GOP Field Quiet Ahead of Health Care Ruling

GOP Field Quiet Ahead of Health Care Ruling
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A Supreme Court ruling could gut an important facet of the Affordable Care Act as early as this week, but you wouldn’t know it from what the Republican presidential candidates have been talking about.

In the lead-up to the key 2012 Supreme Court ruling on health care reform – in which the justices decided the penalty paid by anyone without health coverage was a tax, and therefore constitutional – Republicans were abuzz about the possibility that the law could be overturned, and the issue featured prominently in campaign trail rhetoric.

But this time the GOP candidates for president have uttered barely a peep, even though the high court could decide the federal government cannot subsidize health insurance purchased through the federal exchange, which would leave millions of people without insurance and effectively unravel Obamacare as we know it.

“I personally have been a little frustrated that people don’t seem to be as excited about it,” said Ben Carson, a retired pediatric neurosurgeon who is running for president as a Republican. “I don’t see it as a political issue. I see it as something that needs to be done for the health of the nation.”

The relative silence from the GOP field reflects not only the complexity of the issue at hand, but also a shift in the politics of the reform law over the last three years.

Although the Affordable Care Act remains widely unpopular, with 55 percent of Americans opposing it in a recent CNN/ORC poll, the issue is not as important to voters as it once was. In February of this year, 10 percent of poll respondents said the issue was the most important one to them, according to Gallup; now, just 5 percent rate health care as the most important issue.

The political value of attacking Obamacare has also become less straightforward now that the law has been almost completely implemented. In 2012, before most of the ACA had gone into effect, it was simple for Republicans to call for its repeal; now, there is not broad agreement among opponents regarding how best to replace the law.

Many Republicans also point to the uncertainty surrounding the case, and the potential for a complex decision that could make prognosticators look foolish in retrospect.

“What does it gain you by talking about the decision when you have no idea how it’s going to go?” said Tim Phillips, president of Americans for Prosperity, a conservative advocacy group founded by David and Charles Koch. “It just doesn’t make sense to talk a whole lot about it.”

On the other hand, some Republican candidates for president have been eager to discuss another upcoming Supreme Court ruling – the one on whether states can ban same-sex marriage. In a speech Thursday to a conference hosted by the conservative Faith and Freedom Coalition in Washington, D.C., Sen. Ted Cruz said: “I would encourage everyone here to be lifting up in prayer that [the Supreme Court] not engage in an act of naked and lawless judicial activism, tearing down the marriage laws adopted pursuant to the Constitution.”

And, in 2012, the uncertainty surrounding the court’s decision on the health care law did not dissuade Republican presidential candidates from publicly and visibly making their views on the case known.

"This is the most important issue in this election,” Rick Santorum said in March 2012, as he stood on the steps of the Supreme Court.

"Obamacare violates the Constitution. I'm counting on the Supreme Court to say exactly that," Mitt Romney said in April 2012, more than two months before the court handed down its decision.

The case currently before the court, however, does not loom so obviously as a potential boon for Republicans. Should the justices eliminate the federal subsidies, the onus will be on congressional Republicans to come up with a fix.

“If I were a congressional Republican or anyone in Washington, I’d be very concerned about it, because it’s their problem,” said one senior GOP strategist. “And that holds true whether you voted for it or against it.”

House Republicans put forward a plan last week that, in the event of a ruling to strike the subsidies, would keep them in place for one year as Congress decides how to move forward. 

But this proposal is already creating some friction among party members. Cruz, for one, does not support extending the subsidies for any period of time, his office said.

Another Texan who is running for president, former Gov. Rick Perry, disagrees with Cruz’s tack.

“I think you have to have a transition period. I can’t think of any other way to do this that’s thoughtful,” Perry told RealClearPolitics in an interview. “We moved a long way when this thing became law. You don’t turn around a huge ship just overnight. It takes a transition period. I think most Americans, whether they’re strict conservatives economically, would find that to be out of the realm of appropriate.”

Some Republicans have remained hopeful that a ruling to strike the subsidies could play in their favor. At an event earlier this year hosted by the Club for Growth for its donors, Jeb Bush said such a decision “creates an opportunity for Republicans to offer an alternative.”

Others contend that, just because Republicans haven’t focused on the issue yet doesn’t mean they won’t — and isn’t an indication that a decision to gut the health care law would necessarily put Republicans in crisis.

“I’ve listened to the supporters of Obamacare say, ‘What a disaster for Republicans.’ How can winning be a disaster? I don’t buy this logic,” said former Ambassador John Bolton, who weighed a bid for the presidency. “Have Republicans united around a particular response? No. Is that a catastrophe for Republicans politically? No.”

Rebecca Berg is a national political reporter for RealClearPolitics. She can be reached at


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