As the 2016 Republican presidential primary race moves toward the party’s national convention in Cleveland the organization is still looking for a replacement for Obamacare that they can agree on and support.
The engineering of a “replacement” bill for Obamacare has stymied Republicans since 2009, which was amplified by the 2010 campaign slogan of “repeal and replace.”
Congressional Republicans finally managed to successfully vote to repeal Obamacare in both bodies recently, but President Obama vetoed that effort. Now, Republicans are focusing their attention on replace rather than repeal. However, the continuing trouble for Congressional Republicans has been finding a replacement bill which would pass.
Up until now, there has never been such a plan because no such blueprint ever had anywhere close to the votes needed to pass. A task force commissioned by House Speaker Paul Ryan, R-Wis., is expected to roll out a set of general health care goals sometime in the next five weeks. Ryan hopes the House would address the topic next year.
In the meantime, a pair of GOP lawmakers are introducing an alternative health care plan they say would dramatically reshape the nation’s healthcare system. House Rules Committee Chairman Pete Sessions, R-Texas, and Sen. Bill Cassidy, R-La., plan to introduce what they are terming an “alternative” health care bill which will not repeal Obamacare, but work alongside the existing Affordable Care Act and modify various parts of the system.
The legislation is technically called the HELP Act, short for “Health Empowerment Liberty Plan.”
Sessions notes that the legislation allows people to keep Obamacare if they so desire, noting that his measure does not entail a full repeal of Obamacare.
“Someone who repeals (Obamacare) is left with nothing,” he said.
That’s why his bill works in tandem with the existing law.
The centerpiece of the Sessions-Cassidy plan is a major change to the tax code that would provide every American adult with $2,500 to purchase health coverage, but also shake up the nation’s current employer-based healthy insurance system.
This new standardized tax credit would replace tax breaks that many Americans currently get if their employer provides health coverage.
Health benefits, unlike wages, are not subject to income or payroll taxes, and that means that higher-wage employees with comprehensive health plans often enjoy substantially greater tax benefits than low-wage employees without health coverage.
The proposed tax credit would also be available to people who don’t have work-based insurance, thereby equalizing tax treatment of health benefits.
“Bill Gates will get the same tax break as the guys who mow his lawn,” said John Goodman, a health economist who helped develop the Sessions-Cassidy plan.
Goodman said most Americans, particularly those with lower incomes, would end up getting more money than they do now for health insurance.
Conservatives have long argued that giving Americans a basic tax credit to use to shop for health insurance no matter where they work would free up the health insurance market and drive down costs.
Former President George W. Bush urged such an approach in his second term. And Sen. John McCain (R-Ariz.) made a similar plan a major plank of his 2008 presidential run.
But such plans have never been popular, in part because they threaten to disrupt the popular employer-based system that nearly 150 million Americans rely on for health benefits.
Even many traditionally conservative business groups gave McCain’s 2008 plan a cool reception.
Goodman – a longtime advocate of health savings accounts, or HSAs, and other tools to make consumers shop more the health services – said the Sessions-Cassidy plan would be less disruptive than McCain’s because it would allow Americans to remain in their current health plan if they like it.
Nevertheless, many conservative health policy experts have concluded that any healthcare legislation that aims to replace the Affordable Care Act shouldn’t overhaul employer-based coverage because that would be too controversial.
“One thing we know is that employers are very good at getting people covered,” said Tevi Troy, a former health official in the Bush administration who now works with businesses on health policy.
“I worry about something that might knock employers out of the game.”
Donald Trump, the presumptive Republican presidential nominee, has proposed tax breaks for Americans who don’t get work-based health benefits. But Trump’s campaign healthcare plan, like other recent GOP health proposals, does not appear to envision major changes to employer-based coverage.
Authoring a bill, let alone a bill which doesn’t call for a full repeal of Obamacare, is a huge break in where Republicans have been on the health care issue.
That’s not to say that all Republicans can go along with the Sessions-Cassidy plan because it goes against what has been the GOP doctrine for so long, but it’s significant in the fact that two Republicans are taking this approach.
Make America Better Plan for Health Care
Like many campaign pleas, Donald Trump’s health care policy is big on rhetoric and lacking in details. According to his site, Trump promises:
“It is not enough to simply repeal this terrible legislation. We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.”