Despite passing legislation in the House on Friday to defund the Affordable Care Act, Republicans aren’t completely opposed to health care reform.
Some are saying the Obamacare repeal effort must be accompanied by a replacement proposal. Rep. Darrell Issa, R-Calif., said last week he wouldn’t repeal “without viable replacements for many of the things that the Affordable Care Act chose to do.”
That’s why the Republican Study Committee in the House last week unveiled the American Health Care Reform Act, a plan designed to repeal Obamacare and replace it with “market-based solutions.”
It’s not the first ACA alternative the GOP has produced. In June, Rep. Tom Price, R-Ga. introduced the Empowering Patients First Act. It would provide insurance-premium tax credits based on income, similar to the ACA, but wouldn’t outlaw discrimination against people with preexisting conditions. It has been referred to committee.
If the legislation sounds familiar, it’s because Price sponsored it in the last two Congresses. It did not make it out of committee in either session.
The House GOP’s latest plan is an omnibus package containing measures that failed to gain traction in the past. It has about 30 cosponsors. But a major stumbling block is that the bill is not drafted as a reform of the current law; it depends on a repeal that is going nowhere in the Senate.
“Obamacare is not fixable or reparable,” said Rep. John Fleming, R-La. who worked with the RSC on the bill. “It’s kind of like a skyscraper that was built on a terrible foundation. You would have to tear it down and start over.”
Republican Study Committee Chairman Steve Scalise, R-La., called the bill a 180-degree turn from Obamacare. It would offer standardized tax deductions across income levels, while the ACA provides tax credits on a sliding scale, depending on age and income. Under the GOP plan, everyone would be given the same income- or payroll-tax deduction: $7,500 for individuals and $20,000 for families. For low-income taxpayers, the deduction would be up to the amount of their income taxes or payroll taxes owed.
The GOP plan would use the current individual market but allow consumers to purchase insurance across state lines. It also would allow small businesses to pool together to lower their risk and reduce insurance costs.
The ACA creates a separate marketplace — the exchange — where individuals are able to shop around for the best deal on coverage. However, insurers can opt out of participating in the ACA exchanges and only choose to serve the private market, which in some states has resulted in less competition than intended.
The plans also differ in their treatment of low-income individuals and those with preexisting conditions. Under the Republican plan, individuals not currently on Medicaid or Medicare would be buying their insurance on the existing individual market. The GOP belief is that market competition would drive premium costs down so there are no protections in place for lower-income individuals. While the ACA offers states the chance to expand Medicaid and provides higher subsidies for lower-income individuals, under the GOP plan, those individuals would rely on their standardized tax deductions.
The Republican plan, like the ACA, provides some protections for people with preexisting conditions. But unlike the ACA, which sends these individuals to the exchange, the GOP plan reinstates the state high-risk pools and expands federal support to $25 billion over 10 years, while capping their premiums at 200 percent of the average premium in the state.
Republicans who worked on the bill said their proposed structural changes address what they see as the biggest problem in the American health care system: costs. Among the provisions are a cap to the total damages for medical liability for doctors and a repeal to the federal antitrust exemption for health insurers in an effort to break up monopolies and increase competition in the market.
To appease conservatives, the GOP bill eliminates tax increases, which in the ACA fund the subsidies that make coverage affordable for low-income Americans. According to Rep. Phil Roe, R-Tenn., Scalise insisted that “you can’t have any mandates in this bill. You can’t raise taxes. You’ve got to reform the tax code, but there can’t be any subsidies involved.”
“That’s pretty limited in what we can do,” Roe added. “I think within those parameters, we came up with a pretty good bill.”
What We're Following See More »
Nikki Haley. Jeb Bush. Scott Walker. Lindsey Graham. John Kasich. The list is growing ever longer of Republicans who say they wouldn't even consider becoming Donald Trump's running mate. "The recoiling amounts to a rare rebuke for a front-runner: Politicians usually signal that they are not interested politely through back channels, or submit to the selection process, if only to burnish their national profiles."
"Donald Trump holds a 15-point lead over Ted Cruz in the potentially decisive May 3 presidential primary race in Indiana, according to results from a new NBC News/Wall Street Journal/Marist poll. Trump gets support from 49 percent of likely Republican primary voters — followed by Cruz at 34 percent and John Kasich at 13 percent. If that margin in Indiana holds on Tuesday, Trump would be on a glide path towards obtaining the 1,237 delegates he needs to win the Republican nomination on a first ballot at the GOP convention in July."
In a statement released on Sunday, President and Mrs. Obama revealed that their oldest daughter, Malia, will attend Harvard University in the fall of 2017 as a member of the Class of 2021. She will take a year off before beginning school.
Foreign Policy takes a look at the future of mining the estimated "100,000 near-Earth objects—including asteroids and comets—in the neighborhood of our planet. Some of these NEOs, as they’re called, are small. Others are substantial and potentially packed full of water and various important minerals, such as nickel, cobalt, and iron. One day, advocates believe, those objects will be tapped by variations on the equipment used in the coal mines of Kentucky or in the diamond mines of Africa. And for immense gain: According to industry experts, the contents of a single asteroid could be worth trillions of dollars." But the technology to get us there is only the first step. Experts say "a multinational body might emerge" to manage rights to NEOs, as well as a body of law, including an international court.
Not to be outdone by Jeffrey Goldberg's recent piece in The Atlantic about President Obama's foreign policy, the New York Times Magazine checks in with a longread on the president's economic legacy. In it, Obama is cognizant that the economic reality--73 straight months of growth--isn't matched by public perceptions. Some of that, he says, is due to a constant drumbeat from the right that "that denies any progress." But he also accepts some blame himself. “I mean, the truth of the matter is that if we had been able to more effectively communicate all the steps we had taken to the swing voter,” he said, “then we might have maintained a majority in the House or the Senate.”