Congress must fix Obamacare if court guts it: U.S. official | HIPAA Compliance for Medical Practices |

The U.S. Congress and states would have to fix Obamacare if the Supreme Court disallows its tax subsidies that help people pay for insurance coverage, U.S. Health and Human Services Secretary Sylvia Burwell said on Wednesday.

Anti-Obamacare libertarian activists are fighting to strip the subsidies from 6.4 million Americans in 34 states who use the plan and a ruling in their favor would mark a significant setback for President Barack Obama's signature healthcare law.

"If the court makes that decision, we're going to do everything we can," Burwell told the House of Representatives Ways and Means Committee, after she was asked in a hearing how the Obama administration would react if the court rules against it later this month in the case known as King v. Burwell.

But she added, "The critical decisions will sit with the Congress and states and governors to determine if those subsidies are available."

Burwell added she had not seen a plan in the Republican-led Congress that would repair problems that might follow if the court decides to scrap the subsidies, while at the same time protecting the basic tenets of the Affordable Care Act.

She said Obama would not sign into law proposed legislation by Senator Ron Johnson to extend the subsidies until August 2017, which has attracted the most support among other Senate Republicans.

The Supreme Court is expected to rule by the end of this month in King V. Burwell.

The plaintiffs are challenging subsidies that are paid to low- and middle-income Americans to help them afford insurance coverage on federal healthcare exchanges.

Thirteen states and the District of Columbia would not be affected by the ruling because they have their own health care exchanges. Obama has said there is no legal basis for the court to dismantle the subsidies. The administration has produced no "Plan B" in case he is wrong.

"They refuse to acknowledge that they even are thinking about a backup plan," House Ways and Means Chairman Paul Ryan, a Republican, said after the hearing.

Republicans in Congress have opposed the law since its inception. They say they will unveil a proposed solution after the court rules.

Burwell said the Johnson measure would take away the subsidies over time and repeal key parts of Obamacare, such as guaranteed coverage for people with pre-existing conditions.