WASHINGTON – After months of criticizing Democratic health care proposals from the sidelines, House Republicans this week began presenting their plan, an effort intended to undercut the portrayal of the GOP as the “party of no.”
Unlike the Democrats’ strategy of trying to provide near-universal coverage and force other major changes to the insurance system, the Republican approach is an incremental one with a different goal – controlling health care costs.
GOP lawmakers propose to do so through market-oriented measures that would limit medical malpractice lawsuits, expand the use of tax-sheltered medical savings accounts, let people shop for insurance outside their own states and make it easier for small businesses and hard-to-insure people to get coverage. Those are ideas that reflect conservatives’ suspicion of sweeping new programs, federal spending and additional regulation.
The GOP plan is, by design, a less costly bill with more modest ambitions. Its price tag, which is still to be determined, surely will be far less than the House Democratic bill. According to the nonpartisan Congressional Budget Office, the cost of that plan would exceed $1 trillion over 10 years.
The Republican bill lacks many major elements of the Democratic proposal: There is no expansion of Medicaid, no requirement that individuals buy insurance, no penalties for employers that do not offer coverage, and no subsidies to help the needy pay premiums.
In addition, the GOP proposal does not include one of the most popular elements of the Democrats plan – a ban on denying coverage to individuals with pre-existing medical conditions.
But the GOP plan has adopted some of the more modest Democratic provisions. It too would make it easier for young adults to remain on their parents’ health policies. It would also end the controversial insurance practices of imposing annual or lifetime limits on benefits and of canceling coverage after a policyholder becomes sick.
But rather than give more power to the federal government to address the nation’s health care problems, the Republican plan looks to states, market forces and individuals.
Their bill would provide aid to the states to form “high risk” insurance pools that would cover people – including those with pre-existing conditions – who cannot get coverage through their jobs or in the individual market.