GOP taps Kline to draft 'Obamacare' alternative

House Republicans have tapped Minnesota Rep. John Kline to help draft an alternative to the Affordable Care Act should the Supreme Court strike down the law's use of public subsidies.

The court is expected to rule by June on King v. Burwell, which challenges the legality of taxpayer subsidies for people who buy health insurance on the federally-run health care website — a central part of the act championed by President Barack Obama.

If the Obama administration loses, roughly five million people across the country — many concentrated in Republican-controlled states — would lose their subsidies and potentially their insurance.

Republicans have voted repeatedly to kill the law, known as "Obamacare," in the nearly five years since its passage. That included a vote this week in the U.S. House, the 56th vote Republicans have taken by some counts to undo the law.

Now, though, with a Supreme Court decision expected by the summer, Republicans are looking to write a health coverage bill their party can back. That task falls to GOP Reps. Paul Ryan of Wisconsin, Fred Upton of Michigan and Kline.

Pressed for specifics about what a Republican plan might look like, Kline suggested Republicans would ensure that those with preexisting health conditions would not be denied coverage and that so-called high risk pools offering subsidized insurance for those who couldn't otherwise get coverage would likely be part of the GOP plan.

"We need this to be patient-centered and we need it to cost less," Kline said. He acknowledged those were buzzwords, "but that's what you're going to get until we're ready to put some specifics made public."

And after facing blistering opposition to the Affordable Care Act, Republicans won't get much help from Democrats to replace it, said Minnesota Democratic Rep. Keith Ellison.

"If they wanted to make some proposals to improve it here or there, I would be open to the discussion," Ellison said. "But the train has left the station."

House Republicans come at this issue from a wide ideological spectrum, so it will be hard for them to settle on a single plan to replace Obamacare, said Steve Smith, a political scientist at Washington University in St. Louis.

"Surely, most of the tea party faction in the House would prefer repeal with very little replacement," he said.

The outcome of the Supreme Court case won't affect Minnesota, where the state runs the health insurance marketplace. The court's decision will affect only the states using the federal health plan exchange.

But if the court strikes down the subsidies, millions lose health insurance and Republicans have nothing to offer, it could help tip the 2016 presidential and Senate campaigns towards Democrats, Smith said, adding, "There's a lot of pressure on these guys."