Seizing on the public's continued anxiety over the ObamaCare rollout, a trio of Republican senators on Monday unveiled a sweeping alternative proposal they say would gut the law's mandates and taxes while preserving consumer protections.
Sens. Orrin Hatch, of Utah; Tom Coburn, of Oklahoma; and Richard Burr, of North Carolina, announced their plan one day before President Obama delivers his State of the Union address. It is his first such address since the launch of the state and federal health care exchanges.
The GOP proposal, dubbed the Patient Choice, Affordability, Responsibility and Empowerment Act, would repeal the president's marquee legislative achievement while instituting new reforms the senators say would give states and individuals more flexibility and purchasing power.
"Americans deserve a real alternative, and a way out," Coburn said.
Under the plan, insurances companies would not be able to impose lifetime limits on patients and would be required to allow dependent coverage up to the age of 26, as ObamaCare currently does. The Republican proposal would address the issue of pre-existing conditions by creating a new "continuous coverage" standard that would prevent any individual moving from one insurance plan to another from being denied on the basis of a pre-existing condition so long as that individual was continuously enrolled in a health plan.
The requirements on individuals to buy insurance, and on mid-sized and large businesses to provide it, would be repealed.
Senate aides describing the proposal acknowledged there's little chance of movement in the current Congress, where Democrats control the Senate and have resisted all Republican-led House attempts to repeal or chip away at ObamaCare. Still, the aides said they hope continued public dissatisfaction with the way the law is being implemented might shore up the efforts of Hatch, Coburn and Burr. A new Associated Press-GfK poll shows that while negative perceptions of the new exchanges have eased, 66 percent of Americans say the rollout is not going well.
"The American people have found out what is in ObamaCare -- broken promises in the form of increased health care costs, costly mandates and government bureaucracy," Burr, a North Carolina Republican, said in a statement. "We can lower costs and expand access to quality coverage and care by empowering individuals and their families to make their own health care decisions, rather than empowering the government to make those decisions for them."
While the House has introduced and passed dozens of bills to repeal some or all of the health care law, as a minority in the Senate, Republicans have struggled to get votes on ObamaCare-related bills or amendments. They have instead focused on highlighting what they describe as flaws in the law during speeches or press conferences.
In their most notable legislative assault on the law, Republicans late last year tried to defund the law in a standoff that fueled a partial government shutdown. Democrats consistently have hit the GOP for criticizing the law without offering a comprehensive alternative -- something the Burr-Coburn-Hatch measure is surely aimed at countering.
Their proposal calls for the targeted use of tax credits to help individuals buy health care. Employees who work for a small business with 100 or fewer employees would be able to receive a credit while those whose annual income is 300 percent of the federal poverty level could receive an age-adjusted refundable tax credit to buy health coverage. Small businesses would also be allowed to band together and purchase insurance, even across state lines.
To help offset the costs of the plan, the senators would maintain ObamaCare's cuts to Medicare and also eliminate the unlimited tax exclusion of employer-provided health coverage, instead capping the employer's tax exclusion at 65 percent of an average plan's cost.
There is currently no official estimate of the bill's cost. However the group said it is designed to be "roughly budget neutral" over a 10-year period.
Under the plan, Medicaid reforms would enable eligible individuals to opt out and take advantage of a health credit to purchase coverage, while enrollment would be capped. Federal funds would be distributed to states according to the number of low-income individuals at or below 100 percent of the federal poverty line but would reflect demographic and population changes, according to the senators.
Rounding out the plan would be a series of medical malpractice reforms and disclosure rules that would require insurers to list covered items and services as well as any limitations or restrictions. Eventually, the senators said they hope to work with colleagues and introduce formal legislation to implement these reforms.
"It's critical we chart another path forward," said Coburn, a medical doctor. "Our health care system wasn't working well before ObamaCare and it is worse after ObamaCare."