Congress ready for high court's health care decisions -- then it gets tricky

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Supreme Court nears health care ruling 01:58

Story highlights

  • Democrats and Republicans have spent months honing their messages
  • A decision to overturn the law would be vindication for congressional Republicans
  • Top Democrats publicly say they are confident in the law's legal strength
  • After the court announces, it will take only seconds before both parties launch their messages

No matter how the Supreme Court rules on the challenge to the health care law, it will only be a matter of minutes after that ruling is announced before attention shifts back across the street to the Capitol and to what happens next there.

Congressional press aides will be ready. Democrats and Republicans have spent months honing their messages. House GOP leaders have held "listening sessions" with rank-and-file members, going through various scenarios. Republican leadership aides from the House and Senate have coordinated their messaging plans with Mitt Romney's presidential campaign.

After the ruling is announced, it will take seconds before staffers for both parties begin to flood reporters' inboxes with news releases. They, and their bosses, also will take to Twitter and Facebook to quickly move to frame the political fallout for the other side.

Phase I: Both parties ready messages for court's decision

The messages are already pre-written to respond to the three different rulings the court could hand down -- it could overturn the law entirely, strike down parts of the law including the individual mandate requiring people to purchase insurance coverage or pay a fine, or allow it to stand.

A decision to overturn the law they dubbed "Obamacare" would be vindication for congressional Republicans who unanimously opposed it in 2009.

    But House Speaker John Boehner made it clear he doesn't want Republicans -- who won back control of the House in 2010 in large part because of backlash to the law -- to look insensitive by doing victory dances if the court rules all or part of it unconstitutional.

    In a memo to his rank-and-file last week that was also shared widely with reporters, Boehner firmly directed GOP members: "No one knows what the Court will decide, and none of us would presume to know. But if the Court strikes down all or part of the president's health care law, there will be no spiking of the ball."

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    He stressed that with the economy still recovering, the GOP needs to keep its focus squarely on jobs.

    Some GOP aides and strategists privately acknowledge that if the law is upheld it gives them a cleaner election-year message -- and gives their base a bigger incentive to turn out in November: The only way to take out Obamacare once and for all is to put a Republican in the White House and elect GOP majorities in both the House and Senate.

    To underline their opposition to the health care law and keep it as a central theme going into the November election, House GOP leaders have promised if all or any part of the law is upheld by the Supreme Court, they plan to hold a vote later this summer to repeal it or its remaining provisions.

    The GOP-led House has already passed several bills to retract pieces of the law or restrict funding for implementing it, but those efforts have been stopped by the Democrat-controlled Senate.

    A ruling proclaiming the health care law unconstitutional, or even a move to split the measure apart, would be a devastating blow not only for President Barack Obama but for congressional Democrats.

    They spent more than a year bridging internal divisions to pass it without any GOP support and point to it as a major accomplishment.

    Health-care law timeline

    But many House Democrats concede that backlash to the law and the messy fight to get it through Congress cost them their majority in the 2010 midterm election because it took away from a greater focus on the economy.

    Still they emphasize that their party made health care more affordable and accessible for middle-class Americans. A ruling against the law could fire up their liberal base to turn out at the polls to push back at the Supreme Court, and some of the conservative justices they believe have a political bent.

    Top Democrats publicly say they are confident in the law's legal strength and believe it will be upheld.

    House Democratic Leader Nancy Pelosi has predicted repeatedly the Supreme Court will uphold the health care law, and has even offered her view the justices will rule 6-3, saying law is "ironclad constitutionally."

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    But the No. 2 House Democrat, Steny Hoyer of Maryland, admits there have been talks about contingency plans and the message Democrats will put out right after the decision is announced. He signaled that Democrats will move swiftly to put the onus on Republicans if all or parts of the law are thrown out, to explain how they will ensure that the popular provisions that are in place now won't disappear.

    "Whatever the Supreme Court does, I think the Republicans are going to have to get real about alternatives as opposed to simply saying this is bad," Hoyer told reporters last week. He added, "The American public knows that we have to address the costs and access issues to health care. They know it's critical to them and their families and they like a lot of what we've done."

    Phase II: That's when it gets tricky

    If, as many on Capitol Hill believe is likely, the Supreme Court decides to rule the mandate unconstitutional but allow other provisions to continue, the GOP's next move becomes trickier. What legislation would Republicans propose and would they push for votes before the November election?

    "Unless the court throws out the entire law, the House will vote to repeal whatever is left of Obamacare," Boehner said last week, laying out the first GOP response.

    The next step is tougher for Republicans, especially in a political season.

    While Americans oppose the overall health care law, some provisions are popular — such as prohibiting insurance companies from denying coverage for pre-existing conditions or placing lifetime caps on benefits, allowing parents to keep children on their policies until age 26, and giving seniors help with prescription drug costs.

    Democrats continually point to those benefits and the polls. And Republicans, aware of the popular measures, are struggling to decide what kind of incremental measures they will propose.

    One of the Republicans Boehner tapped to handle the GOP response is Georgia Rep. Tom Price, a physician, who told reporters if all or part of the law is taken down the GOP will move toward a "rational positive transition" but declined to offer any details.

    Price has been pushing for piecemeal measures, such as a bill to allow insurers to sell policies across state lines. But he also said he did not believe any major reforms would be considered until the next Congress. Other Republicans believe that it's important to show voters before November that they will uphold some of the popular pieces, and say these are pieces that could pass with bipartisan support.

    Although they are directing their members to be ready with a response to the court's decision, GOP leaders are also cautioning there's no need to rush legislation to the floor if there's a partial win. Boehner's memo promises action "in the coming weeks," but GOP leaders also want to focus on a bill to renew tax cuts in July before Congress takes its month-long recess in August.

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    Several leading insurance companies announced earlier this month that they will continue to cover young people under 26 who want to stay on their parent's plans and still pay for many preventive health care screenings and that may make it less urgent for Congress to pass new laws. But if reports emerge that people are being dropped in large numbers from insurance rolls or being forced to pay significantly more for coverage, there could be pressure on Republicans to mount a legislative response to address public concerns.

    Pelosi signaled that Democrats plan to remind voters that they fought for these protections and warn about what happens if they are taken away.

    "What we cannot say to the American people (is) we are going to throw you at the mercy of the insurance companies who refused coverage to you, rescinded policies when you're on the gurney going into the operating room, raised your rates to a point of having to be prohibitive," she said.

    Since Republicans run the House, Democrats are up-front about putting the ball in their court.

    "Whatever the ruling is, I think (Republicans) are going to have a tougher time than we are," Hoyer predicted.

    But GOP aides counter that Obamacare belongs to the president, so he'll bear the chief responsibility for laying out a plan if there is uncertainty after the ruling. They'll argue a more step-by-step approach is appropriate, and say the massive government overhaul Democrats pushed made things more complicated for the private insurance market and for the public.

    But given the bitter partisan rhetoric surrounding health care reform, any uncertainty surrounding a court decision will likely persist until after the 2012 election is settled.

    Basics: Health care reform issues

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