Election-year rift opens in GOP

House Republicans are moving full steam ahead with work on a replacement bill for ObamaCare, an effort that Senate Republicans see as dangerous.

House Republicans feel emboldened by last year’s election of Rep. Paul RyanPaul Davis RyanEmbattled Juul seeks allies in Washington Ex-Parkland students criticize Kellyanne Conway Latina leaders: 'It's a women's world more than anything' MORE (R-Wis.) as Speaker to pursue ambitious goals, with none bigger than presenting a conservative alternative to President Obama’s signature healthcare law.


“We have to work together to have that bill, and that’s what this process is,” House Majority Leader Kevin McCarthy (Calif.) said of the effort to draft a consensus ObamaCare replacement bill this year. “We want to get one as soon as possible. I think it’s very positive for us to show the alternatives, especially [given] what the American public has seen about ObamaCare.” 

The two plans gaining the most traction among House Republicans are proposals from House Budget Committee Chairman Tom Price (Ga.) and the Republican Study Committee (RSC), which is chaired by Rep. Bill FloresWilliam (Bill) Hose FloresConservatives call on Pelosi to cancel August recess Overnight Energy: GOP lawmaker parodies Green New Deal in new bill | House Republicans accuse Dems of ramming through climate bill | Park Service chief grilled over shutdown House Republicans accuse Dems of ramming through climate bill MORE (Texas), according to a lawmaker who participated in discussions on the topic at the joint Senate-House Republican retreat in Baltimore last week. 

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellAre Democrats turning Trump-like? House Democrat calls for gun control: Cities can ban plastic straws but 'we can't ban assault weapons?' Churches are arming and training congregants in response to mass shootings: report MORE (Ky.), however, wants 2016 to be a referendum on Obama’s record. He prefers sticking to the basic blocking and tackling of government: passing the annual appropriations bills.

Putting out a broad healthcare reform bill before the election could backfire by giving Democrats a big target to attack. With at least five Senate GOP incumbents facing tough reelection races, Senate leaders argue there’s no point in moving a bill that Obama is sure to veto.

“Until we are in a position to get a new president who will actually sign the repeal of ObamaCare, the president is going to veto it. So it’s really more of a hypothetical,” said Senate Republican Whip John CornynJohn CornynThe Hill's Campaign Report: Battle for Senate begins to take shape The Hill's Morning Report — Trump and the new Israel-'squad' controversy O'Rourke says he will not 'in any scenario' run for Senate MORE (Texas), McConnell’s top deputy.

Cornyn said Senate Republicans are content instead to talk about healthcare reform principles in the months ahead.

“The principles are pretty clear. It’s portability, it’s affordability, it’s access, all the things you’ve heard us talk about ever since the ObamaCare debate,” he said.

Several Senate Republicans introduced plans to replace ObamaCare last year, but none of them bear the imprimatur of the entire Senate Republican conference.

House Majority Whip Steve Scalise (La.) argues that Republicans should rally behind one plan so they can give voters a clear idea of how they would fix the healthcare system if they win the White House and keep control of Congress.  

He thinks it was a “mistake” his party hasn’t done this sooner.

“That’s why we’ve been so aggressive in talking about the fact that we’re going to lay out an alternative to ObamaCare. We’re not just for repealing it. We want replacement reforms that lower costs and put patients in charge of their healthcare,” he said. “I’ve always said we ought to have a replacement to the president’s healthcare law.”

Scalise cited reforms such as allowing people to buy insurance across state lines and fostering greater competition among private insurance companies without saddling them with government mandates.

Price’s Empowering Patients First Act would create a refundable tax credit for health insurance coverage. It would provide a $1,200 credit for people between the ages of 18 and 35, $2,100 for people between the ages of 35 and 50 and $3,000 for people 50 and older.

It would also provide a $1,000 tax credit for contributions to health savings accounts and give federal grants to states to provide health coverage to high-risk pools of people who might have trouble purchasing it on their own. 

Flores, the chairman of the RSC, in June unveiled the American Health Care Reform Act, which would create a standard tax deduction for health insurance. Qualifying individuals would receive a $7,500 deduction, and families would get a $20,500 deduction. 

The RSC plan would promote competition between insurance plans by allowing people to shop for plans across state lines and small businesses to form pools to negotiate for better rates. It would also establish a $15 billion fund for medical research on heart disease, Alzheimer’s and other diseases. 

But Republican strategists argue that it might be better to wait until after the presidential election before rolling out a controversial reform bill for GOP candidates to defend.

“It’s understandable that you want the election to be a referendum on Democrats who control the White House and their failure to lead the country as opposed to pushing something out for them to shoot at,” said Ron Bonjean, a GOP strategist and former Senate and House leadership aide.

“At the same time, when voters are asking what would you do to replace ObamaCare, it’s probably wise to put out a statement of principles of what kind of legislation you would offer instead of getting into the nitty-gritty,” he added. 

With their Republican control of the upper chamber hanging in the balance, McConnell has adopted a more cautious approach. 

Senate Republicans have endorsed healthcare reform principles, but they don’t have any immediate plans to bring an ObamaCare replacement bill to the floor. 

Rich Galen, another GOP strategist, said McConnell would have no problem shrugging off House action on healthcare reform. 

“If McConnell doesn’t want to have a vote, they aren’t having a vote,” he said. “He can refer [the House bill] to about 18 different committees and subcommittees.”  

Senate Finance Committee Chairman Orrin HatchOrrin Grant HatchTrump to award racing legend Roger Penske with Presidential Medal of Freedom Trump awards Presidential Medal of Freedom to economist, former Reagan adviser Arthur Laffer Second ex-Senate staffer charged in aiding doxxing of GOP senators MORE (R-Utah), Sen. Richard BurrRichard Mauze BurrHoekstra emerges as favorite for top intelligence post Trump casts uncertainty over top intelligence role Trump withdraws Ratcliffe as Intelligence pick MORE (R-N.C.) and House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) introduced the Patient Choice, Affordability, Responsibility and Empowerment Act in February of last year.

It would implement some of the central reforms of ObamaCare, such as ensuring that no one can be denied coverage because of pre-existing medical conditions and requiring health plans to cover dependent children up to age 26 — although states could opt out of the latter.

The bill would offer targeted tax credits for people who meet certain qualifications to buy healthcare. Individuals who work for small businesses and have annual incomes up to 300 percent of the federal poverty level would be eligible.

But it was only one of several healthcare plans introduced last year with Senate Republican sponsorship.

It did not have the endorsement of the Senate Republican conference, which makes it difficult for Democrats to use against the senators running for reelection. Democrats argue the CARE Act would kick millions of Americans off their health insurance plans and gut consumer protections. 

Galen said it would be “a bad idea” for Senate Republicans to rally behind and try to pass a broad ObamaCare replacement bill coming from the House. 

“That gives the opposition a target specifically to shoot at,” he said, adding it would be better for Senate GOP candidates to have the general outlines of two or three different plans to discuss on the campaign trail.

Scott Wong contributed reporting.