GOP sees path forward after six-year ObamaCare struggle

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The Republican alternative to ObamaCare just got a little more real.

Five months before Election Day, top Republicans have endorsed the broad outlines of a plan they say would effectively replace the president’s signature healthcare law with a market-driven approach.

{mosads}The unveiling Wednesday has armed House GOP members with a campaign-ready approach to healthcare that, for the first time, has buy-in from their leaders.

“For six years now — six years — we have promised to repeal and replace ObamaCare,” Speaker Paul Ryan (R-Wis.) said as he unveiled the plan at an influential conservative think tank on Wednesday.

“Here it is — a real plan, in black and white. Right here. We are officially putting it on the table,” Ryan said, flanked by a half-dozen other senior Republicans who have spent years on the effort.

While the plan is light on details, Republicans are uniting for the first time around a healthcare platform, something that could help eliminate one of the party’s nagging political weaknesses. Those in favor are calling the plan a “conversation starter” and a significant milestone in the GOP’s long struggle against the law.

In the hours after its release, the plan drew praise from key conservative allies like the U.S. Chamber of Commerce and the Heritage Foundation.

“There are areas where the task force could be more robust but on the whole the proposal is a good first start,” Heritage Foundation health policy director Nina Owcharenko said in a statement. 

Still, the 37-page plan — with no price tag or time frame — puts off almost all of the difficult political trade-offs that would be required in a comprehensive bill.

Due to the lack of details, analysts can’t estimate how many people would see changes to their existing healthcare plans; congressional scorekeepers can’t say how much it will cost; and no specific healthcare industry can oppose it — the problems that nearly doomed Democrats’ fight for Obama-Care in 2010. 

Any fully fleshed out healthcare bill from Republicans would involve wading into battles with powerful lobbying groups, from PhRMA to the AARP, experts say. 

“Republicans are still in the early stages of really understanding the political trade-offs,” said Avik Roy, a conservative healthcare analyst with the Manhattan Institute who advised Sen. Marco Rubio (R-Fla.) on his 2016 presidential bid.

“It takes time to really wrestle with the complexity of healthcare and the trade-offs of healthcare reform. It’s going to take time for Republicans to get there, but the only way you get there is to put out the proposal and get some feedback,” Roy said.

Larry Levitt, senior vice president at the Kaiser Family Foundation, said it’s far easier for the GOP to get praise for its healthcare plan before it fleshes out the details. 

“Health reform is always more popular as a concept and tends to get more controversial when you fill the details,” said Levitt, who has carefully eyed the GOP’s healthcare proposals over the years. “It is very hard to evaluate a plan with no numbers in it.”

The new plan from Republicans — which comes after they voted more than 50 times to repeal the law — follows years of attacks from Democrats over the lack of a proposal. Even the party’s two Supreme Court challenges that threatened to unravel the law did not spur the party to publicly release one.

With the proposal in hand, Republicans can go on the offensive against Democrats like Hillary Clinton, who have been out in front with ideas to expand ObamaCare. 

“This really is an exciting day, where we finally put to rest the notion that Republicans don’t have a healthcare plan,” Budget Committee Chairman Tom Price (R-Ga.), one of the authors of the plan, said during the rollout. 

The GOP’s proposal comes with bold promises to reduce premiums by double digits, to save Medicare and to create sweeping savings across the healthcare system.

Those ideas could resonate in a campaign in which healthcare ranks among voters’ top four issues, according to a recent survey by the Kaiser Family Foundation.

It also allows the GOP to tap into the still-raging opposition to ObamaCare among its base. Six years after the law was passed, the healthcare law is as unpopular as ever. 

An April Kaiser Health Tracking Poll found that 49 percent of people say they oppose the law, compared to 40 percent who support it. When the Affordable Care Act first passed, the same survey found 49 percent of people supported the law, compared to 40 percent who opposed it.

But the plan also leaves the GOP vulnerable to other attacks — particularly on the question of how they would prevent 20 million people from losing the coverage they gained under ObamaCare.

Several employer-focused groups have also raised concerns about the GOP’s call to end tax exemptions on the “most generous” healthcare plans.

The American Benefits Council warned the GOP’s proposal to force some workers to pay taxes on the value of their coverage would “unintentionally erode the employer-based system.” 

Another looming battle is with the AARP.

The GOP’s plan proposes increased costs for older customers. Under ObamaCare, insurers limit the cost of older Americans’ plans to no more than three times what a younger person pays in premiums.

Republicans said Wednesday they would increase that cost to no more than five times, a ratio that many states had in place before the law was enacted.

Peter Sullivan contributed.

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