While many Americans are skeptical of President Barack Obama's
healthcare overhaul, they also tell lawmakers they worry about
keeping their costs from getting out of control. For those voters, a
party that offers a platform to repeal the 2010 law without anything
to replace it may not be very attractive.
As a result, lawmakers from both the establishment wing of the
Republican Party and the more fiscally conservative small-government
proponents in the Tea Party movement are exploring healthcare
U.S. House of Representatives Speaker John Boehner of Ohio said it
would be a major topic at a Republican retreat next week.
"We need to present the American people with a positive," said
long-time Senator John McCain of Arizona, who in 2008 had a detailed
healthcare reform plan as the Republican Party's presidential
candidate against Democrat Obama.
"A number of people are working on it, and we've come up with the
various provisions, and now hopefully we're going to put together a
Republican package" on healthcare, McCain told Reuters outside the
Senate last week.
Several bills have already been introduced by Republicans in the
House and Senate but no single plan has yet emerged.
Some start with the repeal of the Patient Protection and Affordable
Care Act — a move that would almost certainly be vetoed by Obama if
it passed both chambers, which is unlikely as long as Democrats hold
Some bills propose new tax credits or deductions to help people pay
for health insurance.
The law, commonly called Obamacare, passed Congress in 2010 as the
most sweeping U.S. social legislation in 50 years and survived a
legal challenge by opponents in the U.S. Supreme Court in 2012.
It requires most Americans to buy insurance, offers subsidies to
help low-income people receive coverage and sets minimum standards
for coverage. It aims to dramatically reduce the number of Americans
who lack health insurance policies.
Instead of starting with a total repeal, Republican Senator Ron
Johnson of Wisconsin has suggested transition legislation that might
initially eliminate some provisions such as mandatory coverage of
maternity care and move people with pre-existing conditions into
high-risk insurance pools.
Some Tea Party-backed House conservatives also are urging action,
arguing that it may no longer be enough to simply denounce Obamacare
as lawmakers start campaigning for congressional elections in
"What's our alternative to this terrible thing called Obamacare?"
asked Representative Jim Jordan of Ohio at a recent lunch meeting of
House Republican conservatives.
Another conservative, Representative Raul Labrador of Idaho, said
that if Republicans want to win in 2014, they should start "letting
the American people know what we are for."
Boehner, who has presided over dozens of House votes to limit or
curtail Obamacare, said that at their annual retreat January 29-31,
House Republicans would discuss a plan to make healthcare insurance
more accessible and affordable.
WHAT DO REPUBLICANS WANT?
Republicans have opposed the law for years. They say Obamacare
relies too heavily on mandates and results in too much government
interference in the marketplace.
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They point to the rocky rollout of the Obamacare website last
October as evidence of flaws in the law. But analysts wonder whether
they can unify around an alternative.
"The Republicans historically had a lot of health care bills ... The
Republicans never coalesced around a single bill, and that was the
political weakness of the Republicans," said Bob Moffit, a senior
fellow at the conservative Heritage Foundation who was a top health
official under President Reagan.
The administration says Obamacare is settled law now.
Vice President Joe Biden on Thursday touted popular provisions such
as prohibiting insurers from rejecting people with pre-existing
conditions. "We will not go back. America has turned the page."
Republicans are not averse to cherry-picking some of the more
popular bits of Obamacare. Two separate House Republican proposals
would address the needs of people with pre-existing conditions
through state-run "high-risk" insurance pools.
A House bill by Representative Tom Price of Georgia, an orthopedic
surgeon, has been introduced for three Congresses in a row but has
not had a single hearing or vote while Republicans have been more
focused on trying to stop Obamacare.
Price's bill proposes using refundable tax credits based on income
to help Americans with the purchase of health insurance plans.
McCain introduced a similar bill in the Senate.
A bill by Republican Representative Phil Roe of Tennessee would
apply a standard tax deduction to help Americans pay for insurance.
It has 122 co-sponsors and has been embraced by the Republican Study
Committee, the largest bloc of House conservatives.
"No bill does everything," Roe, an obstetrician, said in a telephone
interview. "Let's debate the differences ... I think people want to
hear that there are alternatives out there."
Some outside conservative groups also like the idea of alternatives
to Obamacare. FreedomWorks is surveying its six million members on
ideas and will release the results in March.
Matthew Green, a professor of political science at Catholic
University, thinks it was inevitable that Republicans would move
from just opposing Obamacare to proposing alternatives.
"You can only get votes for so long from people saying, 'I oppose
the status quo'," Green said.
(Additional reporting by Richard Cowan and David Morgan;
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