(Bloomberg Politics) — Republican tensions over the Patient Protection and Affordable Care Act (PPACA) rose Tuesday after Heritage Foundation President Jim DeMint ramped up pressure on the party not to extend health insurance subsidies—even temporarily—that the Supreme Court could erase within days.
In an op-ed titled "Let the subsidies die," the former senator and conservative kingmaker took aim at Republicans who are eyeing a backup plan that temporarily preserves the subsidies to avoid massive disruptions and loss of coverage for millions of Americans.
"It would be uncaring and unfair for Congress to force taxpayers to continue funding Obamacare's subsidies, DeMint wrote in the Washington Examiner. "Extending the subsidies would be political malpractice, not just a mere Band-Aid upon an infected wound." He argued that it would be "far better" to simply repeal the entire law.
The essay throws an intriguing wrinkle into the congressional politics surrounding the imminent Supreme Court decision, which recently has seen Republican opponents of the health care law scrambling to come up with answers for an estimated 6 million Americans likely to lose health insurance tax credits if the justices rule against the Obama administration. A decision in the much-watched case, King v. Burwell (Case Number 14-114), is expected in the next few days.
DeMint's missive could give some of them pause. The outspoken South Carolinian occupies a bully pulpit as the head of the Heritage Foundation, a conservative brain trust with an active political arm, Heritage Action For America.
Dan Holler, a spokesman for Heritage Action, dropped a broad hint that there could be political consequences for Republican lawmakers who try to create a subsidy patch. "It will be difficult for a Republican to go home and explain how saving a key plank of Obamacare helps ensure Obamacare is repealed in 2017," Holler said.
In addition, a DeMint-founded super PAC has specialized in taking aim at Republicans it deems insufficiently conservative. In the 2014 election cycle, the Senate Conservatives Fund spent more than $7 million helping favored candidates—and torpedoing those out of favor, according to figures compiled by the non-partisan Center for Responsive Politics.
Ken Cuccinelli, the president of Senate Conservatives Fund, was blunt about threatening to support primary challenges against Republican lawmakers who back an extension of the PPACA subsidies.
A not-so-veiled threat
"If the Supreme Court strikes down the Obamacare subsidies and mandates, Republicans in Congress should not extend them," Cuccinelli told Bloomberg in a statement. "Republicans should fight for full repeal, as they promised time and time again. SCF supports conservative candidates and a lawmaker's position on Obamacare is one of the most important issues we will examine when deciding whether to support a primary challenger."
But the potential political consequences of not backing subsidies also are worrying to Republicans, who don't want to be blamed for millions of Americans losing their coverage. At issue in King v. Burwell is whether the text of PPACA restricts premium tax credits to Americans enrolled through state-run insurance exchanges, rather than those in three-quarters of states who use the federal exchange. Many Republicans have called on the Supreme Court to void the subsidies; the White House and Democrats say the law clearly makes those subsidies available in all 50 states.
Republican Sen. Ron Johnson of Wisconsin, who faces a tough reelection fight next year, is the author of a bill with 31 cosponsors that would extend the subsidies if the Supreme Court overturns them.
"Obviously I disagree with Senator DeMint's position on that," Johnson said in an interview Tuesday. "My main goal is to make sure no Americans are further harmed by this sloppily written—and what would be then unlawfully implemented—law. And I think we have a responsibility to do that."A tricky rhetorical balance
Sen. John Barrasso of Wyoming, the leader of the Republican effort to craft a contingency plan, responded to the criticisms Tuesday. "We are not going to protect the law," he said. "We are going to protect people."
Republican senators in blue and purple states—Susan Collins of Maine, Kelly Ayotte of New Hampshire and Rob Portman of Ohio—told Bloomberg they support a temporary subsidy extension. Like Johnson, Ayotte and Portman face potentially difficult reelection races in 2016.
