There is a lot of discussion about the effects and wisdom of the Halbig decision, including some amusement at the site of a leading Obamacare architect turn himself into a rhetorical pretzel. However, one thing that has not really been addressed is the need to be serious about “repeal and replace.”
Republicans need to remember that if the Supreme Court actually follows the D.C. Circuit Court panel and knock down all subsidies in states that do not have their own exchanges, millions will find themselves with unaffordable health insurance – and likely go back to the ranks of the uninsured. When that happens, the GOP needs to be ready with an alternative health care reform plan that brings these people back into the insurance market, while reducing the effect of the government’s “invisible foot” in health care in general.
The earliest the Court will hand down a decision is the summer of 2015 (and it could be the summer of 2016). Either way, it will land somewhere in the presidential campaign, meaning the Republican candidate(s) need to spend some time addressing this issue, or get drowned out by the Democrats screaming, “Republicans ended the subsidies and deprived millions of health care just to score political points against Obama.”
Of course, there is plenty of space for right-of-center health care reform: ending the tax-favoritism towards group plans, breaking the AMA’s de facto monopoly on health care prices (handed to them by the federal government), addressing the health-care-provider shortage with supply side economic reforms specific to that industry, etc.
If the defeat of 2012 taught us anything (besides never nominated a TARP backer again), it taught us that an unpopular plan (Obamacare) still beats no plan (Romney’s complete lack of an alternative). The dynamics of a post-Halbig American will drive that lesson home even further. The Republican ticket in 2016 will either learn that lesson, or lament their defeat.