On Wednesday, Republicans in the House of Representatives unveiled their long-awaited healthcare white paper as part of their overall “A Better Way” policy agenda, which also addresses poverty, national security, the economy, the Constitution, and tax reform. The healthcare white paper is the first officially embraced “replace” proposal offered by Republican leadership since the Affordable Care Act was initially proposed in 2009. Numerous alternatives have been offered by congressional Republicans, including the Patient Choice, Affordability, Responsibility and Empowerment (CARE) Act, as well as leading alternatives offered by Tom Price (R-GA) and Bill Flores (R-TX). However, none of these have had the backing of leadership or have been embraced by a majority of congressional Republicans.
This paper was led by House Speaker Paul Ryan, and members of the Task Force on Health Care Reform, which included Budget Committee Chairman Tom Price (R-GA), Education and the Workforce Committee Chairman John Kline (R-MN), Energy and Commerce Committee Chairman Fred Upton (R-MI), and Ways and Means Committee Chairman Kevin Brady (R-TX). It is important to note, the paper is not expected to take the shape of legislation this year, but would form the basis of any repeal/replace effort by Republicans, and potentially be considered under a future Republican presidential administration.
The paper retains many of the reforms put in place by the ACA, while also advancing many of the long-standing healthcare proposals that have been offered by Republicans since before the ACA was enacted. The proposal would retain the consumer protections and market reforms under the ACA, such as protections against pre-existing conditions that would ensure guarantee-issue and prohibit rescissions of services, as well as allow younger consumers to stay on their parents insurance until they are 26. Otherwise, the proposal would differ from the ACA by allowing consumers to purchase insurance across state lines and capping employer exclusion (both of which NAHU opposes), expanding the use of health savings accounts, reestablishing state high-risk insurance pools with $25 billion in new funding, promoting medical liability reform, reconfiguring Medicaid funding by giving states block grants with caps on how much could be spent per enrollee, and increasing private insurance options for Medicare beneficiaries by implementing Speaker Ryan’s long-proposed concept of offering premium supports.
In response to the white paper’s unveiling, congressional Democrats, led by Energy and Commerce Committee Ranking Member Frank Pallone (D-NJ) and Health Subcommittee Ranking Member Gene Green (D-TX), came out quickly to oppose the plan. Their press release called the Republican proposal “half-baked policy ideas,” arguing that it “is conveniently light on details and lacking in numbers entirely.” The Democratic response called on Republicans to “stop litigating the past and to work with us to continue improving the quality of health care in America,” noting that the ACA has provided healthcare coverage to more than 20 million Americans through the marketplaces, expanded Medicaid, and other market reforms.
NAHU appreciates the Republican’s healthcare alternative plan in furthering the discussion on how we can move forward in healthcare reform in the coming years, and we look forward to working with both parties to implement policies that will support a sustainable health insurance market. While healthcare reform has proven its challenges, it is important that any policy proposals not make difficult situations worse.