Health-Care Reform's Supreme Court Showdown

06.29.12

Supreme Court’s Obamacare Ruling Leaves Republicans Scrambling

The Supreme Court ruling on Obamacare dashed both parties’ carefully laid reaction plans, but leaves Republicans in particular grasping for a strategy. Patricia Murphy on how the GOP will try to bounce back.

Until 10:07 a.m.—the moment Thursday that the Supreme Court announced it would uphold nearly all of the Obama administration’s health care law—Democrats and Republicans were fully prepared to launch detailed contingency plans, months in the works, to respond to the opposite scenario.

After all, had the high court struck down all or part of the law, the American health-care system would once again be ripe for litigation, debate, and legislative fixes.

Republicans’ plans were twofold:  introduce a bill to repeal whatever the court did not strike down, and methodically offer up smaller, more popular pieces of the bill that were individually popular, like keeping young adults on their parents’ insurance until they’re 26 and eliminating lifetime-coverage caps.  They would also push traditional Republican-tested ideas that sold well with their base, like tort reform and allowing insurance to be sold across state lines.  

Although the timing of the new bills remained undecided, the ideas came out of a months-long effort to map a post-Supreme Court strategy.  GOP Whip Kevin McCarthy convened four meetings with members, including a separate sit-down with the doctors in the caucus, to prepare for three scenarios—that the bill would be upheld, partially struck down, or entirely struck down.  But members involved in the meetings said the most attention was concentrated on the scenario nearly all of Washington expected—that the individual mandate would not survive.

For their part, Democrats prepared for the same outcome, drafting talking points about a partisan Supreme Court run amok and looking for ways to backfill whatever the justices struck down as unconstitutional.  Democratic senators began to devise bills to introduce immediately after a potential nullification of the act, including small measures to restore a partially gutted law and a much larger bill called the “Health Care Restoration Act” in case the entire Obamacare measure was struck down in one fell swoop.  

The challenge for Republicans is that they have failed to achieve a cohesive message about what a new health care bill would look like.

In the end, none of the complicated, multipart contingency plans was necessary because the Supreme Court essentially upheld the status quo, the one scenario neither side had fully gamed out, leaving both parties scrambling. 

The easier task fell to Democrats, whose only real challenge was not to spike the ball, as John Boehner had warned his members not to do if their side won.  But even composure was too much to ask from some giddy party leaders. DNC Executive Director Patrick Gaspard launched a typically jubilant, if off-color, taunt to Republicans in the frenzied moments after the Supreme Court delivered its decision.  “It’s constitutional. Bitches,” he tweeted. 

Video screenshot

Mitt Romney vows to repeal Obama's healthcare law

Other Democrats skipped the profanity, but could not help gloating just a little. Sen. Barbara Mikulski rushed to a press conference on the steps of the Supreme Court to declare, “This is what democracy looks like!”

Staffers for minority leader Nancy Pelosi, who has been insisting for months that the health-care bill was “iron-clad constitutionally,” released fun facts about what the leader was wearing—including that she had put on her “lucky purple shoes” for the occasion, the same ones she wore when the bill passed two years ago.

Purple shoes and all, a clearly thrilled Pelosi took to the podium to report she had called Vicky Kennedy, Ted Kennedy’s widow, to say she knew the senator had gone to heaven to “help us pass the bill.  Now he can rest in peace.”

No longer needing to produce a legislative Plan B, senior administration officials took the time to release a moment-by-moment account of President Obama’s movements in the White House as he learned that his bill had been left nearly intact, including descriptions of a hug for one staffer and a call to Solicitor General Donald Verrilli, who had argued the case before the Supreme Court.

On the other side of the aisle—and the argument—many Republicans admitted they didn’t see the decision coming.  Rep. Phil Gingrey (R-Ga.), who had been in the doctors’ caucus meetings with McCarthy, said he was “shocked” and “disappointed almost beyond belief” by the ruling.

Boehner, who is known to start nearly all of his meetings on time, postponed his 10:45 press conference for nearly three hours while other top Republicans scrapped plans to speak in front of the court and opted for a standard Capitol Hill press conference instead.

The Speaker, along with a unified chorus of Republicans, promised to repeal the law that the court had just upheld as soon as possible. Majority leader Eric Cantor scheduled a vote—on July 11—to repeal the law, for a second time. (The House already approved repeal in 2011.) McCarthy promised that the health-care debate “has only just begun.”

In practical terms, Democrats said they will do little more on health-care reform other than trying to explain it better in the future than they have in the past.  They’ll also work on finalizing the details of the law’s biggest pieces that will not take effect until 2014, 2016, and even 2018.  “It’s all about continuing to implement the bill now,” a Democratic health-care staffer told The Daily Beast.

The challenge for Republicans, who for two years have promised to repeal and replace the law, is that they have failed to achieve a cohesive message about what the replacement would look like.

One exception is Republican governors, who rule a majority of state houses. Many have said they will refuse to implement the bill at the state level.  The National Association of Insurance Commissioners has predicted only about half the states will be ready to set up new health-insurance exchanges that the bill requires by 2014.

In Virginia, Gov. Bob McDonnell said he’ll eventually implement the law, but added that he won’t start until he knows how the elections turn out in November.  Wisconsin’s Gov. Scott Walker said he’s not doing anything, ever.  “Wisconsin will not take any action to implement Obamacare,” Walker declared.

As for Mitt Romney, without a nuanced ruling or baby-splitting decision, he stood in front of the Capitol with a simple promise.

“What the court did not do on its last day in session, I will do on my first day if elected president of the United States," he said.  And by 5 p.m. Thursday, his campaign said, he had raised more than $2 million from whipped-up Republicans, looking for a way to make Romney’s first day in office a reality.