Republicans Step Up Progress on Obamacare Repeal

Published February 19, 2017

The U.S. House of Representatives is considering a bill that would repeal and replace the Affordable Care Act (ACA) as early as March of 2017, preceding by more than a year one of the  deadlines President Donald Trump has stated for repealing and replacing Obamacare.

House Speaker Paul Ryan (R-WI) has said the House should pass legislation repealing Obamacare before April, and the House Energy and Commerce Committee is one of several aiming to mark up the legislation by March 1, The Hill reported on February 8.

The Trump administration may not be willing to repeal, replace, or repair ACA until the summer of 2018, Trump told Fox News host Bill O’Reilly on The O’Reilly Factor on February 5.

Trump updated his projected Obamacare replacement plan delivery to March 2017 during an extended press conference in which he defended his administration’s competence on February 16.

“It statutorily takes a while to get,” Trump said. “We’re going to be putting it in fairly soon. I think that, yes, I would like to say by the end of the year at least the rudiments, but we should have something within the year and the following year.”

The Trump administration will submit legislation to replace Obamacare “as soon as our secretary is approved,” Trump told O’Reilly.

The Senate confirmed former U.S. Rep. Tom Price (R-GA) as secretary of the Department of Health and Human Services on February 9. Price introduced legislation to repeal and replace Obamacare in every session of Congress since ACA became law in 2009.

Early Action

The Senate and House passed resolutions on January 4 and 13, respectively, authorizing Congress to repeal several ACA provisions through a budget reconciliation process, which requires a simple majority for approval and cannot be blocked by a filibuster. Repealing and replacing other parts of the law will require a simple majority in the House and a filibuster-proof majority of 60 votes in the Senate, unless the Republican Senate majority changes the chamber’s filibuster rule.

Trump ordered executive departments and agencies to slow implementation of Obamacare on January 20.

Republican Plans Abound

Republicans have proposed several plans to remove Obamacare’s mandates, insurance premium subsidies, and Medicaid expansion spending. Most plans would use tax credits or deductions to help people buy health insurance.

The most recently introduced plan is Senate Bill 222, the Obamacare Replacement Act, sponsored by Sen. Rand Paul (R-KY). The bill would eliminate most Obamacare mandates, remove restrictions on the use of health savings accounts (HSAs), provide taxpayers with a tax credit as assistance to pay for health care services and health insurance, and allow local organizations to buy insurance in groups and across state lines.

Other proposals include “A Better Way,” a plan produced by the Ryan’s Task Force on Health Care Reform in July 2016, on which Price served, and the Empowering Patients First Act, formerly sponsored by Price. Republicans also introduced The World’s Greatest Healthcare Reform Act, sponsored by Sen. Bill Cassidy (R-LA), and the Republican Study Committee’s American Health Care Reform Act in the previous session.

Help on the Way

Peter Ferrara, a senior fellow for The Heartland Institute, which publishes Health Care News, and author of Power to the People: The New Road to Freedom and Prosperity for the Poor, Seniors, and Those Most in Need of the World’s Best Health Care, says Democrats’ claim Republican plans will leave patients stranded are unfounded.

“We are going to need to help pay for their health care some way,” Ferrara said. “We cannot maintain the policy of, ‘If they can’t finance their health care, we are all going to just watch them die, or even send them off begging for charity.’ A refundable tax credit to help them buy the health insurance of their choice seems to me the best alternative.”

A universal tax credit to help pay for health insurance would give equal financial assistance to rich and poor, Ferrara says.

“The tax credit has to be refundable, because nearly half of all Americans have no income tax liability and their Social Security tax liability is not all that much either,” Ferrara said.

Credits Trump Deductions

Grace-Marie Turner, president of the Galen Institute, says tax credits would do more to help low-income people pay for health care and health insurance than a tax deduction.

“A refundable tax credit is the best way to provide meaningful support for people that need help in purchasing health insurance,” Turner said. “Most of the people who lack health insurance are in lower-income brackets, people who make too much to qualify for public programs like Medicaid or CHIP but don’t have access to employer-sponsored health insurance. A deduction is worth very little to them because they are in such low tax brackets.”

Ferrara says current law’s tax deductions for dollars spent on health insurance give people a perverse incentive to spend more than they should.

The credit is better than a deduction, because it can be more easily limited to provide assistance for exactly what we want to accomplish, helping low- and middle-income workers purchase basic, essential health insurance,” Ferrara said. “A deduction for health insurance provides more assistance the more the worker spends on health insurance and, perversely, provides more the higher the taxpayer’s income is.”

Plans Fall in Line

More agreement exists among the Republican plans to replace Obamacare than the media reports, Ferrara says.

“Elements of the plans offered by Cassidy and Price are in the Better Way plan,” Ferrara said.

Congress should not delay in repealing ACA and devolving the federal government’s control over health care policy to the states, Ferrara says.

“All of Obamacare needs to be abolished, including all the taxes, all the regulations, and all of the spending,” Ferrara said. “The credit can and should be financed by block-granting Medicaid back to the states, economic growth, and cuts in other government spending.”

Matthew Glans ([email protected]) is a senior policy analyst for The Heartland Institute.

Internet Info:

Peter Ferrara, “Repealing and Replacing Obamacare Made Easy,” The Washington Times, February 16, 2017.