The debate over the Affordable Care Act might not have the weight of 6.4 million subsidy-less people on its shoulders after the Supreme Court upheld a key piece of the law in Thursday’s King v. Burwell decision, but it’s anything but over. Republican presidential candidates already are using the decision to appeal to voters: If you don’t like Obamacare, vote Republican.
The decision, framed as a decisive victory by Democrats and a bitter disappointment by Republicans, doesn’t just move the health care debate forward a year. It also takes away an urgent need for reform that a King win would have created.
“I hope that our standard-bearer on the Republican side, whoever the presidential nominee will be, will bring up and decide on what our replacement plan would be and run on that. But it’s going to be more difficult,” Sen. Ron Johnson, who authored legislation to extend subsidies until after the election should the challengers to the law prevail, said in an interview after the decision.
“We’re going to need a really good argument, a really strong replacement plan by our presidential nominee,” he added.
There’s also the potential for the decision to give Republican presidential candidates a leg up, said Doug Holtz-Eakin, president of the conservative American Action Forum. It prevents them from having to settle on a single response to King, but also gives them an easier path to navigate in their crusade against Obamacare.
“It’s a very awkward thing to prop up a law which you’re intending to kill off, and that’s the position they would have been in,” he said. “Now they have a very clean position.”
The Republican candidates vary in the thoroughness of plans they’ve put forward to repeal and replace the law they despise. Some go hardly any further than stating their hatred of the ACA, while others offer detailed policy proposals.
In a Thursday CNN interview, Sen. Marco Rubio pointed to his consumer-centered plan that he said gives Americans the option of purchasing health insurance from any company—and in any state.
“I disagree with [the court’s] decision,” the Florida Republican told CNN. “I think Obamacare is bad for Americans, it’s bad for the country.”
He wasn’t alone. Almost all of the candidates seized the opportunity to remind voters that although the opportunity presented by King is gone, they are committed to getting rid of Obamacare next year.
“It’s now up to us to keep our promises,” presidential hopeful Sen. Ted Cruz said on the Senate floor just hours after the Supreme Court ruling. “I believe 2016 will be a national referendum on repealing Obamacare.”
The Texas senator, who helped force a 16-day government shutdown in 2013 over repealing the president’s signature health-care law, reiterated his commitment to getting rid of the law. “We will repeal Obamacare,” Cruz said, as he concluded his impassioned floor speech. “And I will fight with every breath in my body to make sure that that happens in 2017.”
Sen. Rand Paul referred to his time as a physician, using this as evidence that he knows what America’s health care system needs. “Obamacare raises taxes, harms patients and doctors, and is the wrong fix for America’s health care system,” Paul said in a statement.
“As president, I would make it my mission to repeal it, and propose real solutions for our healthcare system.”
And in the the significantly smaller field of Democratic presidential candidates, Republicans have opponents who will seemingly be more than happy to engage in a health-care policy fight.
Hillary Clinton, the presumptive Democratic nominee, was quick to point out how the law has insured 16 million people and brought up other ways she feels that the law, though it “isn’t perfect,” has benefitted Americans: Children can stay on their parents insurance until they’re 26. Insurance companies now must cover those with preexisting conditions. And they can’t charge women more than men.
“[Republicans] have voted more than 50 times to repeal or dismantle the law, roll back coverage for millions of Americans, and let insurers write their own rules again—all without proposing any viable alternatives,” Clinton said in a statement. “Now that the Supreme Court has once again reaffirmed the ACA as the law of the land, it’s time for the Republican attacks to end. It’s time to move on.”
And Sen. Bernie Sanders used the ruling to reiterate his vision for a universal health care system. “My view is that there is something wrong when the United States is the only major country on earth that doesn’t guarantee health care to all people as a right,” Sanders told National Journal, “so we’ve got to move to cover all people—not to throw more people off of health insurance, which is what the Republicans are trying to do.”
Among the GOP’s anti-Obamacare talking points are that the individual mandate is a tax on Americans, the ACA has increased premiums, and the law has slowed economic growth. Yet, there’s a way all this can be repealed and replaced, as presidential candidate Jeb Bush said in an email to supporters. And that’s “to make the most generous contribution you can afford right now to stop [Clinton].”
Because no matter which of the many GOP hopefuls voters decide to support, they can be guaranteed one thing. “Whoever the Republican Party may nominate, the one thing I can assure you is that they will repeal and replace Obamacare with something better,” Sen. Lindsey Graham, who is also running for the Republican nomination, said Thursday on the Senate floor. “So, to the people of the United States, you finally have a chance to have your say.”