WASHINGTON -- As the Supreme Court prepares to hear arguments today on whether to invalidate a crucial part of President Barack Obama's health care law, administration officials said they are doing nothing to prepare for the possibility of defeat.
There are no contingency plans in place if the court invalidates the Patient Protection and Affordable Care Act subsidies that 7.5 million people in 34 states are receiving, administration officials said. No one is strategizing with governors, insurance company executives or lawmakers. There is no public-relations plan to reassure people who might suddenly have to pay more for insurance.
If the court rejects the subsidies -- a decision unlikely to arrive until the end of the session -- health experts said premiums could triple within weeks, causing millions of people to lose coverage. That could quickly lead to a collapse of the health insurance markets in two-thirds of the country.
Administration officials insist that any steps they could take to prepare for the potential crisis would be politically unworkable and ineffective, and that pursuing them would wrongly signal to the justices that reasonable solutions exist.
The strategy is meant to reinforce for the court what White House officials believe: that a loss in the health care case would be unavoidably disastrous for millions of people.
"If they rule against us, we'll have to take a look at what our options are. But I'm not going to anticipate that," Obama said Monday in an interview with Reuters. "I'm not going to anticipate bad law."
The strategy echoes the administration's refusal through most of 2012 to acknowledge any planning for the effect of across-the-board budget cuts known as sequestration, wrongly insisting that the cuts would never come to pass.
Also in 2012, the White House and its allies said there were no plans for the Supreme Court ruling on a challenge to the health care law's individual mandate. The court later upheld the mandate.
In the current health care case, legal experts said the White House was savvy in making clear that the situation was dire. They said the justices regularly consider the broader effect of their decisions and often take into account how the executive branch or Congress might respond to a ruling.
The latest legal challenge to the Affordable Care Act was brought by opponents who say that Congress authorized subsidies to be issued only to people who signed up for coverage in state-run marketplaces, not those who signed up through the federal healthcare.gov website. Government lawyers argue that lawmakers intended the subsidies to be available everywhere.
Obama's advisers continue to say they are confident that the law will survive the court challenge. If it does not, the government will have to stop sending tax credits to insurance companies on behalf of the millions who signed up through healthcare.gov and were promised subsidies to offset the cost of premiums.
Most of those people would no longer be required by the law's individual mandate to have insurance, because part of the law provides exemptions when affordable insurance is not available. As a result, all but the sickest would choose to cancel their insurance, experts predicted.
With healthy people no longer choosing to be covered, experts said, most insurance companies would pull out of the markets in those states rather than cover only the sickest -- and most expensive -- customers.
The result would be a "death spiral," according to the Supreme Court brief filed by America's Health Insurance Plans, the nation's health insurance trade group. "It would leave consumers in those states with a more unstable market and far higher costs," the group argued in the brief.
Soon after the ruling, health care experts said, the White House could work with lawmakers to pass new legislation clarifying that the subsidies should be available everywhere. But that would require the unlikely support of Republicans who have fiercely opposed the president's law and sought to repeal it.
"It would take a wrecking ball to a major part of the Affordable Care Act," Rep. Chris Van Hollen, D-Md., said of a loss in court. "It's hard to see how it would be fixed, absent legislation. And Republicans have made it clear they have no interest in fixing it."
Experts said the administration could encourage more states to set up their own insurance marketplaces. Health experts said the administration could also provide waivers, financial assistance or technical expertise to help states, though the process could take years to complete.
The federal government could also approve the formation of regional insurance marketplaces, but political leaders in the states would have to agree to participate.
"There aren't any magic solutions here," said Timothy Stoltzfus Jost, a professor at the Washington and Lee University School of Law.
The situation has angered the administration's Republican critics, who hope that the court will do what they have been unable to accomplish in Congress: unravel the president's chief domestic accomplishment.
"By admitting they have no contingency plan to assist the millions that may lose subsidies, the administration confirms how the misguided law is unworkable for the American people," Sen. Orrin Hatch, R-Utah, said last week.
A Section on 03/04/2015