The GOP’s best chance of knocking down the Affordable Care Act disappeared Thursday when the Supreme Court sided with the administration in King v. Burwell. With the case decided, the Senate could start holding the anti-Obamacare votes leadership said they wanted to attempt when they took the chamber this year.

But with a crowded floor schedule, the prospect of tough amendment votes under regular order and disagreement over what budget reconciliation should be used for, it’s unclear how Republicans will go about taking those votes.

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The Affordable Care Act narrowly escaped a judicial decision that would have shrunk its reach Thursday when the Supreme Court ruled the IRS could continue distributing insurance subsidies nationwide. Now, with the law no longer under an immediate meaningful threat of repeal, some are looking to stretch Obamacare further.

Specifically, governors in several states are renewing their push to expand Medicaid, hoping to bring the federal low-income health insurance program to more of their state’s residents.

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Despite the Supreme Court decision to uphold the subsidies for private insurance in King v. Burwell, the fundamental problems with the Affordable Care Act remain. Ironically, it is the growing government centralization of health insurance at the expense of private insurance that must be addressed.

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Republican leaders vowed to continue their effort to dismantle Obamacare after the Supreme Court ruled for the Obama administration in King v. Burwell, while acknowledging that repealing and replacing the law is extremely unlikely while President Obama is in office.

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The Supreme Court ruling upholding subsidies on the federal health-insurance exchange may prompt state-run exchanges to forge regional networks or use the federal marketplace.

Many of the dozen states operating exchanges under the Affordable Care Act are encountering financial strains, and could join the three dozen states already using the federal marketplace, HealthCare.gov. Some policy experts say it’s possible most of those states will eventually do just that, creating a largely national exchange program.

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While most of the reaction to the Supreme Court’s decision in King v. Burwell has centered on the political victory for the president and the various winners and losers from the decision itself, a more far-reaching consequence has received much less notice. The legal dispute hinged around whether a law means what it says, or means what someone reading later – say, an admistration official – thinks it must have really meant, or prefers it would have meant. More generally, however, the issue raised is whether laws passed by Congress have to be administered as written, or whether a President can change the law it will in whatever what he or she thinks will be better.

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The Supreme Court’s ruling Thursday in King v. Burwell has temporarily saved the Affordable Care Act, but millions of Americans are still hurting under ObamaCare. The high court’s six-justice majority agreed that the IRS can change the wording of the law to the administration’s liking. No one, however, can change that ObamaCare is an expensive failure—unpopular, unworkable and unaffordable.

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Here are six proposals for Congress as it begins the work of ending the disaster that is the Affordable Care Act and crafting a law that will benefit Americans and increase economic growth.

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Thursday’s Supreme Court decision (King v. Burwell) allows Obamacare premium tax credits (subsidies) in states that do not run their own health insurance exchanges. The decision pretty much guarantees that all the Obamacare tax increases will be with us through at least 2016 — and probably forever.

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Congressional Republicans were in a state of shock Thursday after the Supreme Court upheld Obamacare’s insurance subsidies nationwide, but they quickly laid out next steps in their quest to repeal the health care law.

“Everybody’s stunned,” said Rep. Dave Brat, a Virginia Republican. “I think the logic and the plain language was going to be the other direction. … This is a stunner.”

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