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Contingency plans set on US healthcare
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Contingency plans set on US healthcare

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Contingency plans set on US healthcare

The Obama administration has prepared contingency plans in case the Supreme Court strikes down part or all of its signature healthcare reform law later this month, Kathleen Sebelius, health secretary, said on Thursday.

The much-anticipated ruling, expected before the end of June, will have huge political implications in a presidential election year, with a victory for the administration giving President Barack Obama a boost as he campaigns for a second term.

But if the court overturns the “individual mandate” requiring almost all Americans to buy medical insurance, or scraps the entire law, that could give a boost to Republican arguments that the Obama administration has exceeded its power and should be ejected from the White House.

Speaking at a women’s health town hall meeting held at the White House, Mrs Sebelius said the administration remained “confident and optimistic that this change within the law was well within the purview of Congress”.

“Having said that, we’ll be ready for court contingencies,” she said, warning that striking down the law would have a “pretty cataclysmic impact” and would undo the “incredible changes and improvements to Medicare”, the federal health plan for the elderly, introduced over the past two years.

“What we’re doing right now is just working as hard as we possibly can to get ready for 2014,” Mrs Sebelius told the meeting, referring to the year when many of the biggest changes will take effect.

The law, passed by Congress with the narrowest of margins two years ago, introduced a requirement for everyone but the very poor or those with religious objections to buy some kind of health insurance.

It also allows children to stay on their parents’ health insurance policies until the age of 26 and bans insurers from declining to cover people with pre-existing conditions.

The administration estimates that 60,000 people with pre-existing conditions have already been able to buy coverage as a result of the law, officially known as the 2010 Patient Protection and Affordable Care Act but derided as “Obamacare” by Republicans.

It also expanded the Medicaid programme for the poor and ordered the establishment of state-based insurance exchanges by 2014 so people could band together to get better deals from insurance companies.

These changes together mean that more than 30m previously uninsured people would have healthcare coverage.

But “those [changes] would cease to be the law of the land” if the whole legislation was overturned, Mrs Sebelius warned.

If the court rules that the individual mandate – the most contentious part of the reforms – is unconstitutional, that would make the whole package unworkable because it would mean insurers would be forced to insure the old and the sick without offsetting these costs against young and healthy people.

Most Republican lawmakers agree that a partial or full rejection of the law would be a triumph for them and devastating for the president. But they are struggling with the fact that overturning the law would eradicate benefits that are popular among voters, including the provisions that allow young adults to stay on their parents’ plans and the protections for people with pre-existing conditions.

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