WASHINGTONCongressional Republicans intend to seek quick repeal of any parts of the health care law that survive a widely anticipated Supreme Court ruling, but don't plan to push replacement measures until after the fall elections or perhaps 2013.

Instead, GOP lawmakers cite recent announcements that some insurance companies will retain a few of the law's higher-profile provisions as evidence that quick legislative action is not essential. Those are steps that officials say Republicans quietly urged in private conversations with the industry.

Once the Supreme Court issues a ruling, "the goal is to repeal anything that is left standing," said Sen. John Barrasso, R-Wyo., a member of the party's leadership.

Beyond that, "we ought to go step by step to lower the cost" of health care, he added, a formula repeated by numerous other Republicans interviewed in recent days.

Across the political aisle, neither President Barack Obama nor congressional Democrats have said how they will react to a high court ruling that could wipe out the legislation they worked so hard to enact.

"We're not spending a whole bunch of time planning for contingencies," Obama said this spring at the annual meeting of The Associated Press. He expressed confidence the court would uphold the law, and neither he nor his aides have said what fallback plans are under discussion. "We will be prepared in any eventuality," White House aide David Plouffe said Sunday on ABC's "This

Among Republicans, aides to Speaker John Boehner, Senate Republican leader Mitch McConnell and other key lawmakers have convened a series of meetings in recent weeks to plan a post-ruling strategy.

A Supreme Court ruling is expected within the next two weeks on a challenge to the law, which has drawn fierce opposition among most Republicans for its requirement that most individuals carry health insurance.

While three big insurance companies announced plans this past week to retain certain protections for an estimated 40 percent of all individuals who receive their coverage through work, there has been no advance word from the drug industry on how prescription costs for older people might be affected by a finding that the law is unconstitutional.

Even so, Republicans say they have no plans for assuring continuity of a provision that reduces out-of-pocket costs for seniors with high drug expenses. This coverage gap is known as "doughnut hole."

View original post here:

4 presumed dead after avalanche on Mount McKinley

Richmond, Va. --

The issues being decided in the monumental U.S. Supreme Court review of health care reform hit home for John Rayfield. When the uninsured 64-year-old self-employed carpenter needed heart bypass surgery in December 2010, he had no way to pay for it.

Rayfield, who described himself as a "walking time bomb," was able to have life-saving surgery when Access Now, a privately run program that arranges for low-income, uninsured people to get care from specialists, found a doctor and hospital to take his case and donate their time and costs.

The court's decision could be a game changer for such organizations as Access Now, and the local free clinics, community health centers and private providers that make up a health care safety net, providing health care to patients who otherwise might go without.

"If all the Obamacare goes through and everything's constitutional, and we go ahead, probably 50 to 60 percent of our patients are going to qualify for Medicaid," said Connie Moslow, executive director of the Free Clinic of Powhatan.

"Now, does that mean they are going to take it? It puts the free clinics in kind of a precarious situation also, because our thing is we provide health care to the uninsured," she said. "How do we adjust?"

Soon, the Supreme Court is expected to rule on two controversial provisions of the 2010 health care reform law: Can people be required to buy health insurance, and what the expansion of Medicaid will look like.

The individual mandate of health care reform would require most people to maintain a minimum level of health insurance coverage starting in 2014. There would be federal subsidies and tax credits to help people afford the costs.

Critical to the individual mandate is the creation of health benefit exchanges, state-managed marketplaces where people could shop for affordable health plans without the risk of being turned down because they have medical problems such as heart disease or cancer.

Also, under health care reform, state-run Medicaid programs would have to expand coverage to nearly all people under age 65 with household incomes at or below 133 percent of the federal poverty level beginning in January 2014. For a family of one, that's an annual household income of $14,856 in 2012.

More:

Health care reform uncertainty has safety-net providers in limbo

The Supreme Court is set to rule on the constitutionality of the controversial health care law passed in 2010.

STORY HIGHLIGHTS

Washington (CNN) -- The Supreme Court in coming days will issue perhaps as many as four separate opinions on the constitutionality of the health care law.

The Patient Protection and Affordable Care Act (PPACA or ACA) was signed into law March 23, 2010, passed by a Democratic congressional majority and championed by President Barack Obama. It has about 2,700 pages and contains 450 some provisions.

Here are the four issues the high court tackled separately during oral arguments in late March. Those issues are expected to play key roles in the judges' final decisions.

The gateway issue: Anti-Injunction Act

Would those challenging the law be barred from making any legal or constitutional claims until the key provision -- the individual mandate -- goes into effect in 2014? The obscure Anti-Injunction Act, dating back 145 years, prevents asking for a refund on a tax until that tax has been collected and paid. Judges in two federal appeals courts have made that "threshold" argument, which would effectively stop the current legal fight in its tracks.

Citing that law might give the court-- particularly its conservative members -- a way out of deciding the explosive issue in an election year. The majority could decide that the political branches can best resolve the conflicts, at least for now, or that the matter can be handled after the November elections. It could potentially delay a decision on the constitutionality of the individual mandate for at least four years.

The key Issue: Individual mandate

This provision would require nearly all Americans to buy some form of health insurance beginning in 2014 or face financial penalties. May the federal government, under the Constitution's Commerce Clause, regulate economic "inactivity?" Three federal appeals courts have found the PPACA to be constitutional, while another has said it is not, labeling it "breathtaking in its expansive scope." That "circuit split" all but assured the Supreme Court would step in to decide the matter.

View post:

Health care's big four issues: What the justices are tackling

The Affordable Care Act, passed in 2010, affects most major components of the health care system. Here’s a look at Florida’s role in the health insurance debate.

Read more:

High court decision on health-care bill will set off a Florida scramble

The Supreme Court is set to rule on the constitutionality of the controversial health care law passed in 2010.

STORY HIGHLIGHTS

Washington (CNN) -- The Supreme Court is set to release within a few days its much-anticipated rulings on the constitutionality of the Affordable Care Act, the comprehensive health care law enacted two years ago.

The election-year rulings will not only guide how every American receives medical care but will also establish precedent-setting boundaries for how government regulation can affect a range of social areas. Your health and your finances could be on the line.

The outcome's possibilities are myriad: a narrow or sweeping decision? A road map to congressional authority in coming decades? Which bloc of justices, which legal argument will win the day?

Here are five scenarios -- strategic markers of a sort -- to watch as the high court weighs in on health care.

Wait another day?

The first question the high court tackled in its seven-hour marathon argument in March was something few observers had expected: It boiled down to whether the law's individual mandate is a "tax" that could prevent the court from considering the broader constitutional questions.

A little-known federal law -- the Anti-Injunction Act, dating back to 1867-- bars claimants from asking for a refund on a tax until it has been paid.

This "gateway" issue could render moot all the other pending health care questions if the justices think the minimum coverage requirement amounts to a tax.

View original post here:

Five scenarios: Health care options before the justices

The Supreme Court is set to rule on the constitutionality of the controversial health care law passed in 2010.

STORY HIGHLIGHTS

Washington (CNN) -- The Supreme Court in coming days will issue perhaps as many as four separate opinions on the constitutionality of the health care law.

The Patient Protection and Affordable Care Act (PPACA or ACA) was signed into law March 23, 2010, passed by a Democratic congressional majority and championed by President Barack Obama. It has about 2,700 pages and contains 450 some provisions.

Here are the four issues the high court tackled separately during oral arguments in late March. Those issues are expected to play key roles in the judges' final decisions.

The gateway issue: Anti-Injunction Act

Would those challenging the law be barred from making any legal or constitutional claims until the key provision -- the individual mandate -- goes into effect in 2014? The obscure Anti-Injunction Act, dating back 145 years, prevents asking for a refund on a tax until that tax has been collected and paid. Judges in two federal appeals courts have made that "threshold" argument, which would effectively stop the current legal fight in its tracks.

Citing that law might give the court-- particularly its conservative members -- a way out of deciding the explosive issue in an election year. The majority could decide that the political branches can best resolve the conflicts, at least for now, or that the matter can be handled after the November elections. It could potentially delay a decision on the constitutionality of the individual mandate for at least four years.

The key Issue: Individual mandate

This provision would require nearly all Americans to buy some form of health insurance beginning in 2014 or face financial penalties. May the federal government, under the Constitution's Commerce Clause, regulate economic "inactivity?" Three federal appeals courts have found the PPACA to be constitutional, while another has said it is not, labeling it "breathtaking in its expansive scope." That "circuit split" all but assured the Supreme Court would step in to decide the matter.

See the article here:

Health care's big four issues

STORY HIGHLIGHTS

Washington (CNN) -- Winners and losers are the natural consequence of the American legal system. In the Supreme Court, five majority votes among the nine members are enough to fundamentally change lives and legacies.

The high court in coming days will issue rulings in perhaps its most important appeal in a dozen years: whether the sweeping health care law championed by President Barack Obama will be tossed out as an unconstitutional exercise of congressional authority.

The stakes cannot be overstated -- what the justices decide on a quartet of separate questions will have immediate and long-term impact on every American, not only in the field of medicine but in vast, untold areas of "commerce." Health care expenditures alone currently make up 18% of the U.S. economy, and the new law promises to significantly expand that share.

Five scenarios: Health care options before the justices

"I think the justices probably came into the argument with their minds made up. They had hundreds of briefs and months to study them," said Thomas Goldstein, publisher of SCOTUSblog.com and a prominent Washington attorney. "The oral arguments [in March] might have changed their minds around the margin. But we won't find out until the end of June."

A century of federal efforts to offer universal health care culminated in the 2010 passage of the Patient Protection and Affordable Care Act. After months of bare-knuckled fights over politics and policy, the legislation signed by Obama reached 2,700 pages, nine major sections and 450-some provisions.

At issue is the constitutionality of the "individual mandate" section -- requiring nearly all Americans to buy health insurance by 2014 or face financial penalties. Twenty-six states in opposition say if that linchpin provision is unconstitutional, the entire law must go. The partisan debate around such a sweeping piece of legislation has encompassed traditional hot-button topics: abortion and contraception funding, state and individual rights, federal deficits, end-of-life care, and the overall economy. The high court now has the final word.

The court will not say precisely when the health care opinions will be released, but the last scheduled public session of the term is set for June 25. Depending on how long it takes the justices to finish up, that deadline could easily slip a few days.

The justices have already secretly voted on the health care cases, as well as a dozen or so other separate appeals. They met privately as a group just days after the late March arguments, voting preliminarily. Individual justices were assigned to write the one or more opinions, as well as separate dissents. Only they and their law clerks know how this will end.

See original here:

Looming health care ruling will be among Supreme Court's most important

WASHINGTON (AP) -- Congressional Republicans intend to seek quick repeal of any parts of the health care law that survive a widely anticipated Supreme Court ruling, but don't plan to push replacement measures until after the fall elections or perhaps 2013.

Instead, GOP lawmakers cite recent announcements that some insurance companies will retain a few of the law's higher-profile provisions as evidence that quick legislative action is not essential. Those are steps that officials say Republicans quietly urged in private conversations with the industry.

Once the Supreme Court issues a ruling, "the goal is to repeal anything that is left standing," said Sen. John Barrasso, R-Wyo., a member of the party's leadership.

Beyond that, "we ought to go step by step to lower the cost" of health care, he added, a formula repeated by numerous other Republicans interviewed in recent days.

Across the political aisle, neither President Barack Obama nor congressional Democrats have said how they will react to a high court ruling that could wipe out the legislation they worked so hard to enact.

"We're not spending a whole bunch of time planning for contingencies," Obama said this spring at the annual meeting of The Associated Press. He expressed confidence the court would uphold the law, and neither he nor his aides have said what fallback plans are under discussion. "We will be prepared in any eventuality," White House aide David Plouffe said Sunday on ABC's "This Week," although he declined to elaborate.

Among Republicans, aides to Speaker John Boehner, Senate Republican leader Mitch McConnell and other key lawmakers have convened a series of meetings in recent weeks to plan a post-ruling strategy.

A Supreme Court ruling is expected within the next two weeks on a challenge to the law, which has drawn fierce opposition among most Republicans for its requirement that most individuals carry health insurance.

While three big insurance companies announced plans this past week to retain certain protections for an estimated 40 percent of all individuals who receive their coverage through work, there has been no advance word from the drug industry on how prescription costs for older people might be affected by a finding that the law is unconstitutional.

Even so, Republicans say they have no plans for assuring continuity of a provision that reduces out-of-pocket costs for seniors with high drug expenses. This coverage gap is known as "doughnut hole."

Read the original here:

GOP on health care: Repeal quickly, replace slowly

STORY HIGHLIGHTS

Washington (CNN) -- Winners and losers are the natural consequence of the American legal system. In the Supreme Court, five majority votes among the nine members are enough to fundamentally change lives and legacies.

The high court in coming days will issue rulings in perhaps its most important appeal in a dozen years: whether the sweeping health care law championed by President Barack Obama will be tossed out as an unconstitutional exercise of congressional authority.

The stakes cannot be overstated -- what the justices decide on a quartet of separate questions will have immediate and long-term impact on every American, not only in the field of medicine but in vast, untold areas of "commerce." Health care expenditures alone currently make up 18% of the U.S. economy, and the new law promises to significantly expand that share.

Five scenarios: Health care options before the justices

"I think the justices probably came into the argument with their minds made up. They had hundreds of briefs and months to study them," said Thomas Goldstein, publisher of SCOTUSblog.com and a prominent Washington attorney. "The oral arguments [in March] might have changed their minds around the margin. But we won't find out until the end of June."

A century of federal efforts to offer universal health care culminated in the 2010 passage of the Patient Protection and Affordable Care Act. After months of bare-knuckled fights over politics and policy, the legislation signed by Obama reached 2,700 pages, nine major sections and 450-some provisions.

At issue is the constitutionality of the "individual mandate" section -- requiring nearly all Americans to buy health insurance by 2014 or face financial penalties. Twenty-six states in opposition say if that linchpin provision is unconstitutional, the entire law must go. The partisan debate around such a sweeping piece of legislation has encompassed traditional hot-button topics: abortion and contraception funding, state and individual rights, federal deficits, end-of-life care, and the overall economy. The high court now has the final word.

The court will not say precisely when the health care opinions will be released, but the last scheduled public session of the term is set for June 25. Depending on how long it takes the justices to finish up, that deadline could easily slip a few days.

The justices have already secretly voted on the health care cases, as well as a dozen or so other separate appeals. They met privately as a group just days after the late March arguments, voting preliminarily. Individual justices were assigned to write the one or more opinions, as well as separate dissents. Only they and their law clerks know how this will end.

Read this article:

Health care decision looms over Supreme Court