House Republicans say their long-awaited plan to replace Obamacare is generating enough buzz to be a springboard for legislative work in 2017, so long as the election goes their way, though members say the election-year proposal is a “starting point” and not a shovel-ready plan.
The plan released by Speaker Paul D. Ryan and top committee chairmen is six years in the making and would end the heavy mandates and government-run exchanges of Obamacare in favor of free-market levers designed to entice customers into private market plans.
It’s been pitched as a blueprint rather than an actual bill, so it is unclear how many people it would cover or how much it would cost taxpayers. But its policy prescriptions have been well-received by center-right think tanks, and members say it is enough to start the conversation with voters in the coming months.
“Obviously, at the end of the day, we don’t know what any replacement plan will look like in its totality, and it’s difficult getting there. But it gives us something to start on,” said Rep. Adam Kinzinger, Illinois Republican.
Rep. John Fleming, Louisiana Republican running for Senate, said the white paper holds promise, since it is “based on a collection of central ideas that we’ve all supported.”
Indeed, new plan includes longtime GOP favorites such as allowing insurance companies to sell policies across state lines — something presumptive Republican presidential nominee Donald Trump endorses — and calls for health savings accounts, a tax-advantaged fund that encourages savings for future medical expenses.
That’s enthusing members like Rep. Michael Burgess, Texas Republican and doctor who says consumers would be well-served by pairing their high-deductible health plans with HSAs.
“That’s a pretty powerful tool for consumers to use,” Mr. Burgess said.
The House Republicans’ campaign arm started to test their talking points even before Mr. Ryan rolled out the plan in late June. They found that Cincinnati constituents responded well to parts of the plan that would replace government requirements with consumer-driven reforms, though they offered a lukewarm response to a GOP proposal to begin taxing a portion of generous employer plans.
Some conservatives haven’t fully embraced the plan, saying the November election will determine if they have a White House ally in Mr. Trump, who says he will repeal Obamacare, or if they must play defense against presumptive Democratic nominee Hillary Clinton, who plans to build on President Obama’s 2010 law.
Rep. Steve King, Iowa Republican, said it is important to pursue repeal no matter what, yet GOP members have been trickling out replacement proposals for years, and “it’s hard to decide what actually has legs and what doesn’t.”
“For me, I’ve been reluctant to sign onto them. I want to keep my options open,” he said.
Mr. King is particularly concerned about a part of the GOP plan that offers an age-adjusted tax credit intended to help offset the costs of buying insurance for those who don’t get coverage through their job or through a government program.
“There will be the pragmatists who say the public is never going to go back to where they were, they’ve been weaned onto Obamacare, so let’s give them ‘Obamacare lite,’” Mr. King said. “I say that’s wrong, we’re a free people.”
The plan does keep the more popular parts of Mr. Obama’s law in place, including letting young adults stay on their parents plans until age 26. It also says people with pre-existing medical conditions cannot be denied coverage.
Yet Republicans envision a one-time open enrollment period for uninsured individuals to purchase coverage, regardless of how sick they are. They would enjoy a refundable tax credit that’s large enough to purchase the typical pre-2010 plan, and it would be age-adjusted so that older Americans receive more support.
Lanhee J. Chen, a fellow at Stanford University’s Hoover Institute and former adviser to 2012 GOP nominee Mitt Romney, said the plan is meaty enough for GOP candidates to use in a campaign setting.
“Ultimately, it is going to be hard to make the case for repeal effectively without a solid plan to replace the law,” he said. “The Ryan blueprint gives them the ideas and the ammunition that candidates need to make the argument.”
Leading Democrats said they fully expect Republican candidates to use health care as a wedge issue this year, though they argue the GOP alternative lacks key details and will fall short of Obamacare’s gains.
“I certainly expect them to run on it, but they’ve been running on it for the last six years,” House Minority Whip Steny Hoyer, Maryland Democrat, said. “But they certainly have not given any kind of road map to the American people where they are going to ensure that Americans have access to affordable, quality health care.”
Democrats are not only promising to double down on Obamacare, they are lurching further to the left.
Mr. Obama and Mrs. Clinton, say customers with limited options on Obamacare’s web-based exchanges should have a “public option,” or government-run plan that competes with private plans.
That had been a bridge too far for centrist Democrats just six years ago, underscoring the political divide that Republicans will face even as they try to rally their own caucus and overhaul health care once more.
“The [Affordable Care Act] is now the status quo, so undoing it and replacing it with something else is just as disruptive and difficult as implementing the ACA to begin with,” said Larry Levitt, senior vice president at the nonpartisan Kaiser Family Foundation. “It’s definitely not something that could happen over night.”