Republican leaders unveil outline for a new health law
WASHINGTON—Top House Republicans unveiled a rough sketch of a massive health care overhaul to rank-and-file lawmakers Thursday, but a lack of detail, cost estimates and GOP unity left unresolved the problem that’s plagued them for years: What’s the party’s plan and can Congress pass it?
At a closed-door meeting in the Capitol basement, House Speaker Paul Ryan, R-Wis., and other party leaders described a broad vision for voiding much of President Barack Obama’s 2010 statute and replacing it with conservative policies. It features a revamped Medicaid program for the poor, tax breaks to help people pay doctors’ bills and federally subsidized state pools to assist those with costly medical conditions in buying insurance.
Lawmakers called the ideas options, and many were controversial. One being pushed by Ryan and other leaders would replace the tax increases in Obama’s law with new levies on the value of some employer-provided health plans—a political no-fly zone for Republicans averse to tax boosts.
“You have to legislate with a sense of political reality,” said Rep. Tom Cole, R-Okla., who said backing that proposal “would set up an ad against you from multiple directions” during upcoming elections.
The scant health care progress mirrors a lack of movement on other issues in a capital run by the GOP. No proposals have surfaced to pursue President Donald Trump’s campaign promises to build a border wall with Mexico or buttress the nation’s infrastructure, and Republicans have yet to coalesce around another priority, revamping the nation’s tax code.
Senate Republicans have criticized a House GOP plan to change how corporations are taxed.
The health care outline was aimed at giving Republicans something to exhibit during next week’s congressional recess, at a time of boisterous town hall meetings packed with supporters of Obama’s law. Ryan told reporters that Republicans would introduce legislation voiding and replacing Obama’s statute after Congress returns in late February, but offered no specifics.
Highlights of the proposal:
MEDICAID: Phases out Obama’s expanded Medicaid coverage for more low-income people that 31 states accepted, which is nearly completely financed by federal funds. States could continue covering current beneficiaries for an undefined “limited period,” but the extra federal money would expire. The 19 states that didn’t expand would get additional money. In the future, states could decide to receive Medicaid money based on the fluctuating number of beneficiaries in the state and other health factors, or a lump sum.
OBAMA’S INDIVIDUAL
MANDATE: Penalty for not buying coverage would end immediately. During transition away from Obama’s system of subsidizing most people who buy insurance on online marketplaces, younger people could get slightly bigger subsidies than today and those for older people might get smaller. That’s an attempt to draw younger, healthier people into insurance markets in hopes of stabilizing them that’s opposed by groups representing seniors like AARP.
TAX CREDITS: Available for people not covered by employers or government agencies. Paid in advance, refundable so people with little or no tax liability would get an IRS check. Higher credit for older people, not based on income. Not usable for plans that cover abortions.
TAXES: All or some of the Obama overhaul’s tax increases on high-earners, health care companies and others would be repealed. Taxes could be levied on the value of employer-provided health coverage exceeding $12,000 for individuals, $30,000 for families.
HEALTH SAVINGS ACCOUNTS:
People could contribute more than current annual limits of $3,400 for individuals, $6,750 for families.
HIGH-RISK POOLS: States would get federal money to help people with costly conditions to afford coverage.
MEDICARE: Proposes no changes.
COSTS: No estimates provided.