House Republicans are planning to unveil a unified alternative to the Affordable Care Act this spring, the Washington Post reported on Monday. Though details of the plan remain sketchy, the measure is “hardly intended as a full replacement of the federal health-care law” and will focus on filling gaps in the health care system.
According to the Post, lawmakers will endorse “ability to buy insurance across state lines, guaranteed renewability of policies and changes to medical-malpractice regulations.” Once Obama’s health care reform law is repealed, insurers will be able to discriminate against individuals with pre-existing conditions, though the GOP-backed proposal will offer sicker individuals coverage through “high-risk insurance pools” managed and subsidized by the states.” The alternative will also promote health savings accounts, allow small businesses “to purchase coverage together” and permit young people to stay on their parents’ health care plan until age 26.
If that last plank sounds a whole lot like the Affordable Care Act, that’s because it is. Of the seven provisions outlined by the Post, five — save health savings accounts and malpractice reform — are already included in the law in one way or another. The provisions may not be drafted exactly the GOP’s liking, but they accomplish very similar goals:
— Buying insurance across state lines. SEC. 1333 of the ACA creates “Health Care Choice Compacts,” which allows insurers to sell policies within the confines of state compacts, so long as the companies follow the consumer protection standards designed and agreed to by the states.
— Renewability. SEC. 2703 of the ACA states that “if a health insurance issuer offers health insurance coverage in the individual or group market, the issuer must renew or continue in force such coverage at the option of the plan sponsor or the individual, as applicable.”
— High-risk insurance pools. SEC. 1001 of the ACA created a temporary program that provided immediate access to insurance for individuals with pre-existing conditions. Ultimately, the initiative — which provided coverage only to sick people — proved unsustainable and ran out of money earlier than expected.
— Small business purchase coverage together. SEC. 1311 of the ACA “provides for the establishment of a Small Business Health Options Program (in this title referred to as a ‘‘SHOP Exchange’’) that is designed to assist qualified employers in the State who are small employers in facilitating the enrollment of their employees in qualified health plans offered in the small group market in the State.”
— Children on their parents’ plans. SEC. 2714 of the ACA states that “A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child until the child turns 26 years of age.”
A GOP alternative is not a certainty, however. Republicans had promised to introduce a single party-backed alternative to the law since 2009 and have repeatedly reneged on that pledge. Some conservative lawmakers are still “wary of the push to have House Republicans sing as a unified chorus,” arguing that the party out of power does not have to offer a detailed governing agenda and could make gains in 2014 by criticizing the unpopular law. A detailed proposal could also open the party up to policy criticism. When Republicans last offered a leadership-supported plan in 2009 — which closely resembles the above mentioned principles — the Congressional Budget Office estimated that “the number of nonelderly people without health insurance would be reduced by about 3 million relative to current law, leaving about 52 million nonelderly residents uninsured.”