* Republicans pledge new health plan if Supreme Court acts
* New legislation could aid party?s election year aims
* Aides see step-by-step approach on health issues
By David Morgan
WASHINGTON, April 22 (Reuters) ? Republicans in Congress are
getting ready to answer an election-year question that has
dogged the party?s campaign for months: How would it replace
President Barack Obama?s healthcare law if the measure is
overturned or repealed?
House Republicans are working to create a legislative
blueprint they can sell to voters after the Supreme Court rules
on Obama?s Patient Protection and Affordable Care Act, the
nation?s most sweeping healthcare legislation since Medicare and
Medicaid in the 1960s.
Lawmakers and their aides say a Republican plan would focus
on controlling healthcare costs and allowing people to retain
coverage while changing jobs. They will avoid Obama?s
comprehensive approach to extend coverage to 32 million
uninsured Americans.
The aim is to lay out a prospective agenda for the newly
elected political leadership in 2013, based on a ?step-by-step?
approach consisting of separate bills that address specific
problems within America?s $2.6 billion healthcare system.
But if the high court justices struck down the entire law,
Republicans could try to salvage some of the Affordable Care
Act?s provisions that are already in force and have proved
popular with voters.
Representative Tom Price, an orthopedic surgeon who heads
the House Republican Policy Committee, said stopgap legislation
could be crafted for 2012 if the court ended health insurance
safeguards for young adults and children with pre-existing
medical conditions.
?That would present a significant void and vacuum in health
policy,? Price said. ?There will be a need to have some things
to fill that vacuum.?
But a Senate Republican aide said there would be no need for
Congress to act this year if necessary adjustments could be
achieved by the administration alone or by industry.
?There?s a lot of shadow-boxing going on,? said one
healthcare industry lobbyist.
Closed-door discussions have not yet turned to specific
legislative options, w hich may be drawn from a swath of
previously proposed Republican legislation. But some say a
consensus between leaders and key committee chairmen could
emerge as early as the May 28 Memorial Day holiday, weeks before
a Supreme Court ruling widely anticipated for June.
?When the Supreme Court acts, we will be ready with plans
that actually work to lower the cost of care and to help people
keep the care they want,? said Republican Senator John Barrasso,
another orthopedic-surgeon-turned-legislator who is Price?s
policy counterpart in the Senate.
A DEMOCRATIC PLAN, EVENTUALLY
The Affordable Care Act , Obama?s signature domestic
achievement, introduces new consumer protections and encourages
market innovations intended to improve the quality of care while
eventually lowering costs.
But 26 states and an independent business group asked the
Supreme Court to overturn the law on grounds that it exceeded
the federal government?s constitutional authority by requiring
most Americans to buy health insurance and imposing a dramatic
expansion of the federal-state Medicaid program for the poor.
The court?s impending decision, which would land in the
middle of the 2012 campaign battle for control the White House
and Congress, could strike down all or part of Obama?s reform
act, or leave the two-year old package in place.
Whatever the outcome, the decision is expected to kick off
an aggressive new chapter in the election campaign that will
spotlight healthcare far more prominently, according to analysts
and lobbyists.
There has been no word on whether House Republicans are
consulting with the party?s presumptive presidential nominee
Mitt Romney, who has proposed his own set of market-oriented
healthcare reforms and has vowed to kill Obama?s healthcare law.
Up to now, Republicans on the campaign trail have chiefly
attacked ?Obamacare? and vowed to repeal it, leaving them
vulnerable to charges the party has no credible reform plan of
its own.
?They need something positive. ?Repeal? alone is negative,
and people want consequential health reform that solves real
problems that are facing them,? said Robert Moffitt of the
Heritage Foundation, a conservative think tank that has
contributed reform ideas to both sides of the partisan aisle.
Moffitt and James Capretta of the conservative American
Enterprise Institute advocate an approach they say would make
consumers more cost-conscious.
It would move away from the current tax break for
employer-sponsored healthcare, in exchange for fixed tax credits
that would help cover the cost of individual plans sold in a
competitive marketplace. Consumers would have to bear any cost
over the fixed tax credits.
In an article titled ?How to Replace Obamacare,? in the
current edition of the quarterly journal National Affairs, the
two analysts also call for changing existing laws to protect
people with pre-existing conditions and adopting policies that
would better encourage reform initiatives at the state level.
Similar ideas and others have been circulating for years in
Republican legislative proposals that have never become law.
Some call for insurance reforms allowing individuals to buy
insurance from other states or for letting small businesses,
churches and civic organizations form new insurance pools.
Proposals also would protect doctors and other healthcare
providers from malpractice suits and convert Medicare into a
program that provides vouchers to help the elderly and disabled
meet the cost of purchasing private insurance.
But some of those ideas have been found wanting in the past.
In 2009, the nonpartisan Congressional Budget Office
examined a Republican proposal that sought to allow the
interstate sale of insurance, imposed medical malpractice
reforms and offered incentives for state-level reforms.
The CBO found the plan would cut the deficit by $68 billion
over 10 years, extend coverage to only 3 million uninsured and
raise insurance rates for some, including those less healthy.
By contrast, the CBO has said the Affordable Care Act would
reduce the deficit by $132 billion through 2019.
The Obama administration is also showing signs of thinking
about what to do if the Supreme Court?s ruling proves
unfavorable.
Officials still say they are confident the Affordable Care
Act will be upheld and that their focus is on implementing its
provisions. But references to ?a plan? have begun to emerge in
recent comments by the White House and the Department of Health
and Human Services.
?We will eventually, I?m sure, have a plan. But that really
isn?t where all the time and energy is focused right now,?
Health and Human Services Secretary Kathleen Sebelius told
Reuters after a recent speaking engagement.
(Additional reporting by Thomas Ferraro; Editing by Michele
Gershberg and Peter Cooney)
Article source: http://www.reuters.com/article/2012/04/22/usa-healthcare-republicans-idUSL2E8FJH1K20120422
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