April 13, 2012 – 10:12 p.m.

Uncertain Fate of Health Care Law Complicates GOP Legislative Efforts

With the 2010 health care law in a legal limbo, Republicans say they may put major health legislation on hold until the Supreme Court rules on the law’s constitutionality.

The court’s decision, widely expected in June, could uphold the law (PL 111-148, PL 111-152), throw out all of it or strike down some provisions, such as the planned Medicaid expansion or the requirement that most people either buy insurance or pay a penalty.

Until the court’s intentions are known, legislators writing bills can only assume that the law will stand.

That complicates things when it comes to appropriations. Republican appropriators in the House want to withhold money for the parts of the law they oppose, while Senate Democrats want to fully fund implementation. Lawmakers are starting to work on fiscal 2013 spending bills, but neither side knows what will be in place when the next fiscal year starts Oct. 1.

Denny Rehberg, chairman of the House Appropriations subcommittee that funds the Health and Human Services Department, says the June date allows him some flexibility but makes writing legislation more difficult than in previous years.

“This is unique for a subcommittee like mine because you have to think of all the various combinations of what the court might do,” the Montana Republican said.

The subcommittee could wait until the court announces its decision. After all, Rehberg did not introduce his fiscal 2012 spending bill (HR 3070) until late September. But that would put legislators on a tight deadline and leave stakeholders waiting and wondering.

Rehberg’s proposal last year would have prohibited spending on implementation of the health care law until 90 days after all legal challenges were completed. “It seems foolish to me for them to be spending money on implementation if certain provisions are going to be thrown out,” he said.

In the Senate, Tom Harkin, D-Iowa, chairman of the Labor-HHS-Education Appropriations Subcommittee, is confident the court will uphold the law and plans to write his spending bill assuming it will remain intact, said spokeswoman Kate Cyrul.

And, until the high court hands down its decision, Republican authorizers also are not inclined to try to move any legislation that would address issues covered by the current law.

“The Affordable Care Act goes away July 1, you bet I’m down there first thing,” said Rep. Michael C. Burgess, R-Texas, a member of the Energy and Commerce Subcommittee on Health. “Or I’m introducing that bill the next day to build on the states’ programs of reinsurance, risk pools — the kinds of stuff that Sen. [John] McCain [R-Ariz.] talked about the last election.”

With Democrats controlling the Senate and the White House, Republicans’ only chance at shaping health care policy this Congress may depend on how the nation’s top court rules.

“The Supreme Court’s ruling will be a major turning point in this debate, and we look forward to developing additional replacement legislation when the court rules,” said Energy and Commerce spokeswoman Debbee Keller.