Republicans who have been hoping that the Supreme Court will upend President Obama’s health care law are now confronting an urgent and uncomfortable question: What if they win?

Republicans in Congress would face an enormously complicated challenge to fashion an alternative, and they fear the fallout could lead to election losses if millions of Americans abruptly found themselves without health insurance.

If the court voids a federal rule allowing subsidies in states that use the federal insurance marketplace, many Republicans said, they would support a temporary continuation of subsidies for people with low or moderate incomes.

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Later this month, the Supreme Court is expected to hand down its ruling in the case of King v. Burwell, a challenge to the Affordable Care Act (ACA) with potentially major consequences for millions of Americans who have received health insurance under the law’s coverage expansion provisions.

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More small businesses will have to adopt Obamacare’s insurance changes next year, which business groups say could result in higher premiums.

Obamacare required small-group healthcare markets to cover essential benefits similar to those in the individual market. Those include capping enrollees’ out-of-pocket costs and not excluding people due to pre-existing conditions.

Insurers also have to set rates using a single risk pool that includes all enrollees across their small group plans in the state.

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If a “death panel” never rationed health care, did it really earn the name?

That’s the question for Congress this week: The House soon will vote to repeal the Independent Payment Advisory Board established by the Affordable Care Act, dubbed at various times a “death panel” and rationing board by its opponents.

The irony, though, is that the board, which was created to come up with Medicare savings if the program’s spending grew too quickly, hasn’t had any work to do and might not for years to come—which now paradoxically might make it easier for the new GOP Congress to end it.

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House Republicans have launched another assault on Obamacare. This time, they have some support from their foes on the other side of the aisle.

Two bipartisan bills that would repeal parts of Obamacare are scheduled to reach the House floor this week. One would get rid of a job-killing tax on medical device manufacturers. The other would do away with a powerful and unaccountable board of 15 members charged with cutting Medicare spending.

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Most feel that Congress and states should act if the Court rules for the plaintiffs, but there is no agreement among partisans. Opinion on the law overall remains divided, with 42 percent of the public reporting an unfavorable view and 39 percent reporting a favorable one, statistically unchanged from when we last asked the question in April.

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Nearly two-thirds of Americans want Congress to ensure that residents in every state can receive insurance subsidies though the Affordable Care Act, according to a new national poll conducted as the Supreme Court prepares to decide a legal challenge that could strip away the subsidies in more than 30 states.

Asked whether lawmakers should pass a law “so that people in all states can be eligible for financial help,” just one-quarter of those surveyed said no, according to the poll by the nonprofit Kaiser Family Foundation.

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Hillary Clinton says she will propose fixes for ObamaCare over the course of her presidential campaign, while strongly defending the law as a whole.

In an interview with The Des Moines Register published on Sunday, she cited the “family glitch,” which prevents some low-income families from qualifying for subsidies under the law as one example of something she should seek to fix.

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The White House on Monday threatened to veto a bill to repeal ObamaCare’s unpopular medical device tax.

The bill is headed for a vote in the House later this week, and the 2.3 percent tax on medical devices has drawn criticism from some members of both parties who say it stifles innovation.

But the White House on Monday called the bill “a large tax break to profitable corporations.”

It argues that healthcare industries gain from new customers under ObamaCare and therefore should pay some of the cost of the coverage expansion.

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With a Supreme Court decision looming that could lead to the loss of health insurance for millions of Americans, supporters and opponents of President Obama’s health-care law already are mobilizing for the next stage of the battle: influencing policy alternatives if the court upends a key component of the law.

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