Ask the 242 House Republicans what kind of health policy theyâ€™d like to enact instead of President Barack Obamaâ€™s health care reform law and you might get 242 different answers.
Even after three years of railing against Obamaâ€™s plan, Republicans have coalesced around only a few basic tenets of health policy â€” let alone a full replacement plan.
They are even divided over whether some of the popular pieces of Obamaâ€™s health law are a good idea. For example, most Republicans support the health lawâ€™s requirement that insurance companies accept all applicants â€” but the replacement plan put forward by the most prominent Republican ignores that idea.
â€śItâ€™s a terrible idea,â€ť Rep. Tom Price (R-Ga.), the sponsor of the plan, told POLITICO. He said Democrats only enacted the provision in order to require exactly what kinds of insurance Americans must have. He would rather expand coverage voluntarily.
The wide range of GOP opinions could make it hard for the party to come together behind a single plan to replace Obamaâ€™s health care law if itâ€™s overturned by the Supreme Court this summer.
A ruling against all or part of the legislation has the potential to reopen the health care wars of 2009, putting the differences among Republicans on full display. Itâ€™s a divide Democrats would try to exploit as they press Republicans on how theyâ€™re going to solve the countryâ€™s health care problems.
â€śIf the Supreme Court throws out the presidentâ€™s plan, weâ€™re going to have to have something on the table,â€ť said Rep. Paul Broun (R-Ga.), a physician.
House Republicans wonâ€™t be the only ones with replacement plans. Gov. Mitt Romneyâ€™s health agenda relies more on state-level reforms and private competition than Obamaâ€™s law.
On Capitol Hill, there are a handful of pending Republican health bills.
Days before the Supreme Court heard oral arguments over the health law, Broun introduced a plan that allows Americans to deduct all of their health care costs; encourages the use of health savings accounts; converts Medicare to a â€śpremium supportâ€ť model that subsidizes private coverage; allows consumers to buy insurance across state lines; and encourages the use of association health plans, which allow groups of people or co-workers to buy health care together.
Broun said heâ€™s trying to drum up support among lawmakers and outside groups and already has the backing of FreedomWorks, the conservative group led by Dick Armey.
The plan thatâ€™s likely to get the closest look from Republicans is sponsored by Price, an orthopedic surgeon and one of the Houseâ€™s leading voices on health care. He released a video on Wednesday touting the plan, which he originally introduced in 2009.
His plan would provide tax credits â€” on a sliding scale, based on income â€” to help Americans buy insurance premiums and extend a tax deduction to people who buy coverage on the individual market. The plan would also allow groups to pool together to buy health care, allow consumers to shop for insurance across state lines and enact a cap of $250,000 on noneconomic damages in patient injury suits.
Priceâ€™s plan does not require insurance companies to accept all applicants â€” a provision in the Democratsâ€™ law that could be struck by the Supreme Court this summer and that some Republicans support.
â€śIf you step back and recognize that what we need to do is provide the kind of health coverage that patients want â€” not what the government wants for them â€” then the solution is to provide an opportunity for every single American to have the financial wherewithal to be able to purchase the coverage they want, not what the government wants for them,â€ť he said.
Price argues that his plan ensures everyone has access to coverage because his insurance pools will allow everyone to get access and drive down everyoneâ€™s health costs.
Another Republican bill â€” this one introduced by Rep. Sean Duffy (R-Wis.) â€” includes several insurance reforms, but not the Democratsâ€™ requirement that young adults be allowed to stay on their parentsâ€™ insurance plans through age 26. Itâ€™s a provision that has been embraced by several Republicans.
Instead, he extends the benefit through age 23 because Duffy believes â€śkids should lead independent lives at some point and that age would typically get them through college,â€ť his spokesman, John Gentzel, told POLITICO.
Rep. Joe Heck (R-Nev.), an osteopath, introduced a bill in March that essentially is a combination of the insurance industry reforms in the health law, including the option for young people to stay on their parentsâ€™ plans through age 26. It also includes the requirement that insurance companies accept everyone and bans insurers from dropping coverage and imposing lifetime caps.
While the bill would most likely be popular with the public, policy experts widely agree that insurance premiums would skyrocket if there are too many demands placed on the industry without a way to encourage healthy people to buy an insurance plan.
There are many areas of health policy on which Republicans generally agree, beginning with repeal of the Democratsâ€™ law. Most of them support enacting medical malpractice reform, expanding the use of health savings accounts and allowing consumers to buy insurance across state lines. There also appears to be wide support for allowing small businesses and individuals to pool their resources to buy coverage together.
Still, Rep. Henry Waxman (D-Calif.) has his doubts that Republicans can come together on a plan.
â€śWhile the bill was pending, they didnâ€™t really have much of an alternative. They wanted to do something on interstate sales and medical malpractice, but they didnâ€™t seem to want to do anything to regulate the insurance companies to prohibit discrimination based on pre-existing medical problems,â€ť Waxman said. â€śThey didnâ€™t want to come up with any idea to make sure everybody had health insurance. So Iâ€™m skeptical that theyâ€™ll really have a solution.â€ť
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