GOP draws battle line with ObamaCare alternative

GOP draws battle line with ObamaCare alternative
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Speaker Paul RyanPaul Davis RyanBiden's inauguration marked by conflict of hope and fear The Hill's 12:30 Report: Sights and sounds from Inauguration Day Revising the pardon power — let the Speaker and Congress have voices MORE on Wednesday formally unveiled the House GOP alternative plan for the Affordable Care Act, billing it as the culmination of years of party pledges and effort. 

“For six years now, we’ve promised to repeal and replace ObamaCare and make healthcare actually affordable,” the Wisconsin Republican said at an event at the American Enterprise Institute. “Well, here it is: a real plan — in black and white — right here.”


The plan envisions a simpler system than ObamaCare with limited financial assistance, lighter regulation and less federal spending on healthcare. It allows for less generous, basic health plans, as opposed to ObamaCare plans, which must cover an array of required elements.

Democrats immediately attacked the plan, saying it is just a broad outline, and one that, if ever implemented, would roll back the coverage gains of ObamaCare.

“The proposal introduced by Speaker Ryan is nothing more than vague and recycled ideas to take health insurance away from millions and increase costs for seniors and hardworking families,” said White House spokeswoman Katie Hill.

The plan does not include some key details, like dollar amounts on how much financial assistance it would provide, which are crucial for assessing its effect on coverage and the budget.

“We're not at the legislative language point,” said House Budget Committee Chairman Tom Price (R-Ga.), when asked about the lack of specifics. “We want to have a discussion, literally a policy discussion, over the next six months with folks, and see what kind of feedback there is.”

“Nothing's happening from a legislative standpoint on this before this president leaves office,” he added.

Price and Ways and Means Committee Chairmen Kevin BradyKevin Patrick BradyK Street navigates virtual inauguration week Growing number of lawmakers test positive for COVID-19 after Capitol siege Overnight Health Care: US sets record for daily COVID-19 deaths with over 3,800 | Hospitals say vaccinations should be moving faster | Brazilian health officials say Chinese COVID vaccine 78 percent effective MORE (R-Texas) both said they had not spoken to Donald TrumpDonald TrumpMcCarthy says he told Rep. Marjorie Taylor Greene he disagreed with her impeachment articles against Biden Biden, Trudeau agree to meet next month Trump planned to oust acting AG to overturn Georgia election results: report MORE about the plan, but they were hopeful he would take it up if elected.

The plan centers on a tax credit to help people afford coverage. Unlike ObamaCare’s financial assistance, which increases based on income to give more help to low-income people, the Republican plan’s assistance would be flat and based on age.

“The GOP plan would tend to benefit higher-income people and those who live in low cost areas,” said Larry Levitt, a healthcare expert at the Kaiser Family Foundation. “Low income people would likely be worse off.”

Backers of the plan argue that it is a positive that the market would be opened up to allow people to buy skimpier coverage instead of heavily regulated, more comprehensive coverage required under ObamaCare.

The market would “not be constrained into these very tightly regulated options,” said Scott Gottlieb, a healthcare expert at the conservative American Enterprise Institute.

He said these regulations, limiting choice, are “a big reason why you've seen anemic competition in the market.”

Experts said that it is hard to assess whether the GOP plan would lead to drastically fewer people being covered.

“It is hard to tell whether fewer people would be covered because there’s a lot of uncertainty on how people would react to a flat dollar tax credit,” Levitt said.

However, he added, “it is clear that people would end up with skimpier coverage,” due to the less generous assistance.

The new caps on Medicaid spending per person and the rolling back of ObamaCare’s Medicaid expansion could also lead to fewer people with coverage, but the flip side is that the government would be spending less on healthcare, a key tenet of the GOP plan.

The GOP plan would also abolish ObamaCare’s protections for people with pre-existing conditions, and instead only protect people if they already had coverage and are simply switching to a new plan.

Uninsured people with pre-existing conditions could find coverage in a separate, government-subsidized, “high-risk pool,” for sick people.

The GOP plan puts forward $25 billion over 10 years to subsidize this coverage, but that might not be enough.

“$25 billion over ten years is certainly not enough to fully subsidize the cost of people with pre-existing conditions,” Levitt said. 

The plan also moves to make Medicare more market based and financially sustainable. Under the system, seniors would receive financial assistance to help them purchase a private insurance plan or traditional Medicare, and the eligibility age would rise to 67.

Congressional Democrats jumped on the plan.

“This Republican ‘plan’ would increase the Medicare eligibility age and end the program as we know it,” said Senate Democratic Leader Harry ReidHarry Mason ReidSchumer becomes new Senate majority leader Biden faces tall order in uniting polarized nation Senators vet Mayorkas to take lead at DHS MORE (D-Nev.).