GOP duo unveils healthcare bill maintaining parts of ObamaCare

Greg Nash

Two Republican lawmakers are breaking with their party’s long-stated goal of repealing ObamaCare by putting forward a healthcare plan that leaves parts of the system in place.

While the new bill from Rep. Pete Sessions (R-Texas) and Sen. Bill Cassidy (R-La.) is a departure from the core Republican idea of full repeal, it could provide a roadmap for changes that could be enacted under a GOP president. 

{mosads}At the center of the bill is a $2,500 tax credit that any citizen could use to purchase health insurance. The plan would repeal ObamaCare’s mandates for individuals to have coverage and for employers to provide it, as well as the reform law’s requirements for what an insurance plan must cover. 

But much of ObamaCare would remain, including its safeguards against insurers discriminating based on pre-existing conditions. The law’s tax increases would also be kept.

Sessions and Cassidy acknowledged that their plan is a departure from the GOP’s six-year quest to repeal the whole law; they said they are dealing with the “political reality.”

“We know that the only way that we’re going to be able to totally repeal and replace now is if we keep the House, have 60 Republican senators, or enough Democrats who will vote with us, and a Republican president,” Cassidy said. “If we get that, we will go the whole way, but we can’t kind of not do anything waiting for those stars to align.”

Leaving some of ObamaCare in place has some benefits, in that it would make a replacement plan easier to accomplish.

By keeping the Affordable Care Act’s tax increases and Medicare cuts, their plan helps to address the thorny question of how Republicans would pay for their ObamaCare alternative. The measure also leaves in place popular regulatory protections like those for people with pre-existing conditions. 

Joe Antos, a healthcare expert at the conservative American Enterprise Institute, called the bill “very realistic politically and very realistic from a health system standpoint.”

Insurers are largely against full repeal of ObamaCare, given that they have already spent six years adapting to the new system, but modifications could be a different story. 

“I think insurers could support this, because it’s not turning everything upside down,” Antos said. “If there is a Republican president, they’re going to have to take this seriously.”

Cassidy said that he has already made initial overtures about the proposal to the campaign of presumptive Republican presidential nominee Donald Trump. He said he has spoken to Rep. Duncan Hunter (R-Calif.), who is Trump’s envoy to Congress, in addition to “a person doing policy” for the Trump campaign. 

Still, it is far from clear that a proposal from the two Republican lawmakers can catch on in the broader party. 

One major complicating factor is that Speaker Paul Ryan (R-Wis.) has already set up a task force that is developing its own ObamaCare replacement plan, which is expected to call for completely repealing the health law, though some elements, like a tax credit, could be similar. 

Sessions, the chairman of the powerful House Rules Committee, said he is not trying to compete with the Speaker’s task force. 

“I don’t know why every idea would be stepping on anybody’s toes,” Sessions said. “This is complimentary.”

He noted that his plan is an actual bill, in legislative language, making it more detailed than the outline of ideas that will be put forward by the task force. 

“Instead of principles, we’re dropping a bill,” Sessions said. He added that he began work on the bill long before he knew that there was going to be a task force.

Asked if the Speaker supports Sessions’s bill, Ryan spokeswoman AshLee Strong said: “Republicans continue to show they have health care solutions for Americans. House Republicans look forward to releasing our health care recommendations as part of a broader agenda in June.”

Sessions and Cassidy argue that their bill represents an improvement over ObamaCare in several ways.

For starters, by eliminating the requirements for what insurance plans must cover, their measure would open up the market and allow for cheaper plans, they said.

In addition, they said it would give people more control over their healthcare spending, as people could put the tax credit in a Health Savings Account. This tax credit would be $2,500 for everyone, unlike ObamaCare’s financial assistance, which is adjusted based on income.

Drew Altman, president of the Kaiser Family Foundation, a health policy research group, warned that $2,500 could be insufficient to help low-income people afford coverage. He noted that the average cost of an individual health insurance plan in the employer market was around $6,000 in 2015. 

The Sessions-Cassidy bill also changes the current system of not taxing health insurance plans that are provided through employers, an idea that is politically fraught. However, employers could stay in the current system if they wanted.

A better picture of the cost and coverage effects of the bill would come with an analysis from the Congressional Budget Office, which has not been conducted. 

Sessions and Cassidy said they were starting to reach out to their colleagues in Congress. For example, Sessions said he had spoken to Sen. John Cornyn (R-Texas), the Senate’s No. 2 Republican, who had agreed to study the proposal. 

“We will be selling this,” Sessions said. 

Tags Donald Trump John Cornyn Paul Ryan

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