The Tribune - Two House GOP Members Announce Their Alternative to Obamacare

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By William L. Spence

Two congressional Republicans unveiled the modestly named "World's Greatest Health Care Plan" this week, saying it offers states and consumers a viable alternative to the Affordable Care Act.

House Rules Committee Chairman Pete Sessions, R-Texas, noted the legislation doesn't completely repeal Obamacare. For example, restrictions prohibiting insurance companies from denying coverage for pre-existing conditions are left in place.

However, the bill does eliminate the mandates requiring most individuals and employers to purchase health insurance or provide it for their employees. It also removes some of the "minimum essential benefits" health plans are required to provide.

"The only way to repeal Obamacare is to have 60 votes in the Senate (to block a filibuster) and a Republican president," said Sen. Bill Cassidy, R-La., who co-sponsored the bill with Sessions. "If we get that, then the whole thing goes away. But we can't do nothing waiting for the stars to align."

The centerpiece of their bill is a transferable tax credit of $2,500 per person or $1,500 per child. Consumers could use the tax credit to purchase basic insurance themselves; alternatively, they could put the money into a health savings account and pay their medical expenses directly or transfer the credit to an employer to help pay for a company health plan.

"For years I've had people ask me, 'Where's the Republican health care alternative,' " Sessions said. "That's what we're bringing today. We believe there should be a healthy debate about the options available to those who choose not to participate in Obamacare or who don't qualify for premium subsidies."

Although Obamacare has helped drive the country's uninsured rate to its lowest level in history, there are still millions of Americans who lack health insurance, either because they object to the mandate, don't qualify for premium subsidies or can't afford the deductibles.

Cassidy, who is a physician, said the "World's Greatest Health Care Plan" provides equal tax treatment for everyone, by offering them the same tax credit. It also lets consumers decide for themselves whether to stick with Obamacare, buy private insurance or rely on the health savings account.

In a meeting with reporters, Sessions and Cassidy were vague about how to pay for the plan, although they said budget experts assured them the net cost would be minimal.

Some savings might come from the Medicaid "payment reforms" that are included in the bill. Sessions said it would turn Medicaid into a block-grant program, with states receiving funding based on the overall number of patients, rather than the specific services provided.

Cassidy noted the measure also gives states the ability to opt out of Obamacare. In addition, it gives them authority to create their own "opt-out" catastrophic health program for uninsured individuals.

Under this approach, "passive" individuals who don't want to take control of their own health care decisions would automatically be enrolled in a catastrophic health insurance program and related health savings plan.

"If you don't do anything, that's what you'd have," he said. "If you want to be more proactive, you can (opt out of the catastrophic plan) and pool your resources to buy a different plan."

Opt-out programs typically have much higher participation rates than what states are seeing under Obamacare, Cassidy said, so this could help expand the risk pool and lower costs. States that go this route would receive a payment equal to 25 percent of the individual tax credit to help pay for the catastrophic insurance.

Given that Congress will be on recess for much of the summer, it's unlikely the bill will advance this year, but it could provide a blueprint for congressional Republicans following the November election. Sessions said they're willing to discuss the proposal with the major presidential candidates, but have not done so yet.

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