Senators Richard Burr of North Carolina, Tom Coburn of Oklahoma
and Orrin Hatch of Utah released a legislative blueprint that
analysts say could help the Republican Party offer a much-needed
vision for healthcare ahead of November's mid-term congressional
elections, voting that will determine which party controls Congress
in the final two years of the Obama presidency.
The proposals came a day before Obama is scheduled to defend his top
domestic policy in his State of the Union address on Tuesday night.
"The American people have found out what is in Obamacare — broken
promises in the form of increased healthcare costs, costly mandates
and government bureaucracy. They don't like it and don't want to
keep it," Burr said in a statement.
Obama's Patient Protection and Affordable Care Act has extended
health coverage to millions of people, despite a botched October
rollout. The administration says 6.3 million people have signed up
for private insurance as a result of implementation. A similar
number have been determined eligible for Medicaid coverage.
The Republican alternative — dubbed the Patient Choice,
Affordability, Responsibility and Empowerment Act, or CARE Act — would repeal Obamacare's mandates, taxes and fees and replace the
law with what aides called "common-sense, patient-centered" reforms
intended to lower costs.
As with earlier Republican initiatives, the approach would address
costs by making consumers responsible for more of their medical
bills, with assistance from health savings accounts funded with
pre-tax dollars that could be used to pay for insurance premiums as
well as healthcare services.
The plan would keep in place two popular Obamacare provisions by
banning lifetime limits on insurance benefits and allowing adult
children to stay on their parents' health plans until age 26. It
would scale back Obamacare subsidies to help lower-income people buy
private insurance, allow insurers to charge older people more and
protect the sick against insurance market discrimination only if
they remain continuously insured.
Medicaid, the program for the poor, which Obamacare would expand to
Americans with incomes of up to 138 percent of the federal poverty
level, would be limited to mothers, children and the frail. Federal
payments would be capped but states would receive greater
flexibility to run their own Medicaid programs.
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Funding for the CARE Act would come mainly from new federal taxes on
employer-sponsored health plans, which are currently excluded from
taxation. The Republican proposal would make 35 percent of a plan's
value taxable for employees but keep employer tax deductions
At the same time, it would leave in place as estimated $700 million
in reduced payments to Medicare, while lawmakers seek a separate
bipartisan agreement on how to reform the program for the elderly
The White House was dismissive. "This looks very much like just
another repeal proposal, another attempt to raise taxes on the
middle class, to keep uninsured Americans with pre-existing
conditions locked out of the market, to raise costs on seniors and
to take away Medicaid from the millions of Americans," White House
spokesman Jay Carney told a briefing.
But analysts said the proposal could help Republicans in the coming
"It gives them an opportunity to talk about these things in a more
positive way than just repeal and replace," said Joseph Antos of the
American Enterprise Institute, a conservative Washington think tank.
Republicans have already made Obamacare a major campaign issue in
hopes of leveraging the law's unpopularity into active voter support
in November. Republicans voted to repeal, defund or dismantle the
law more than 40 times in the House of Representatives.
Of likely U.S. voters, 43 percent view Obamacare at least somewhat
favorably, while 52 percent have an unfavorable view, according to a
Rasmussen Reports poll released on Monday.
But there is no consensus on how to replace the law and party
leaders believe it important enough to offer a positive vision that
House Republicans have made it a major topic for their annual
retreat this week.
(Additional reporting by Roberta Rampton;
editing by Steve Orlofsky)
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