House Ways and Means Committee Chairman Paul Ryan (R-Wis.), presides over a hearing on June 10, 2015. At right is Rep. Charles Rangel (D-N.Y.). (Manuel Balce Ceneta/AP)

Things clearly had gotten off on the wrong foot.

Rep. Paul Ryan (R-Wis.), chairman of the House Ways and Means Committee, wanted to know whether President Obama is going to work with Congress to rewrite health-care law if the Supreme Court strikes down Obamacare — “or is he going to put concrete around his ankles and say, ‘It’s my law or nothing’?”

This gave the panel’s ranking Democrat, Rep. Sander Levin of Michigan, a toehold. “You talk about concrete, having feet in concrete,” he responded. “That’s exactly where you’ve been” on the Affordable Care Act. “Your feet have been in concrete while you have brought up bill after bill to try to destroy ACA.”

Proposed Levin, “The shoe should really be on the other foot.”

Maybe both of them should put a sock in it.

Wednesday’s hearing, coming as the nation awaits word on whether the Supreme Court will strike down the law that defines the Obama presidency, was less a legislative forum than a pageant of ankle-biting.

Ryan accused the Obama administration of “acting like a purse snatcher” and rolled out an assortment of invective: “The law is on the fritz. . . . Obamacare is just flat busted. . . . The whole law is a lemon.”

Retorted Levin: “What’s busted is not ACA but your attacks on it, endless attacks, never coming up with a single comprehensive alternative all these years. . . . You’re livid because it’s getting better. . . . Your frustration is millions and millions and millions of people are benefiting.”

With that tone set, the rank and file followed. “Why does the administration choose to trample on the Constitution?” Rep. Charles Boustany (R-La.) wanted to know.

Rep. Jim McDermott (D-Wash.) proclaimed that states such as Alabama and Georgia “clearly don’t care about the level of health care” — which prompted Rep. Tom Price, a Georgia Republican, to interrupt with a request that McDermott “take back the disparagement of the citizens of Georgia.”

Rep. Sam Johnson (R-Tex.) couldn’t even bring himself to utter the usual pleasantries to the witness, Health and Human Services Secretary Sylvia Mathews Burwell. “I guess I’m supposed to thank you for being here, but I have to tell you I’m not in agreement with much of what you’re saying,” he announced.

The Affordable Care Act is facing another challenge at the Supreme Court in King v. Burwell, which deals with subsidies for health insurance. The case could cut out a major provision of Obamacare, causing the law to unravel. Here’s what you need to know about the case. (Julie Percha/The Washington Post)

If the playground taunts achieved anything, it was to demonstrate why the stakes are so high in the looming King v. Burwell decision. If the Supreme Court does invalidate key parts of Obamacare, it seems highly unlikely that this fiercely divided Congress will have the capacity to come up with anything to replace the health-care law. The alternative to Obamacare is nothing.

Five years after the law’s passage, the nation has moved on — only 1 in 20 Americans thinks health care is the top problem facing the country, a fifth of the number during the Obamacare debate — but lawmakers have hardly changed their talking points at all.

“The answer is to repeal and replace this law,” Ryan declared.

A few Republican members tried to argue with Burwell about the merits of the law, but this did not prove to be a fruitful pursuit for them.

“It looks like to me everything’s going up,” Johnson said, complaining about health-care costs.

Burwell pointed out that Medicare spending was $300 billion below forecast and that per-capita health-care cost growth has been the lowest in 40 years.

“Well, but the insurance rates are going up,” Johnson pressed.

Burwell said rates are going up at a lower rate than before enactment.

“Okay,” Johnson said. “Let me just change subjects for a second . . .

Few in the room put their best feet forward during Wednesday’s hearing.

Price said Obama “ignored reality” and lacks “the knowledge or the humility or the concern or the desire to work together” with Congress.

Rep. Charlie Rangel (D-N.Y.) said Republicans were drinking “that Kool-Aid that you have in the back.”

Ryan informed Burwell that “the administration has kind of been a little two-sided” and asked whether Obama would have a “my way or the highway” approach in the future.

“Talk about two-sidedness,” Levin replied, adding that “my way or the highway” is “precisely what has been your approach.” The Democrat said to Ryan, “All you’ve done is issue op-eds.”

“And bills,” Ryan said, interrupting.

“And bills — contrary, contradictory bills,” Levin continued. “So you don’t have any plan, like you haven’t had a plan for 60 years.”

The 45-year-old Ryan smirked, grinned and rolled his eyes as Levin spoke, and he hectored the 83-year-old Democrat, who didn’t conceal his disgust with the chairman.

And these guys, if the Supreme Court strikes down Obamacare, would have to write a new health-care law together? That would be quite a feat.

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