In the five years since Obamacare became law, millions of Americans have seen their insurance premiums rise and their deductibles skyrocket. Millions more have been pushed out of their plans and onto Medicaid — a notoriously ineffective health program. And all the while, Washington has tried to paper over these problems with subsidies.

Soon the Supreme Court will rule on the legality of the federal subsidies given to people who have purchased health coverage from Healthcare.gov, the federally-operated insurance exchange. In the case of King v. Burwell, the nine justices on the Supreme Court are given yet another opportunity to either apply the plain meaning of federal law, or to give the green light to the Obama administration's lawless and politically convenient handouts.

If the Supreme Court upholds the rule of law and blocks the Obama administration, attention will quickly turn to Congress. The big question: Will lawmakers try to save Obamacare from crumbling, or will lawmakers finally begin the process of removing Obamacare's obstacles to quality care and begin to start over with real reform?

This should be an easy choice for opponents of Obamacare. The end of federally subsidized exchanges will be the first step in freeing patients, doctors, and insurers from government control. Unbelievably, however, some are considering legislation to extend the subsidies, should the Supreme Court block them.

It would be uncaring and unfair for Congress to force taxpayers to continue funding Obamacare's subsidies that do nothing to lower the real cost of coverage nor increase healthcare choices for most Americans. Extending the subsidies would be political malpractice, not just a mere Band-Aid upon an infected wound. Rather than diagnosing the underlying disease — a broken, unsustainable system — such a patch would allow Congress and the president to avoid making the tough decisions about cost and quality of care.

It would be far better for far more people if Congress simply repealed Obamacare, removed barriers to competition, and started fresh. Fortunately, many in Congress realize this. For example, Rep. Paul Gosar, R-Ariz., recently proposed the Premium Reduction and Insurance Market Reform Act of 2015, which would get rid of harmful regulations and end the benefit mandates that are driving Obamacare costs through the roof.

A significant number of insurers have already requested double-digit rate increases for 2016. Why drive the nation further into debt by subsidizing unaffordable coverage, when Congress can just as easily make coverage more affordable? Gosar's bill takes the latter approach, as do several other proposals.

No one bill can fully "fix" Obamacare. The ultimate cure for Obamacare's sickness will have to be an all-of-the-above initiative — a panoply of health reforms that can be pursued piece by piece with full public understanding and transparency. Sweeping bills with thousands of pages are what got us into this mess; we shouldn't look for another grand top-down scheme to get us out of it.

Heritage Foundation polling reveals that most Americans agree with this approach — and they want it to start sooner rather than later. Fifty-eight percent think healthcare in our nation is worse than it was four years ago. More than two-thirds (69 percent) agree that passing legislation to continue Obamacare subsidies just prolongs the problem. Why should Congress extend a system which clear majorities don't want?

More than seven of every 10 Americans (73 percent) either "somewhat agree" or "strongly agree" with removing Obamacare's requirements and regulations. They're right to think so: Getting rid of these requirements would reduce insurance premiums in 34 states. Millions of Americans would get cheaper healthcare if the mandates are allowed to die with the subsidies.

As far as conservatives are concerned, there shouldn't be any "somewhat" about it. The movement that has made the repeal of Obamacare a defining issue since 2010, that in 2014 helped to elect many candidates who ran on that issue to the House and Senate, and that stood against a President who falsely assured his countrymen "If you like your healthcare plan, you can keep it," can ill afford to snatch defeat from the jaws of victory.

Most Americans already fault the President for his signature legislation and its attendant ills. Instead of doing Americans a disservice by extending subsidies, Congress should leverage a Supreme Court victory to restore competitive insurance markets, put patients and doctors back in the driver's seat, and finally get the government out of our business.

 - Jim DeMint, a former Republican U.S. senator from South Carolina, is president of The Heritage Foundation.