Speaker Paul D. Ryan has instructed his health care task force to “go big and go bold” in its push to replace Obamacare so that voters can see a clear GOP alternative before Congress breaks this summer for the presidential conventions, a powerful House Republican said Wednesday.
Rep. Fred Upton, Michigan Republican and chairman of the Energy and Commerce Committee, said the task force will reach consensus on a plan, though it’s doubtful they’ll bring it up for a vote as long as President Obama is still in office and wields a veto.
“We know what the outcome would be,” Mr. Upton said, adding that the goal of the task force is instead “to begin the foundation to prepare for a Republican president in 2017.”
But as the Affordable Care Act enters its third year of full implementation, the Obama administration says the health law has become ensconced, and is now helping provide insurance to about 90 percent of Americans.
“This is the first time in our nation’s history that this has been true,” Health and Human Services Secretary Sylvia Mathews Burwell told the House Ways and Means Committee.
Her department has struggled to meet enrollment projections, with just 12.7 million people signing up for private coverage on the health exchanges for this year. The Congressional Budget Office had initially said the number would be above 20 million.
“Poor enrollment results show Americans just aren’t buying what the president’s selling on this law,” said Ways and Means Chairman Kevin Brady, Texas Republican. “In fact, millions would rather pay the punitive individual mandate tax penalty than buy Washington-designed insurance they don’t want.”
Mrs. Burwell, though, said the lower enrollment number is actually a victory, since it means fewer Americans have been forced into the exchanges after losing coverage through their businesses.
She said Congress should judge success not by the number of enrollees in the exchanges, but by the dropping level of those without coverage at all.
Mrs. Burwell has less than a year on the job before Mr. Obama’s term is up, and Republicans in Congress are already planning for that.
Mr. Brady and Mr. Upton are two of Mr. Ryan’s four pointmen on replacing Mr. Obama’s signature law with “patient-centered” reforms. House Budget Committee Chairman Tom Price of Georgia and Education and the Workforce Committee Chairman John Kline of Ohio round out the working group, which is soliciting ideas from rank-and-file lawmakers as part of Mr. Ryan’s bottom-up approach to governing.
“He’s committed not only to getting the big idea right, but also getting the process right,” Mr. Upton said of the speaker.
For now, Republicans have a set of goals: A replacement plan must reduce costs while increasing choices for patients, bolster competition in the insurance marketplace and help vulnerable Americans with targeted assistance, Mr. Upton said.
Their plan would get rid of Obamacare’s unpopular insurance mandates on employers and individuals, plus its byzantine coverage requirements.
“Just erased, like an Etch-a-Sketch,” Mr. Upton said.
People with pre-existing medical conditions would still be guaranteed access to coverage, though Republicans would try to foster competition by letting insurance companies sell their plans across state lines, he said.
Republicans would give states more flexibility in how they run their Medicaid programs, and they would expand the use of health savings accounts so that Americans take personal responsibility for how much they spend on care.