Republicans aimed to erase doubts about whether they plan to replace Obamacare, pointing to a series of bills they say will start rebuilding the healthcare marketplace.
“We know on our side we are gonna repeal Obamacare,” Rep. Greg Walden, R-Ore., chairman of the House Energy and Commerce Committee, said during a subcommittee hearing Thursday on the four bills, three of which were introduced in prior Congresses and one recently drafted. “We have to save this individual healthcare market. It is collapsing.”
But Democrats blasted Republicans for wanting to repeal the law without an immediate replacement and chided Walden’s new draft bill on protecting people with pre-existing conditions, an unusually popular provision of the law.
The committee will hold a pivotal part in the debate over Obamacare, as it is one of four panels in the House and Senate tasked with creating repeal legislation.
While three of the bills were considered in the last Congress, the committee also considered a new bill that aims to maintain coverage safeguards for people with pre-existing conditions such as diabetes or cancer.
The draft bill issued from Walden isn’t complete, as it has placeholder language for new patient protections in the individual and small group markets.
“It is literally half-written,” said Rep. Frank Pallone of New Jersey, the top Democrat on the Energy and Commerce Committee. “The chairman’s bill literally runs off the page.”
He added that the individual market, which is for people who don’t get insurance through their job and includes Obamacare’s exchanges, isn’t collapsing under its own weight.
“The reason the [Affordable Care Act] is gonna have problems here is because you and the president are purposely. in my opinion. making it collapse because of the policies you are espousing,” he said, referring to the Trump administration pulling some Obamacare ads.
Wyden defended his bill, saying that it is a starter for discussions with both parties.
“There are some opportunities to weigh in,” he said. “That is what a legislative process is supposed to look like.”
The other bills were introduced in other Congresses but didn’t go anywhere.
One of the bills aims to give states more flexibility for age-rating ratios. The ratio governs how much more insurers can charge seniors compared to what they charge younger patients.
Currently, the Affordable Care Act calls on all states to have a 3-1 ratio, meaning that a plan can charge a senior only three times the premium what a younger person pays.
Before the law, the average ratio was about 5-1. The bill would raise the ratio to 5-1 across the country, but give states the ability to loosen or widen the formula.
The committee pointed to a report from the nonpartisan Congressional Budget Office that showed the true cost of healthcare for an average 64-year-old was roughly 4.8 times more than costs for the average 21-year-old.
Another bill aims to require patients who get insurance through special enrollment periods to provide verification before getting a plan. A special enrollment period allows a person to enroll in Obamacare year-round, and there are periods for circumstances such as getting divorced or losing your job and healthcare coverage.
But the periods have become a headache for insurers, who say that too many people are using the periods to enroll for coverage when they get sick and drop out when they are better. That hampers insurer finances because people don’t stay in the markets and pay premiums long enough.
The administration has tried to clamp down on special enrollment periods due to complaints from insurers.
The last bill also would shrink the grace period for when a person getting Obamacare tax credits has to pay their premiums.
“Theoretically, this means patients receiving the advance premium tax credits and cost-sharing reductions can pay for only nine months of health insurance, but receive a full year of coverage,” a committee memo said. The bill would change the grace period to one month to ensure people don’t game the system.
