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Originally published Thursday, June 14, 2012 at 10:05 PM

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Republicans, Democrats plot forceful response to health-care ruling

Republican and Democratic groups are planning a variety of responses to whatever the Supreme Court decides on the health-care law.

The New York Times

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WASHINGTON — House Republicans are not waiting for the Supreme Court verdict on the new health-care law to plot their strategic response. If the measure is not thrown out entirely, House leaders plan to immediately force a vote to repeal the law to reinforce their opposition.

The emerging game plan is only one element of the coordinated planning by groups on both sides of the issue as the Supreme Court ruling approaches as early as next week.

The Republican National Committee, in consultation with congressional campaign offices and Mitt Romney's presidential campaign, is readying a war room. The National Republican Congressional Campaign has mounted a petition drive for repeal, complete with a function allowing signers to watch their faxed petitions arrive over the Internet.

At the White House, meanwhile, top officials continue to project confidence that the court will rule in its favor and that the administration will move on from there to put the law into force.

But White House allies and advocates of the new law do not necessarily share that view and are gearing up in the event of an unfavorable decision.

Pro-health-care law groups from key political states converged on Washington this week for two days of meetings to coordinate their political response at the behest of Families USA, one of the law's most stalwart defenders. Democratic aides on Capitol Hill are readying a comeback designed to force Republicans to show their hand on the issue of the uninsured.

House Democrats have been issued a "pocket card" to carry with them, spelling out in big numbers how the law has helped people: 86 million who have received free preventive care, 105 million who no longer face a lifetime cap on benefits, and as many as 17 million children who no longer can be denied coverage because of pre-existing health conditions.

And the health-insurance industry has started a lobbying and social-media effort to drive home its contention that popular regulatory provisions in the law cannot survive if the Supreme Court strikes down the mandate that all Americans buy health insurance.

"Our focus is making people understand the inextricable link between the coverage mandate and the rest of the insurance regulations," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the insurance industry group behind a campaign known simply as "The Link."

Sweeping implications

Rarely in the Supreme Court's history has a decision had so much riding on it, for the economy, for the vast health-care industry and for the nation's body politic — from the White House race to the 435 House campaigns.

After a burst of prognostication around oral arguments over the health-care law, known as the Affordable Care Act, groups on both sides have fallen back into a state of nervous anticipation. No one is certain how the court will rule, or how the politics will shake out later.

Lawmakers, political strategists and activists are preparing for three contingencies: The court upholds the law, the court invalidates the insurance-purchasing mandate but preserves most of the law, or the court throws out the law, President Obama's signature domestic achievement.

In the event the law is crippled or eviscerated, the contest will be to ensure the other party is held responsible, not only for the popular provisions lost but what comes next for the 46 million people still without health insurance.

House Majority Leader Eric Cantor of Virginia said that, unless the court throws out the law in its entirety, House Republicans intend to push the issue back to the floor and call for its repeal.

Contractual obligations

Since Republicans believe insurers are contractually obligated to maintain some of the most popular provisions, such as allowing adults younger than 26 to remain on their parents' health plans or ending lifetime payment caps, until the next insurance open-enrollment period, they contend there will be less pressure on Republicans to produce the "replace" part of their promise to "repeal and replace" the Affordable Care Act.

Republicans say their view was bolstered by recent signs from insurers that they will retain some popular benefits.

"I don't think we would take the step of countering with a comprehensive, thousands-of-pages bill like Obamacare, no," Cantor said. "I don't think that's what the country wanted. I think that's what scared so many people."

After a repeal vote, Republicans plan to first let the dust settle. Then, Cantor said, they would move forward incrementally with bills to allow the purchase of insurance across state lines, to loosen restrictions on consumers wishing to change insurers, and to bolster tax-preferred health savings accounts.

After several Republican lawmakers suggested popular parts of the health-care law would be maintained, conservatives revolted. House Speaker John Boehner of Ohio stepped in to say the law must be wiped clean before any next steps are taken.

A senior Republican House aide said it was up to the White House, not Republicans, to produce a contingency plan for those left behind by a court invalidation, such as the thousands of sick people or consumers with pre-existing conditions who have joined new federally backed high-risk pools.

Even before those moves, advocates are trying to seed the political battleground. The conservative group American Crossroads and Crossroads GPS began a $4.6 million advertising campaign against six Democratic Senate candidates Wednesday, including an attack on Heidi Heitkamp of North Dakota centered on "Obamacare."

On the other side of the issue, Ron Pollack, executive director of Families USA, said this week that advocates of the law from the most politically important states are gathering to coordinate messages.

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