Days after top House Republicans asked President Obama to expand a provision in the Affordable Care Act, Rep. Paul Ryan (R-WI) admitted on Wednesday that the ACA incorporates provisions that Republicans “have always been talking about,” including solutions he himself proposed in 2009.
During an appearance on MSNBC’s Morning Joe, Ryan singled out state-based exchanges and high-risk insurance pools, both of which Democrats included in the final law after months of negotiations with Republicans on the Senate Finance Committee. The exchanges or new regulated marketplaces for insurance will go online by 2014, while the temporary high risk pool program for individuals and families with pre-existing conditions has enrolled more than 100,000 people, but stopped accepting new applicants in February.
The House Budget Chairman — who on Tuesday introduced a measure that would repeal most of the health care law — claimed that the administration “screwed” the Republican-backed proposals and “destroyed” them, pointing to a 2009 bill he offered with Sens. Tom Coburn (R-OK) and Richard Burr (R-NC) as a plan to fix the broken health care system:
RYAN: Look, exchanges at the state level is something we have always been talking about. Tom Coburn and I had a bill. I think they have kind of messed up the idea of exchanges but the idea from conservative standpoint is a revived idea that can work. The other thing is high risk pools. They screwed the high risk pools and didn’t work in Obamacare but a way of making them work from our minds to make sure that people with preexisting conditions can get considerable health insurance. We think some in that law were destroyed but revive those things in an effort to replacing the law.
Ryan introduced the Patient Choice Act as an alternative to President Obama’s health care proposal on May 20, 2009. And while the bill taxed the full value of employer health benefits, issued refundable tax credits, and expanded the use of Health Savings Accounts, it had some similarities to what ultimately became the ACA.
For instance, the measure encouraged states to “establish rational and reasonable consumer protections” by forming State Health Insurance Exchanges to give Americans a choice of “different” private “health insurance policies” and issue standard benefits, offering “coverage to any individual regardless of age or health.” The bill even included “non-profit, independent board” to penalize insurance companies “that cherry pick health patients and reward insurers that cover patients with pre-existing conditions.” It described the board as “a model that works in several European countries.”
The high-risk insurance pools that are included in the ACA were advanced by the GOP during Sen. John McCain’s (R-AZ) presidential bid in 2008. The measure is designed as a bridge to the exchanges for families and individuals who don’t have an offer of coverage from an employer and cannot find insurance in the individual market.