| WASHINGTON, March 20
WASHINGTON, March 20 As the U.S. Supreme Court
prepares to hear legal challenges to President Barack Obama's
healthcare overhaul next week, Republican lawmakers are weighing
options for repealing the law or even replacing it with a plan
of their own.
In fighting the 2010 Patient Protection and Affordable Care
Act that will extend health coverage to millions more Americans,
Republicans have not offered a definitive alternative.
But should the entire law get struck down by the court, it
would reignite the debate over whether a comprehensive plan or
step-by-step approach is best to fix a healthcare system that
many lawmakers from both parties agree is too expensive and
leaves too many people without affordable medical coverage.
Here is a look at how the Republican strategy is likely to
unfold, according to party lawmakers, their congressional aides
and political analysts:
Q. Why not offer an alternative plan now?
A. Anything Republicans advanced would become a political
target for Obama's Democratic Party ahead of Nov. 6 national
elections. Many in Congress don't expect Republicans to put
forward a proposal until after the Supreme Court rules in late
June. What they do will depend largely on how the court rules.
It could strike down the entire law, or focus exclusively on the
core question of whether the requirement that all Americans buy
health insurance is constitutional.
Meanwhile, Republicans are pressing their attack against the
law they dismissively brand as "Obamacare." They are putting
forward a series of measures aimed at repealing parts of it.
None is expected to pass the Democratic-led Senate. But voter
doubts about the law helped Republicans take control of the U.S.
House of Representatives in 2010 and it remains a major issue
for them in this year's elections. Republicans planned to
actively focus on the healthcare law in the days leading up to
its two-year anniversary on March 23 and the Supreme Court oral
arguments the following week, aides said.
Q. What if the Supreme Court strikes down the entire law?
A. Most likely Republicans would put forward a limited plan
to address insurance and healthcare costs along the lines of an
alternative offered by House Ways and Means Committee Chairman
Dave Camp during the 2009 debate over Obama's healthcare law.
That bill aimed to increase competition among health insurers,
which are regulated by states, by allowing them to sell policies
across state lines. It also would encourage businesses to pool
together to purchase medical coverage for their employees.
Republican Representative Tom Price, a physician, is a lone
voice within the party who is encouraging a comprehensive
approach without the mandate. He warns of the dangers of
unintended consequences by tinkering with the system. Price's
plan includes many of the ideas put forward in Camp's plan. It
also aims to increase health coverage through tax credits for
low-income people and gives those with Medicare and other
government health plans the option of receiving a tax credit to
help purchase private coverage. It also calls on states to
voluntarily set up Internet-based insurance purchasing sites to
help consumers shop for, and compare, coverage plans.
Q. What if the Supreme Court just strikes down the mandate
requiring everyone to purchase insurance?
A. Striking down just the mandate to purchase insurance will
most likely intensify calls to repeal the entire law. Insurance
premiums could soar since insurers are barred under the law from
turning away customers with pre-existing conditions, but will
not be able to buffer their exposure through premiums paid by
healthier individuals who may opt out of coverage.
Republicans who have been fiercely opposed to the law are
unlikely to cooperate with any Obama administration efforts to
modify it, especially in an election year. They may put forward
a proposal to encourage more plans, known as high-risk insurance
pools, in individual states to cover people with pre-existing
Q. What if the Supreme court upholds the Obama healthcare
A. Expect Republicans to continue targeting various
provisions of the law at least through the November elections.
Already they have succeeded in forcing some changes, including
repeal of a provision that would have imposed more tax reporting
requirements on small businesses. Republicans have succeeded
also in pushing through measures requiring the government to
reclaim greater amounts of insurance subsidy overpayments than
was originally included in the law. House Republicans are
pushing through legislation to do away with an independent
payment advisory board for Medicare and to eliminate a new tax
on medical devices that was put in place to help cover the cost
of the new law.
(Editing by Michele Gershberg and Lisa Shumaker)