By Sam Baker - 05/10/12 09:00 AM EDT
Republicans might not offer a comprehensive plan to replace President Obama’s healthcare law if the Supreme Court strikes it down this summer.
House Republicans had said they would have a healthcare bill ready to go by the time of the ruling to present a clear alternative to the Democrats’ Affordable Care Act.
“I don’t want to go that route,” said Rep. Phil Gingrey (R-Ga.), a doctor and a member of the Energy and Commerce Committee.
The Supreme Court is expected to decide next month whether the healthcare law’s individual mandate is constitutional — and, if not, whether the rest of the law can stand.
A decision striking down all or part of the Affordable Care Act would validate GOP criticism of the law while renewing debate over how to fix a healthcare system that both parties agree is broken and unsustainable.
Rep. Joe Pitts (R-Pa.), chairman of the Energy and Commerce subcommittee on Health, told reporters early this year that Republicans were already working on a “replacement” plan that would pull together several longstanding GOP priorities.
But some Republicans, including Gingrey, now say a comprehensive bill isn’t the right approach. They argue it would be foolhardy for Republicans to put forward broad healthcare legislation after sharply criticizing the length and scope of Obama’s bill.
“I don’t believe we need to have another big omnibus bill that we’re going to roll out,” Gingrey said. “I don’t think that we need to make the same mistakes that the Obama administration and the Democrat Congress made.”
Sen. Jim DeMint (R-S.C.) is making the same case to Republicans on the other side of the Capitol.
“Whether the courts strike it down or Congress repeals it, Republicans shouldn’t repeat the Democrats’ mistake of rushing through our own big bill,” DeMint said.
DeMint — a power broker on the right — said the public opposes Obama’s healthcare law in part because of the messy process through which it passed. He wants conservatives to take an incremental approach that keeps the focus on individual policies.
“We have a number of simple, common-sense solutions, including allowing folks to buy health plans in other states, giving tax equity to those who don’t get healthcare from their employer, expanding health savings accounts, and state pools for those with pre-existing conditions,” DeMint said.
“These can be passed in a step-by-step process that would allow Americans to digest each new reform and build trust that each of these ideas stand on their own and will improve quality and lower costs.”
Ditching a comprehensive proposal could also make it easier for Republicans to steer the public’s focus away from popular elements of the Affordable Care Act that are unlikely to make the cut in a GOP plan.
The healthcare law, for example, prohibits insurance companies from denying coverage to people with pre-existing conditions. But that policy is seen as unworkable without an individual mandate, and Republicans acknowledged months ago that they wouldn’t include the non-discrimination policy in a replacement plan.
Other pieces of the Affordable Care Act — such as allowing children to stay on their parents’ health plans through age 26 — might be feasible on their own, but are not high priorities for the GOP.
But a piecemeal strategy on healthcare could present its own risks. Republicans campaigned in 2010 on “repealing and replacing” Obama’s law, but have struggled to clearly articulate a healthcare platform of their own.
Republicans could also open themselves up to attacks from Democrats that they have no plan for fixing healthcare if they respond to the Supreme Court ruling with a pitch for small-bore policy changes.
A handful of comprehensive proposals are already on the table. A bill sponsored by Rep. Tom Price (R-Ga.) seems to be the leading candidate for a broad replacement plan, though the party hasn’t fully coalesced around any one bill.
Price introduced his bill in 2009 as an alternative to the Affordable Care Act, and has since added a section to repeal the new law.
The Georgia Republican said there has been “a lot of conversation” among Republicans about the political wisdom of a single proposal versus an incremental approach, but no decision has been made.
He’s still advocating for his bill, but said either tack can work as long as Republicans focus on a core set of conservative ideas. Either way, it’s essential for the party to have something it can point to in the wake of the Supreme Court’s decision, he said.
“I don’t know about immediately, but without too much of a lapse of time, it’s imperative,” Price said. “The contrast needs to be very clear.”
Price’s bill includes several of Republicans’ top healthcare priorities, such as allowing insurers to sell policies across state lines and limiting awards in medical malpractice suits. The bill would offer low-income people a refundable tax credit to purchase insurance and give small businesses a credit for offering coverage.