WASHINGTON -- Facing a pivotal Supreme Court decision on the future of his signature health care law, President Barack Obama said Tuesday that attacks on the Patient Protection and Affordable Care Act should end now that millions of Americans depend on it for insurance coverage.
"There's something, I have to say, that's just deeply cynical about the ceaseless, endless, partisan attempts to roll back progress," Obama said Tuesday in a speech to Catholic hospital officials in Washington. "It seems so cynical to want to take coverage away from millions of people, to take care away from the people who need it the most."
Republicans, who have led the charge to repeal the Affordable Care Act, will act to support people who would lose government subsidies for their coverage if the court rules against the Obama administration, Rep. Paul Ryan, R-Wis., said.
"We will have a Republican alternative to deal with this so that people who are caught in the crossfire of this unconstitutional law -- should the court determine that it's unconstitutional -- have a way to go," Ryan, the chairman of the House Ways and Means Committee, said.
Sen. John Barrasso, R-Wyo., said Tuesday that House and Senate lawmakers were "very close" to a bill creating temporary tax credits that they would unveil after the court's decision.
A decision is expected this month in the lawsuit, King v. Burwell, which challenges the availability of tax credits to discount the cost of insurance in about three dozen states that rely on the federal insurance exchange, healthcare.gov. Opponents of the law say it allows subsidies in no more than 16 states that created their own insurance exchanges.
The exchanges, a cornerstone of the law, allow Americans who don't get health benefits at work to shop online among plans that must all offer basic benefits and cannot turn away customers, even if they are sick. Consumers making less than four times the federal poverty level -- about $47,000 for a single adult and $97,000 for a family of four -- qualify for subsidies.
The case centers on a provision in the law that says subsidies are available to people living where the insurance exchanges had been "established by the state." The Obama administration, the law's congressional architects and many outside legal experts said the law clearly was supposed to make the aid available in all states.
More than 6 million consumers risk losing discounts on their monthly premiums if the court rules against the Obama administration.
Rates for millions more could rise if the insurance markets collapse in the states that use the federal insurance exchange.
"Five years in, what we are talking about is no longer just a law," Obama said in his speech, at the the annual conference of the Catholic Health Association.
"This isn't about myths or rumors that folks try to sustain. There is a reality that people on the ground day to day are experiencing. Their lives are better."
The suit is the latest challenge to a law that has survived dozens of congressional attempts to repeal it, a 2012 Supreme Court case to determine its constitutionality and an election in which the president's challengers vowed to overturn it. An adverse Supreme Court ruling would throw insurance markets into disarray, Obama said Monday after a meeting of the Group of Seven nations in Germany.
The president has said he is confident that won't happen. The Supreme Court probably shouldn't have taken up the case challenging the federal subsidies, Obama said Monday.
To rule against the health care law, the justices would have to make a "contorted" and "twisted" reading of the law, he said.
"This should be an easy case," Obama said. He said he assumed that the Supreme Court "is going to do what most legal scholars who have looked at this would expect them to."
The president said Monday that Congress could settle the issue at the heart of the Supreme Court case with a "one-sentence" change to the law. Some Republicans, however, see the lawsuit as an opportunity to undo what they view as the law's most onerous provisions.
"Republicans aren't interested in a one-sentence fix -- unless that sentence is: 'Obamacare is repealed,'" Wyoming's Barrasso, the fourth-ranking Republican in the chamber, said in a speech preceding Obama's remarks. "We want to protect the American people from this complicated, confusing and costly health care law."
In his speech Tuesday, the president made the case that the law is already benefiting millions of people. He described several families that had received life-changing care.
"There are parents in Texas whose autistic son couldn't speak," he said. "Today, that little boy can tell his parents that he loves them."
Anticipating the president's speech, Senate Majority Leader Mitch McConnell, R-Ky., said Tuesday that Obama was "jousting with reality again."
"I imagine the families threatened with double-digit premium increases would beg to differ, as would the millions of families who received cancellation notices for the plans they had and wanted to keep," McConnell said. His office issued an email citing news reports about surging health care costs, potential rate increases and canceled health plans.
While the president highlighted the accomplishments of the health law, its adoption has not been without flaws. The initial sign-up period was marred by a faulty website, and a report Tuesday from a government watchdog agency found new problems verifying tax-credit claims.
The Treasury Inspector General for Tax Administration released an audit that found the Internal Revenue Service did not get the required information on 1.7 million households in a timely manner from Department of Health and Human Services. As a result, the audit said, the IRS was unable to verify that people claiming health insurance tax credits on their tax returns had in fact purchased coverage.
But before the president's speech, the White House released a fact sheet detailing benefits of the health care law, including a reduction in the uninsured rate to 11.9 percent in the first quarter of 2015 from 17.1 percent in 2013.
The White House also released a letter written by Sen. Ted Kennedy, D-Mass., who pushed for the health legislation before he died in 2009.
"I felt confident in these closing days that while I will not be there when it happens, you will be the president who at long last signs into law the health-care reform that is the great unfinished business of our society," Kennedy wrote in the letter to Obama dated May 12, 2009. He instructed his wife to send it to Obama after his death.
The White House also unveiled a new website intended to put the Affordable Care Act into a broader historical context. The site features a timeline suggesting that efforts to expand health coverage began more than 100 years ago.
The first entry in the timeline is from Aug. 6, 1912, when, the White House said, "President Theodore Roosevelt campaigns on national insurance." Later events include calls for more health coverage from all the presidents since then.
"We can and we must strive now to assure the availability of and accessibility to the best health care for all Americans, regardless of age or geography or economic status," President Lyndon Johnson told Congress on Jan. 7, 1965.
Information for this article was contributed by Toluse Olorunnipa, Mike Dorning, Peter Cook and Alexa Papadopoulos of Bloomberg News; by Michael D. Shear of The New York Times; by Noam N. Levey of Tribune News Service; and by Jim Kuhnhenn, Ricardo Alonso-Zaldivar, Erica Werner and Alan Fram of The Associated Press.
A Section on 06/10/2015