House Republicans Unveil Long-Awaited Substitute for Obamacare

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House Republicans last week set forth their vision for repealing and replacing the Affordable Care Act, bridging several political mine fields in the process.

In a 37-page proposal (pdf) from House Speaker Paul Ryan and GOP committee chairmen, Republicans said they would strike the law in its entirety, but then reinstate some requirements, such as a ban on insurance companies dropping consumers just because they get sick.

The Republican plan would include new tax credits and coverage guarantees for people who don’t get insurance through a job, and cap the tax benefit for health coverage offered by employers. The party has squabbled for years over whether and how to create an alternative to the Democrats’ 2010 federal health law.

“[For] six years, we have promised to repeal and replace Obamacare, and make health care actually affordable. Well, here it is, a real plan, in black and white, right here,” Mr. Ryan said at a packed event at the American Enterprise Institute. “This is our consensus for a better way forward.”

House Republicans cast the proposal to limit the employer exclusion as a way to increase take-home pay since workers accept lower pay in exchange for tax-free benefits as well to curb national health spending and making insurance less expensive for people buying it on their own.

GOP chairmen who stayed after Mr. Ryan delivered his remarks at the AEI event defended the move.

“The intent is not to do away with employer-provided health care,” said Rep. John Kline (R-MN) who heads the House committee on Education and the Workforce. “It’s to make it actually more available for more people, and we’re going to do that by driving down the cost.”

The GOP plan would sweep away the health law’s requirement for insurers to offer coverage to all regardless of their medical history, one of the most popular provisions of the law, at the same time that it does away with the unpopular requirement for most individuals to obtain coverage or pay a penalty.

Instead, Americans could get tax credits that could be used to purchase insurance through the individual market, which would be estimated to cover at least the cost of catastrophic insurance. The exact value of the credit wasn’t specified.

Uninsured people would have a one-time opportunity to sign up for coverage, and then they would be required to maintain insurance to benefit from the guarantee that they could buy it at the same price, regardless of their medical history and any existing conditions. People who tried to enroll late would likely see a period of higher costs.

“We believe that what we have designed here allows people to have continuous coverage and therefore their existing conditions covered,” said Rep. Fred Upton (R-MI), the chairman of the House Energy and Commerce Committee.

The Obama administration and other supporters of the law attacked those proposals as insufficient.

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

Steve’s Take: The last time I checked, estimates on exactly how many times Republicans have tried to repeal all or part of the Patient Protection and Affordable Care Act were up to approximately 63.

Shortly before the last repeal vote, House Speaker Paul Ryan (R-WI) was asked why he was moving forward with a bill to eliminate the ACA before the Republican alternative was ready. His answer: “Just wait.” So now we finally have the GOP’s substitute for Obamacare, and it, like the previous repeal bills, has zero chance of succeeding until and unless there is a Republican in the White House.

I’ve always been intrigued by the notion of “moving on”–something we all have to do now and again–leaving behind relationships, careers, places we have lived, dreams of a first World Championship for the Chargers or Padres, etc.

Although painful, the process more often than not is necessary to continue growing and moving forward. It’s been over six years since Obamacare was signed into law. Six years since the Republicans lost that particular battle.

I agree with those who say the worst thing you can do is try to cling to something that’s gone, or to re-create it. Isn’t it time for us as a nation to move on to other priorities than a 64th attempt to obliterate Obamacare?

Monday, June 27, 2016 / Vol. 24 / No. 25

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