The Supreme Court could have killed the Patient Protection and Affordable Care Act (PPACA) premium tax credit program, and, in effect, the PPACA commercial health insurance regulation system as a whole, in the King v. Burwell ruling.
Some Republican members of Congress tried to come up with proposals for shoring up the U.S. commercial health insurance system up during a transition period between the end of PPACA World and the arrival of Post-PPACA World.
Few other players seemed especially interested in keeping the health insurance system breathing during that transitional period. The other players seemed to be quite comfortable with the idea of letting the system, and, possibly, some patients, die just to make the players on the other side look bad.
On the one hand, that’s politics.