No Consensus on GOP Plans to Replace Obamacare

Lawmakers have launched efforts, but leadership has yet to back one.

House Speaker John Boehner (R-OH) (R) and House Majority Leader Eric Cantor (R-VA) attend a presser to speak to the media after attending the weekly House Republican conference at the U.S. Capitol, October 29, 2013.
National Journal
Tim Alberta
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Tim Alberta
Nov. 6, 2013, 5:28 p.m.

Beat­ing up on Obama­care is the easy part.

But even­tu­ally, many Re­pub­lic­ans ac­know­ledge, the web­site will be fixed, new en­rollees will spike, can­cel­la­tion let­ters will cease, and the sting of the Af­ford­able Care Act’s ugly im­ple­ment­a­tion will fade.

At some point, Re­pub­lic­ans will have to ad­dress the one Demo­crat­ic re­but­tal that cuts deep­est: What is the Re­pub­lic­an al­tern­at­ive?

“I’ve al­ways be­lieved that we need to have a pos­it­ive, prin­cipled solu­tion as an al­tern­at­ive,” said Rep. Tom Price, R-Ga., a lead­ing con­ser­vat­ive and med­ic­al doc­tor. “We re­main the minor­ity party in Wash­ing­ton, and that’s part of the role of the minor­ity—not just to hold the oth­er side to ac­count, but to provide that con­trast from a policy stand­point.”

In­deed, many House Re­pub­lic­ans have grown wary of the “party of no” la­bel and are anxious to ap­pear pro­act­ive on the health care front. But they have yet to co­alesce around a plan.

Rep. Fred Up­ton, R-Mich., chair­man of the House En­ergy and Com­merce Com­mit­tee, re­cently in­tro­duced the “Keep Your Health Plan Act,” which would nar­rowly ad­dress the epi­dem­ic of can­cel­la­tion no­tices from in­surers in re­cent weeks.

There also are broad­er pro­pos­als be­ing pushed with­in the House GOP. Earli­er this year, Rep. Steve Scal­ise, R-La., chair­man of the Re­pub­lic­an Study Com­mit­tee, com­mis­sioned a work­ing group to craft an Obama­care re­place­ment pack­age. That pan­el, led by Rep. Phil Roe, R-Tenn., un­veiled the “Amer­ic­an Health Care Re­form Act” in Septem­ber.

Months earli­er, Price, a former RSC chair­man who as­sisted that work­ing group, in­tro­duced a third it­er­a­tion of his “Em­power­ing Pa­tients First Act.”

Solu­tions are on the table. The di­lemma, GOP law­makers say, is un­cer­tainty over when—if ever—these ideas will be ad­vanced by House Re­pub­lic­an lead­er­ship. Speak­er John Boehner in­formed mem­bers dur­ing a mid-Oc­to­ber con­fer­ence meet­ing to ex­pect move­ment on health care le­gis­la­tion in the near fu­ture. But ac­cord­ing to mem­bers in at­tend­ance, nobody un­der­stood quite what he meant.

“No idea,” said Rep. Paul Gos­ar, R-Ar­iz., a mem­ber of the RSC work­ing group, after the meet­ing. “The speak­er didn’t get in­to spe­cif­ics.”

Ac­cord­ing to top Re­pub­lic­an aides, Boehner was pur­posely vague to al­low some flex­ib­il­ity on tim­ing. House Re­pub­lic­ans have voiced a wide range of opin­ions on how to ap­proach health care le­gis­la­tion mov­ing for­ward, and the speak­er un­der­stands that build­ing con­sensus with­in the con­fer­ence won’t hap­pen quickly.

“There are a lot of op­tions on the table, but no de­cisions have been made,” said a GOP lead­er­ship aide.

Of course, Boehner isn’t in any rush. His lead­er­ship team wel­comed this week away from Wash­ing­ton, bet­ting that Obama­care’s im­plo­sion would speak louder than any Re­pub­lic­an cri­ti­cism. In fact, be­cause of the Af­ford­able Care Act’s rocky rol­lout, Boehner is ex­pec­ted to steer clear of any com­pre­hens­ive GOP pro­pos­al that could dis­tract from Obama­care’s af­flic­tions and let Demo­crats off the hook.

“I think the con­cern lead­er­ship has is, in­stead of talk­ing about all the blem­ishes and pimples and hic­cups of the Af­ford­able Care Act, they’ll be talk­ing about what our bill doesn’t do,” Roe said.

That isn’t stop­ping Roe and Price, phys­i­cians both, from push­ing hard for their re­spect­ive health care bills. Both law­makers have met re­cently with lead­er­ship to dis­cuss their spe­cif­ic pro­pos­als. They also have dis­cussed po­ten­tial le­gis­lat­ive move­ment with the com­mit­tees of jur­is­dic­tion and lob­bied their col­leagues to sign on as sup­port­ers. (The RSC bill has amassed more than 100 co­spon­sors, some of them non-RSC mem­bers.)

Still, the time and or­gan­iz­a­tion ne­ces­sary to push a broad­er health care re­place­ment pack­age may not ex­ist. That’s why Re­pub­lic­an law­makers and aides ac­know­ledge that Up­ton’s bill, which aims to nar­rowly blunt the im­pact of Obama­care in one area, is the lo­gic­al choice for lead­er­ship to rally be­hind. If suc­cess­ful, Up­ton’s bill could spawn oth­er GOP meas­ures tar­get­ing spe­cif­ic de­fi­cien­cies of the Af­ford­able Care Act.

This ap­proach, law­makers say, would al­low House Re­pub­lic­ans to at­tempt their in­cre­ment­al dis­mant­ling of Obama­care while con­tinu­ing to de­nounce the law in broad rhet­or­ic­al strokes.

“If we put a man on the moon 40 years ago, we ought to be able to build a Web page, for God’s sake,” Roe said, shak­ing his head.

Re­pub­lic­ans push­ing a com­pre­hens­ive ap­proach ac­know­ledge that ma­jor health care le­gis­la­tion is highly un­likely to pass Con­gress in an elec­tion year. Still, they em­phas­ize the im­port­ance of start­ing the con­ver­sa­tion now, while some Demo­crats are run­ning away from Obama­care, in hopes of build­ing bi­par­tis­an sup­port for an al­tern­at­ive pro­pos­al.

“The more we hear from Demo­crats who are frus­trated and anxious about Obama­care … that may be a great­er open­ing and op­por­tun­ity for some lar­ger deal to move for­ward. It will take bi­par­tis­an activ­ity,” Price said, adding, “The last thing we need is an­oth­er ab­so­lutely par­tis­an bill.”

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