The Johnson plan would prohibit new customers in both the state and federally operated exchanges from receiving subsidies and repeal the individual and employer mandates. In addition, it would eliminate the Affordable Care Act’s minimum essential benefit requirements, allow states to set those benefit rules, and grandfather in existing health plans that are not compliant with the ACA.Another proposal, by Sen. Ben Sasse (R-Neb.), would continue premium subsidies for 18 months but phase them out over that period. For six months after the court rules, financial assistance for all subsidy-eligible exchange customers would be set at a flat 65% of premium costs. That would decrease by 5 percentage points each month until the subsidies were completely eliminated. During the transition period, insurers would be prohibited from raising premiums. In addition, the Sasse bill would prohibit HHS from providing federal exchange technology to states interested in establishing their own exchanges. […]
On the House side, House Ways and Means Committee Chairman Paul Ryan (R-Wis.) and two other committee chairmen have proposed to offer a flat tax credit to people now receiving subsidies through the federal exchange. In addition, they would let states opt into an alternative Republican reform model without insurance mandates and including traditional GOP policy nostrums such as allowing insurers to sell plans across state lines.
What the two Senate proposals would do is just to make the end to subsidies happen a lot more slowly, and force the law to wither on the vine. No new people could enroll in Johnson’s plan and it’s essentially a slow-walk back to the pre-Obamacare status quo, where insurance is too expensive for too many. Sasse’s would have the same result, with the nice added bit of blocking states from forming their own exchanges. Ryan’s plan is Obamacare lite, his tax credits being pretty much exactly the same as Obamacare’s subsidies, just with some GOP stuff scattered in.Here’s the really fun part though: “in the wake of a Supreme Court ruling in King v. Burwellstriking down subsidies, any proposal that offers any subsidies could be scored by the Congressional Budget Office as new spending.” Get that? New spending. Republicans would have to spend new money on Obamacare or face the political consequences of millions of people losing their insurance—millions of people mostly in red states. Their only other option is to try to pass one of these “fixes” with reconciliation in the budget process, and do it before the Supreme Court rules an existing law is still the baseline that CBO uses to calculate costs.
Beyond this is their very basic problem of finding enough Republicans to vote for a fix, and if they even manage to do that in the House, keeping Ted Cruz or Rand Paul from derailing it in the Senate. Right now, you gotta believe that the most fervent wish of Republican congressional leaders is that the Supreme Court bails them out and upholds subsidies.