By Tom Howell, Jr.
With a major Obamacare sign-up deadline past, Republicans are turning their attention to the “replace” half of their repeal and replace strategy, hoping to make up ground lost over the past four years as they seek to show voters that they have an alternative to the president’s health care overhaul.
Retired surgeon Ben Carson sat down with the House Republican health care caucus Thursday to hash out ideas. The doctor urged lawmakers to set some deadlines of their own for writing a plan.
“It doesn’t do any good to have a lot of good ideas but not to get behind one and really push it,” said Mr. Carson, who has been mentioned as a potential Republican presidential contender.
The first enrollment period for Obamacare has ended, and President Obama has claimed success with the sign-ups of 7.1 million Americans in the federal and state health insurance exchanges set up under the law.
Democrats say the final tally means millions now have coverage thanks to provisions that prohibit caps on spending and prevent companies from denying insurance for pre-existing health conditions. They argue that a repeal by Republicans would leave all of those Americans worse off.
Republicans were already under pressure to elucidate how their vision contrasts with that of the Democrats they hope to unseat in November’s midterm elections, and to offer a realistic alternative to Obamacare.
House Speaker John A. Boehner, Ohio Republican, said this week that the party is seeking consensus around an alternative plan.
Louisiana Gov. Bobby Jindal offered one version, which calls for block grants to give states the option of offering subsidized plans to low-income residents on the condition that people with pre-existing conditions are not denied coverage. Three Republican senators offered a comprehensive blueprint in January.
On Thursday, House members, Sen. Rand Paul and Mr. Carson discussed expansion of health savings accounts. Republicans see the model as a practical tool with tax advantages that allow Americans to take control of their own health care spending.
Mr. Carson is leading the Save Our Healthcare project for the American Legacy PAC. He released a set of principles Thursday that he said would promote individual and state flexibility over a top-down approach to health care reform from Washington. A step-by-step plan will follow soon, the political action committee says.
The GOP alternative
The various Republican plans share certain principles. Each would let states take the lead in administering health care programs and covering people with pre-existing conditions through block grants or continuity clauses, rather than taking the Obamacare approach of mandating individuals to acquire coverage to balance risk pools.
“When people say Republicans don’t have a plan, really it’s because they haven’t been paying attention or we haven’t gotten the message out well enough,” said Mr. Paul, a Kentucky Republican and potential presidential contender who attended the Carson meeting.
Mr. Paul said many of the plans offered through Obamacare exchanges have high deductibles, “and you’re going to find thousands of people — hundreds of thousands of people — who are going to complain about how much they have to pay out of pocket. A health savings account would help them.”
It’s doubtful that any of the Republicans’ plans would pass this year because Democrats control the Senate and have rejected all but the smallest of changes to the Affordable Care Act.
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