GOP surprises with push for smaller ObamaCare changes

Greg Nash

House Republicans are considering small-bore changes to ObamaCare even as they prepare to release an outline for replacing the entire law. 

The House Energy and Commerce Committee on Friday held a hearing on five bills that would make relatively small changes to the health law, such as changing the documentation required to enroll in coverage or changing how insurers can use someone’s age in setting premiums.

{mosads}The moves indicate that Republicans have not ruled out making adjustments to the existing law despite preperations to tout their long-awaited replacement plan for all of ObamaCare, coming from Speaker Paul Ryan’s (R-Wis.) task force later this month.  

Asked about any conflict between the replacement task force and the consideration of smaller bills, Energy and Commerce Committee Chairman Fred Upton (R-Mich.) noted that the full replacement plan would not actually be voted on or put into legislative language. 

“Remember, we’re not intending to move this piece through the committee or the House,” Upton said of the task force’s work. “It’s a discussion document. It’s a place where we think most of our colleagues can be, principles that we stand for.” 

The task force’s replacement plan is part of Ryan’s high-profile effort to show voters that Republicans have policy solutions. The smaller-scale bills considered Friday, on the other hand, could actually move at least some distance through the legislative process.  

There has been talk of bringing the smaller-scale measures to a markup in committee before the August recess, and time has been set aside on the calendar to do so, though action is not certain. 

“We still have time scheduled for markup, yeah,” Rep. Joe Pitts (R-Pa.), the chairman of the health subcommittee, said before the hearing. 

Adding to the signs of movement, lobbyists say that the House Ways and Means Committee could move forward next week with a hearing on small-scale changes related to healthcare taxes.  

Still, it is unclear how far the bills will actually go. Democrats oppose the measures, and there is limited time left on the legislative calendar due to the 2016 elections. 

The measures are favorable to health insurers and could help shore up their bottom lines amid heavy financial losses for many on the ObamaCare marketplaces so far. 

One bill would allow insurers to charge older people higher premiums to account for the higher cost of their care. The bill would allow older people’s premiums to be five times higher than younger enrollees’, rather than three times higher, as it is under ObamaCare currently. 

Another measure would require people signing up for ObamaCare in extra sign-up periods to provide documentation proving that they qualify before enrolling, rather than after. 

A third bill would reduce the grace period for enrollees who don’t pay their premiums to 30 days, from 90 days, before they lose their coverage. 

Democrats warned that the measures would make it harder for people to enroll in or afford coverage. 

Rep. Gene Green (D-Texas), the health subcommittee’s top Democrat, said the bills “only serve to help insurance companies rather than people.”

While he is opposing the legislation, Green said in an interview ahead of the hearing on Wednesday that it is progress that Republicans are holding a hearing on any changes to the health law, rather than full repeal. 

“I’m happy about it,” Green said. “I’ve been asking for that for about six years. Let’s go back and fix it, because any bill Congress ever passed, typically we wait a year or two, see how it works, we go back in and fix the problems. We haven’t had that opportunity because it’s always just repeal.” 

Some Democrats expressed openness to compromise around some of the measures.

Rep. Kurt Schrader (D-Ore.) suggested a possible middle ground of 60 days for the grace period, in between the current 90 days and the GOP proposal for 30 days.  

America’s Health Insurance Plans (AHIP), the insurer trade group, wrote a letter to the committee in support of the bills. 

The group said it “share[s] the committee’s concerns” about issues including “upward pressure on premiums.”

“We appreciate that today’s hearing will focus on several bills that offer promising strategies for addressing some of these concerns,” AHIP wrote. 

There have been a few other signs that Republicans are starting to focus on changing the health law instead of repealing it, though that could change under a Republican president.  

Sen. Bill Cassidy (R-La.) and Rep. Pete Sessions (R-Texas) introduced a replacement bill that left some of ObamaCare in tact last month, saying they were recognizing “political reality.” And the Senate Appropriations Committee this week approved a bipartisan health spending bill that largely steered clear of attacks on ObamaCare.   

Some lobbyists, though, expressed some confusion as to why Republicans on the House committee are going forward with small-scale changes to the law at the same time as they seek to repeal it. 

One Republican healthcare lobbyist said the move “surprises us.”  

“It seems like making these fixes runs counter to what the GOP has been preaching on repeal,” the lobbyist added. “For example, why do we have to fix the grace periods when we want to repeal the bill?” 

At the hearing, Republicans cast the bills as a remedy for rising premiums across the country, an issue where they have been putting heat on Democrats in an election year. 

After citing reports of various proposed premium increases, Pitts said, “This is why we are here today: To offer better care at a fairer price.”

Tags Gene Green Paul Ryan
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