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Obama Defends Health Care Law As Supreme Court Ruling Nears

ROBERT SIEGEL, HOST:

President Obama is defending his signature health care law. He says it's helped millions of Americans who used to live in fear of costly medical bills. The president's remarks come as the Supreme Court is considering another serious challenge to the Affordable Care Act. The president says he's optimistic the high court will leave the law as is, but congressional Republicans are preparing to jump in if the court's ruling goes against the administration. Here's NPR's Scott Horsley.

SCOTT HORSLEY, BYLINE: President Obama told a group of Catholic hospital operators today the health care law is working even better than supporters hoped, extending coverage to more than 16 million people and helping put the brakes on runaway medical bills.

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BARACK OBAMA: When you talk to people who actually are enrolled in a new marketplace plan, the vast majority of them like their coverage. The vast majority are satisfied with their choice of doctors and hospitals and satisfied with their monthly premiums. They like their reality.

HORSLEY: Obama also dismissed what he called Chicken Little warnings that the health care law would be a job killer.

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OBAMA: America has experienced 63 straight months of private sector job growth, a streak that started the month we passed the Affordable Care Act.

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HORSLEY: But the health care law still faces a serious legal challenge. The Supreme Court is set to rule this month on whether a single phrase in the law bars the federal government from subsidizing health coverage in up to 34 states that didn't set up their own insurance exchanges. More than 6 million people in those states could lose their subsidies. Sister Carol Keehan, who heads the Catholic Health Association the president was addressing today, says that would be devastating for those families.

SISTER CAROL KEEHAN: We can't be a nation that lets so many people go without one of the most basic services needed to preserve life.

HORSLEY: Obama warns ending the subsidies could also have far-reaching ripple effects, de-stabilizing health insurance markets well beyond the federal government's exchanges. Yevgeniy Feyman, of the free-market Manhattan Institute, is no fan of Obamacare. But he's surprised the White House isn't doing more to get ready.

YEVGENIY FEYMAN: They really don't have a plan B. The president's defense appears to be that, you know, it's hard because you have interconnected parts. But even if you have interconnected parts preparing for what they consider to be the worst-case scenario would seem to be a smart idea.

HORSLEY: A high court ruling against the subsidies would be a mixed blessing for Republican lawmakers. They've long wanted to get rid of the health care law, but they're wary of a sudden disruption in the market. Wisconsin Senator Ron Johnson has drafted a bill that would preserve the subsidies, but only temporarily.

RON JOHNSON: It's basically a two-year transition that sets up 2016 as the election to really have the American people be involved in the decision of what our health care system ought to look like.

HORSLEY: But while Johnson's bill would initially maintain the subsidies, it would do away with the requirement that individuals carry health insurance. Backers of the Affordable Care Act say without that requirement the law doesn't work. Supporters have always described the health care law as a package deal in which popular provisions, such as guaranteed coverage regardless of one's health, must be coupled with other features, like the individual mandate. You have a model where all the pieces connect, the president said this week, and today, he added we are not going back.

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OBAMA: This is now part of the fabric of how we care for one another. This is health care in America.

HORSLEY: That fabric could still unravel, though, with an adverse ruling from the Supreme Court. Scott Horsley, NPR News, the White House. Transcript provided by NPR, Copyright NPR.

Scott Horsley is NPR's Chief Economics Correspondent. He reports on ups and downs in the national economy as well as fault lines between booming and busting communities.