King v. Burwell: "The goal is to not let our guys look like they're going crazy & letting the world spin into chaos."

Over at Talking Points Memo, Sahil Kapur has a story which, on the one hand, reveals nothing that most people didn't already know...but at the same time includes some quotes from anonymous Republican staffers which are almost Onion-like in their point-blank candor:

Republicans Are At A Loss On What To Do If SCOTUS Nixes Obamacare Subsidies

"It's an opportunity that we've failed at for two decades. We've not been particularly close to being on the same page on this subject for two decades," said a congressional Republican health policy aide who was granted anonymity to speak candidly. "So this idea — we're ready to go? Actually no, we're not."

...But conversations with more than a dozen GOP lawmakers and aides indicate that the party is nowhere close to a solution. Outside health policy experts consulted by the Republicans are also at odds on how the party should respond.

Of course, there's a pretty simple reason why the Republican Party can't come up with an alternative to the ACA: Medicaid expansion aside, it pretty much was their alternative healthcare plan. Dreamt up by the Heritage Foundation, pushed for by Newt Gingrich, implemented at the state level by Mitt Romney (you know, the guy who would then run for President on a platform of repealing his own law at the national level a few years later).

The party that has failed to unify behind an alternative to Obamacare for many years now has five months to reach an agreement. It's an unenviable predicament, especially for the congressional Republicans leading the effort to devise a response — all of whom hail from states that could lose their subsidies.

"There are a lot of ideas," Senate Finance Committee Chair Orrin Hatch (UT) told TPM on Tuesday. "If the case goes the way I think it should go ... then we've gotta come up with a way of resolving the problems we're in. We're quietly looking at all that and trying to do that."

THIS is pure gold (again, this is coming from a "prominent outside conservative close to Republican lawmakers"):

..."What I worry about is — the goal is to not let our guys look like they're going crazy and letting the world spin into chaos."

Did you catch that? Their goal isn't to not be crazy and let the world spin into chaos; it's to not let them look crazy.

Of course my old pal Avik Roy shows up as well, desperately trying to pound at least some sense into the totally-not-crazy-not-letting-the-world-spin-into-chaos Republican leadership...

Avik Roy, a conservative health care adviser, laid out the party's options at the strategy meeting in Hershey: do nothing, work with Democrats to fix the law, or seize what he calls "their best opportunity to reform the health care system" and propose a serious conservative alternative.

...but apparently they're not having any of this silly "sanity" business:

Republicans don't view the first two options as viable.

Of course, while "fixing" the law would take all of 5 minutes by simply scrawling (in crayon, if they prefer) "...or the Federal Government" into a single sentence of a single paragraph of a single subsection of the law, we all know that that isn't going to happen. That means that the next-easiest solution would be for the states on the federal exchange to set up their own exchanges (at least by the bare minimum standards required, anyway). However...

Republicans also aren't ready to call on their states to set up exchanges, likely because conservatives could attack that as supporting Obamacare. Asked about the prospect Sens. Jerry Moran (R-KS), Jeff Sessions (R-AL) and Alexander demurred. Each would face a situation where many of their constituents lose insurance subsidies and perhaps their coverage.

As an aside, some people have asked me why I've been sounding the alarm about the time factor here...that is why it's not OK for the states on the federal exchange to just kick back with a "wait and see" approach. Well, here's the problem with that:

  • A ruling in June would be only months before open enrollment for 2016 begins in October, leaving little time for states to act.
  • Of the states that would lose tax credits, only eight have legislative sessions that extend beyond June. Because states need to have the legal authority to set up a marketplace—and because most governors do not have the statutory authority to act on their own—state legislatures would need to act.

Got that? Even if all 34-37 states (I'm not sure what the status of Oregon, Nevada or New Mexico would be) wanted to set up their own exchanges, most of them wouldn't even be in a position to set one up legally, much less financially or logistically. I suppose an Emergency Session or whatever could be called in the states which shut down their normal sessions before the ruling came out, but that's pretty slim pickings.

...And there's the Democratic Party's attack ad in a nutshell:

  • Millions of people will lose their healthcare coverage because Republicans are being colossal assholes.