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
Add to Briefcase
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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