Bloomberg News

Repealing, Not Replacing, Health Law Tops Republican Plan

July 11, 2012

U.S. House Republicans, united in opposition to President Barack Obama’s health care overhaul, used to pledge to “repeal and replace” it.

Now, as they prepare to vote as soon as today to kill the law they call Obamacare -- their 33rd effort to undo all or parts of it -- Republican leaders have dropped the word “replace” from their promise.

The omission is the result of an election-year calculation: They figure they stand to gain from public distaste for the 2010 measure’s central provision, the requirement that most Americans buy health insurance, and will lose if they start providing details about what they would do instead.

“They don’t care to replace it,” Ross Baker, a professor of American politics at Rutgers University in New Brunswick, New Jersey, said in a telephone interview. “They want to revert to the status quo. Whatever plan they have is going to end up alienating somebody, especially during a presidential campaign.”

Renewing the debate over how to provide wider coverage while containing health costs would divert attention from the stagnant economy, which Republicans say is their winning issue. Also, it runs the risk of emphasizing a patchwork of Republican proposals that wouldn’t provide universal protection or retain such popular features of the 2010 law as requiring insurance policies to cover pre-existing conditions.

‘Step by Step’

The best legislative approach is “step by step” while going “after the problems that we can solve,” Representative Tom Cole, an Oklahoma Republican, said in an interview. House Republicans haven’t scheduled further votes or hearings on health care proposals.

Achieving universal coverage is “going to be very difficult,” Cole said. Even so, “you do it more through incentives than you do through penalties and this bill is full of penalties and not incentives.”

The House won’t pursue other legislation before the November election because “the big thing is going to be the election,” Representative Wally Herger, a California Republican who leads the health subcommittee of the Ways and Means Committee, said in an interview. “Everybody is looking to the election, everything is second fiddle to November.”

Unless Republicans win the presidency and control the Senate majority next session, their attempts to repeal the law will go no further than the House.

“This is another of their message weeks dedicated solely to the politics of their base,” House Minority Whip Steny Hoyer, a Maryland Democrat, said of the Republican efforts.

Court’s Decision

The U.S. Supreme Court’s June 28 decision upholding the core of the health care law, known as the Patient Protection and Affordable Care Act, will energize voters who oppose it, said Representative Jim Jordan, an Ohio Republican who leads the Republican Study Committee.

The justices, voting 5-4, said Congress can require Americans to carry insurance or pay a penalty, which the court said was within lawmakers’ constitutional power to tax. Hospital company HCA Holdings Inc. (HCA:US) rose after the ruling, as did Medicaid insurer Molina Healthcare Inc. (MOH:US) Commercial carrier WellPoint Inc. (WLP:US) fell as a result of the law’s regulations.

The ruling “probably helps our side,” Jordan said at a Bloomberg Government breakfast yesterday. He said Republicans may reignite their success from 2010 when Democrats lost control of the House. Democrats provided all of the votes to pass the health overhaul.

219 Bills

The Republican Study Committee has compiled a list of 219 bills that address repeal and individual pieces of a health care overhaul. Proposals include letting seniors delay enrollment in Medicare until age 70 without risking their Social Security benefits; allowing the purchase of health insurance across state lines and providing a tax deduction for the cost of health insurance and unreimbursed prescription drugs.

“I doubt” that all the proposals backed by Republicans would receive votes this year, Jordan said at the breakfast.

While Republicans have crafted alternative proposals, the party doesn’t want to advance them now because discussion of them “diverts the debate away from the economy” and the flaws of Obama’s health-care law, Herger said.

Republican proposals may become a target of attacks by Democrats who “have nothing to run on so they are looking for anything to divert the debate,” Herger said.

Boosting Jobs

Instead, House Speaker John Boehner, Majority Leader Eric Cantor, a Virginia Republican, and Majority Whip Kevin McCarthy, a California Republican, are casting the law’s repeal as an effort to boost jobs, particularly among small businesses.

Boehner, an Ohio Republican, said yesterday at a press conference in Washington that he visited his home state and “people kept asking the same question: ‘Where are the jobs?’ That’s why this week the House will vote to repeal Obamacare, which is driving up the cost of health care and making it harder for small businesses to create jobs.”

When asked what steps House leaders would take to replace the law after a repeal, Boehner spokesman Michael Steel said in an e-mail: “First, we need to repeal this law, which is making it harder for small businesses to create jobs, then we can move on to step-by-step, common-sense reforms that will actually lower costs.”

Steel didn’t say what those steps would be.

Floor Time

Democrats criticized House Republicans for devoting several days of floor time this week to the repeal bill, H.R. 6079, saying they should be advancing legislation focused on job creation.

“I want lots of time on a jobs bill” instead of debating a repeal that is “going nowhere,” Representative Jim McGovern, a Massachusetts Democrat, said during a House Rules Committee meeting July 9.

“You don’t have a plan,” Representative Alcee Hastings, a Florida Democrat, told Republicans at the meeting.

The House passed a repeal resolution in 2011 instructing committees that oversee health-care policy to craft legislation that would “increase the number of insured Americans,” including those with pre-existing conditions. It also sought proposals to overhaul the medical malpractice system and lower health-care premiums by promoting competition among insurers.

Punitive Damages

Since then, the House has voted to cap punitive damages for medical malpractice at $250,000. Proponents say this would reduce the incentive for doctors to practice “defensive medicine” by ordering expensive tests to avoid being sued for malpractice.

The Republican-led House passed legislation to prohibit government funding of abortions under the health-care law. It voted to abolish an independent board set up to propose ways to curb Medicare spending.

Other proposals have languished in committee without floor debate. They include a proposal by Georgia Republican Paul Broun to raise to $10,000 the maximum amount people can contribute each year to health savings accounts.

Illinois Representative Judy Biggert, whose re-election is rated a tossup by the nonpartisan Cook Political Report, said she wished her fellow Republicans would spell out for voters some health care alternatives they would try to enact.

Lawmakers should present their proposed changes “right away,” Biggert said in an interview. She said Congress “absolutely should keep” some provisions, such as one allowing young adults to remain on their parents’ plan until age 26.

Targeting Republicans

The Democratic Congressional Campaign Committee yesterday targeted several Republicans in close races, including Reid Ribble of Wisconsin, by issuing a release that accused them of protecting their health care benefits by supporting repeal.

“Congressman Ribble will vote to give himself lifetime guaranteed government health care, rather than having the same health care as his constituents,” Jesse Ferguson of the Democratic campaign committee said in the press release.

Before the Supreme Court’s decision, Dean Clancy, the health-care policy director for FreedomWorks, wrote in a June 21 memo that Boehner “has gone out of his way to assure us” that House Republicans “are still firmly on board with a full repeal.” FreedomWorks is aligned with the anti-tax Tea Party movement.

Clancy said he was told Boehner “won’t try to preserve or re-enact the supposed ‘good’ parts of Obamacare,” such as letting parents keep children on their plans until they’re 26.

Still, Clancy wrote that Republicans are politically vulnerable from “their long-standing hesitation to be too specific about what they’d do on the ‘replace’ side of the ‘repeal and replace’ agenda.”

The House repeal legislation, after this week’s vote, will die in the Senate. Senate Minority Leader Mitch McConnell, a Kentucky Republican, said yesterday that Republicans in that chamber will seek a repeal vote in “the near future.”

To contact the reporters on this story: Roxana Tiron in Washington at rtiron@bloomberg.net; James Rowley in Washington at jarowley@bloomberg.net

To contact the editor responsible for this story: Jodi Schneider at jschneider50@bloomberg.net


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