The House Republican rank and file has successfully convinced its leadership, more than 40 times now, to hold votes on repealing various segments of the president’s health care law. But can it convince GOP leaders to bring up a new bill that would replace Obamacare entirely?
Rep. Steve Scalise, R-La., thinks there’s substantial interest in and enthusiasm for a 181-page measure painstakingly drafted by a working group within the conservative Republican Study Committee, of which he is the chairman.
“This would be a great bill even if there was no Obamacare,” Scalise said at a Wednesday afternoon news conference convened to unveil the legislation.
The measure’s first item of business is to fully repeal the current health care law to give Congress, in Scalise’s words, a “clean slate.”
Though supporters insist the measure maintains support for people with pre-existing conditions — a hallmark of Obamacare — it appears to allow insurance companies to deny coverage to those with pre-existing conditions if they experience a gap in coverage. A bill summary described the provision as guaranteeing "that individuals with pre-existing conditions can move between the large group, small group, and individual health insurance markets, so long as they maintain continuous coverage."
When Obamacare fully takes effect next year, insurance companies will be prohibited from denying coverage based on pre-existing conditions.
The RSC bill would provide $25 billion over 10 years to bolster state-run, high-risk pools, a “federalist solution to address a segment of the population that has been unable to obtain affordable insurance,” the summary states.
The wide-ranging bill also would overhaul the ways in which medical malpractice lawsuits are brought to court; allow people to purchase health insurance across state lines; create a tax incentive for parents who establish a deferred-use health savings account for a child before he or she turns 5; and expand opportunities for disabled veterans to contribute to their HSAs regardless of whether they have dipped into Veterans Affairs medical services in the past three months.
The bill also would not require health plans or providers to cover abortions and would prohibit federal funds from covering abortion except in cases of rape, incest or when the life of the mother is in danger.
Because the legislation has only just been formally filed, leadership has not yet committed to bring up the bill. But Scalise anticipates it would be subject to hearings and markups in a variety of committees, as was the case with the Affordable Care Act.
The primary committee of jurisdiction, Scalise said, would be the Energy and Commerce Committee, and Chairman Fred Upton, R-Mich., is reportedly enthusiastic.
“The committee continues to be encouraged by the wealth of Republican ideas to strengthen the American health care system,” a spokeswoman with the committee said in an email.
Sources also say the measure has support from key conservative advocacy groups such as the Club for Growth and Heritage Action for America, organizations that have the muscle to make or break bills.
But unless it gets establishment support, the bill's chances for survival in an all-too-busy Congress are dim.
“It has a lot of smart, innovative, conservative reforms,” a GOP leadership aide said, but “the focus right now is on defund and delay.”