WASHINGTON — Congressional Republicans, who once promised to “repeal and replace” President Barack Obama’s health care law, for now have all but given up pushing alternatives to the sweeping legislation the president signed in 2010.
In the last year and a half, House Republicans have sent the Senate just one 36-page bill designed to limit medical malpractice lawsuits, despite pledging to develop detailed legislation to slow rising health care costs, help Americans keep their health plans and broaden access to insurance.
And, as the House prepares to take its 33rd vote to repeal all or part of the Affordable Care Act, senior Republicans say they will not try to move a replacement plan until 2013 at the earliest. “There might be a chance for us to do this next year,” House Rules Committee Chairman David Dreier, R-Calif., said Tuesday.
At the same time, GOP lawmakers are rejecting the notion that any replacement legislation should expand health coverage as much as the current law.
“Conservatives cannot allow themselves to be browbeaten for failing to provide the same coverage numbers as Obamacare,” Sen. Orrin Hatch, R-Utah, told a gathering at the conservative American Enterprise Institute this week.
Repeal bill stuck
Many Republicans say it makes little sense to write replacement legislation when they can’t get a repeal bill through the Democratic Senate. “I’m perplexed by this obsession with the replace part when the repeal hasn’t occurred,” said House Republican Policy Committee chairman Tom Price, R-Ga.
But the retreat from a central 2010 campaign promise to deal with the nation’s health care problems has prompted even some conservative health care experts to say Republicans owe voters more detail about how they would control costs and protect sick and poor Americans.
“One of the big questions that the public needs to ask Republicans who are so focused on repeal is what will come in its place,” said Gail Wilensky, who headed the Medicare and Medicaid programs under President George H. W. Bush and advised Sen. John McCain, R-Ariz., during his 2008 presidential campaign.
Tom Miller, resident fellow at the American Enterprise Institute, said it isn’t enough for the GOP to simply talk about limiting government and empowering markets. “We need to swap some myths and miracles for real progress,” he said.
Clear on principles
Republican lawmakers say they have been clear about their broad principles for health care, including controlling costs, giving patients more choices and limiting government involvement.
“I just don’t think government does big things well,” said Sen. John Barrasso of Wyoming, a physician and leading critic of the Affordable Care Act.
Individual GOP lawmakers also have sponsored numerous health care bills that would reduce state regulations on insurance companies, encourage small businesses to pool together to buy health plans and change the way that insurance is treated under the tax code.
And conservative policy experts at the Heritage Foundation and elsewhere have outlined comprehensive plans to address rising health care costs while assuring broad protections for the poor and the sick.
But Republican leaders have not brought any of these proposals to a vote.
That has shielded the party’s ideas from close scrutiny by independent analysts, a politically risky process that could highlight legislation’s costs and its impact on consumers and others.
Such scrutiny proved embarrassing for House Republicans in 2009 when they proposed a detailed alternative to the health care legislation that Democrats were developing at the time.
The nonpartisan Congressional Budget Office concluded the GOP proposal would have left more than 50 million Americans without health insurance and reduced costs for healthy people while raising them for the sick.
Similar study of the House Republicans’ 2011 budget plan indicated that a proposal to make Medicare beneficiaries shop for commercial insurance with a government voucher would leave seniors paying thousands of dollars more for their health care.