the 2016 elections.
Pollster David Winston, who advises the GOP congressional leadership, said, “Ultimately, the challenge for Republicans is not just how to deal with this law, but where’s the direction? Where are the alternatives?”
More than 6 million Americans — most of them in conservative states — would have suddenly been without the government subsidies that make health insurance affordable under the act.
And it would have primarily been the responsibility of Republicans — a party that is on record as favoring repeal of the law — to come up with a solution that could pass both houses of Congress and be signed into law by President Barack Obama. A decision to severely undermine the law also would also have presented a tricky political challenge for conservative governors and legislatures, and for more than a dozen GOP candidates running for president.
Not that the issue will go away.
“Obamacare is fundamentally broken, increasing health-care costs for millions of Americans,” House Speaker John Boehner, R-Ohio, said in a statement issued by his office. “Today’s ruling doesn’t change that fact.”
The initial round of rhetoric after the court decision suggested that the court decision might even have inflamed the right, and given the growing field of Republican presidential contenders a new battle cry. While all are on record as opposing the law, none has come up with a detailed description of what they believe should replace it.
“Our Founding Fathers didn’t create a ‘do-over’ provision in our Constitution that allows unelected, Supreme Court justices the power to circumvent Congress and rewrite bad laws,” former Arkansas governor Mike Huckabee said in a statement while campaigning in southern Iowa.
“The decision turns both the rule of law and common sense on its head,” added Sen. Rand Paul, R-Ky., in a statement. “As president, I would make it my mission to repeal it, and propose real solutions to our health care system.”
The justices, in a surprisingly strong 6-to-3 vote, ruled that subsidies should remain available not only in 16 states that have set up their own health insurance marketplaces, but also in the 34 states — most of them dominated by Republicans — that have refused to do so, relying on the federal government exchange instead.
That might sound like a technical issue — resolving ambiguous language in the bill that Obama signed into law in 2010. But the practical effect of taking government assistance from people who bought their coverage on the federal exchanges could have made the entire law unworkable, because so many consumers would have found their new insurance policies unaffordable, many health-care experts said.
“Today Democrats, and my guess is Republicans, are breathing one gigantic sigh of relief,” said Sen. Chuck Schumer, D-N.Y.
Making the politics more treacherous is the fact that Americans hold paradoxical views of the law and the choice that was before the court.
In a May Washington Post-ABC News poll, only 39 percent of respondents said they approve of the law, while 54 percent said they opposed it. But when asked whether the court should take away subsidies in states that rely on the federal exchanges, 55 percent said the justices should not, and only 38 percent said they should.
Rick Wilson, a Florida-based strategist for Republican statewide candidates nationwide, said he was “relieved by the decision,” which has given his party of reprieve from having to navigate those straits.
“I’ve been telling clients for about a month now, listen, this is probably going to be passed, they’ll approve it, and you should not be freaked out by it, because otherwise you’re going to spend the next year and a half getting ads run against you where a weeping Hispanic woman looks at the camera and says, ‘They took away my son’s health care. Now he’s dead,’ ” Wilson said.
“What I don’t want is a political environment where for the next year we’re in a ditch with people asking, ‘What’s your exact health-care plan?’ and then when we present one it gets torn apart,” Wilson added. “Anyone who thinks that’s a great political frame to put yourself in for 2016 hasn’t ever done an election.”
Former Michigan governor John Engler, a Republican who now heads the Business Roundtable, said that pressure will remain to fix individual elements of the law that are opposed by many in both parties, including the tax it would impose on high-cost “Cadillac” health policies and its tax on medical devices.
But he said of the court decision: “What this means is that probably major changes in the Affordable Care Act will be debated in the 2016 election.”
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Washington Post staff writer Ed O’Keefe contributed to this report.