House Republicans this week will begin debating a series of healthcare reform proposals aimed at winning over GOP lawmakers who are reluctant to support the main GOP proposal to start whittling away at Obamacare.
The proposals would reform lawsuits for medical malpractice, allow health insurance purchases across state lines and eliminate the insurance industry’s antitrust protections in order to improve competition.
The measures, Republicans believe, would help lower the cost of health insurance much more than the 10 percent reduction over the next decade under the main GOP bill that is anticipated by the Congressional Budget Office.
“We have always acknowledged that we must move separate legislation to fully repeal and replace Obamacare with a patient-centered, free-market system,” said House Majority Leader Kevin McCarthy, R-Calif. “In the weeks to come, we will consider several bills to increase patient choice and market competition and prevent abusive medical lawsuits. These bills are just the beginning of phase three of our continued efforts to reform our healthcare system so it works for the American people.”
By moving the legislation alongside the Obamacare repeal-and-replace bill, Republicans hope to make the main bill attractive enough to cobble together a House majority.
It’s not clear, however, if the two-pronged approach will work in the Senate, where Republicans hold a razor-thin majority and can afford to lose only two GOP votes.
Sen. Bill Cassidy, R-La., said he has not decided whether he would support the House measure to repeal and replace Obamacare.
The bill would zero out most of Obamacare’s taxes and mandates and would replace subsidies with tax credits. Older people would pay more for health insurance, and the Medicaid expansion under Obamacare would be phased out and turned into a block grant program, which would reduce funding.
“I think the states should have the dollars to go to the expansion so they can still provide for low-income Americans,” said Cassidy, who has authored his own health insurance reform bill.
Cassidy said his decision on the bill could be influenced by McCarthy’s “sidecar” proposals, but he’s not confident they will survive a Senate filibuster.
The House plan to sell insurance across state lines may be attractive, for instance, Cassidy said, but might not pass the Senate, where eight Democrats would be needed to stop an expected filibuster.
“All that is subject to challenge,” Cassidy said of the GOP replacement proposals. “Put it this way. It is not a bird in the hand.”
Senate Minority Leader Chuck Schumer, D-N.Y., said last week that Democrats are willing to negotiate with the GOP on new health insurance reform measures if Republicans drop the Obamacare repeal provision.
But Republicans can pass the repeal-and-replace measure in the Senate without any Democrats by using a budgetary tool requiring only a simple majority.
The sidecar legislation, however, would require at least eight Democrats for it to advance in the Senate, but it would also be much more appealing to Democratic lawmakers than the repeal-and-replace measure and could win support from the party.
The antitrust legislation, for example, would likely have the support of many Democrats, who have advocated for similar legislation in the past. The legislation the GOP will offer is similar to a version authored by Rep. Pete DeFazio, D-Oregon, which has nine Democratic co-sponsors.
Minority Whip Richard Durbin, D-Ill., called the GOP sidecar legislation “cosmetic,” but did not pledge all Democrats would oppose it.
Sen. Angus King, a Maine Independent who votes with the Democrats, said he may support medical malpractice reform and a measure to allow health insurance purchases across state lines if it is included with a bill with other reforms.
“It’s got to be part of a bigger package,” King said. “I would have to see what else is in the package.”
Sen. Tim Kaine, D-Va., said he doesn’t oppose insurance purchases across state lines, but he believes it is already possible without new legislation.
“States can approve it already,” Kaine said. “There is no federal bar for it.”
Like King, Kaine seemed open to the idea of supporting malpractice reform.
“If it’s part of a whole series of reforms, I am not going to take anything off the table,” Kaine said.
