On the eve of the president’s State of the Union speech, Republican Sen. Richard Burr of North Carolina on Monday offered a plan to repeal Barack Obama’s signature accomplishment, the Affordable Care Act, and replace it with a plan he says would lower costs and expand access to coverage.
His proposal would keep popular elements of Obamacare: the ban on limits on lifetime insurance benefits and the option for people to keep adult children on their plans until age 26.
But the rest is different, and its rollout the day before the president’s annual report to Congress helped put Republican ideas on how to replace the law into public debate, though it has virtually no chance of passing as long as the Senate is controlled by Democrats.
The White House dismissed the plan as “just another repeal proposal.”
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But Burr in a press statement said it addressed cost problems.
“Our nation’s health care system was unsustainable before Obamacare, and the president’s health care plan made things worse,” he said.
Republican Sens. Orrin Hatch of Utah and Tom Coburn of Oklahoma joined Burr in support of the plan, called the Patient Choice, Affordability, Responsibility and Empowerment Act. It would not require Americans to buy insurance, a key element of the health law does.
Insurance companies would be allowed to charge older people five times what they charge younger ones, compared to the 3 to 1 ratio allowed under Obamacare. The Republican senators say that the result would lower health care costs for many.
One major difference is how people with pre-existing conditions would be protected.
Under the Republican proposal, if they moved from one health plan to another, they could not be denied a plan based on pre-existing conditions.
There would be a one-time open enrollment period for people who are uninsured.
The plan gives some details on how this would work, but some have not yet been spelled out, according to Joe Antos, a health policy expert at the American Enterprise Institute, a conservative research group in Washington.
The penalty probably would be higher premiums if people didn’t buy insurance at the enrollment time, he said.
The proposal also would give small businesses help with the high costs of insurance through a tax credit. People with incomes of up to 300 percent of the federal poverty level – $34,470 for an individual – would be eligible for a refundable tax credit to buy health coverage or pay health bills.
The amount could be modest. A person age 18 to 34 who earns 200 percent of the poverty level – $22,980 for an individual – would receive $1,560, according to an outline of the plan.
In addition, it would rely on high-risk pools to help people with expensive health problems who don’t have insurance.
The Republican senators also said they would not expand Medicaid, as the president’s health law does, to provide insurance to the poor who haven’t had it. Instead they would encourage state reforms of the Medicaid system. States would receive federal grants to help low-income children and families, elderly people and those who are disabled if they aren’t able to buy insurance.
“We believe our proposal is roughly budget neutral over a decade,” the senators said in a question and answer sheet. They said that the insurance, Medicaid and tax changes they recommend would lower costs.
White House spokesman Jay Carney said on Monday that it looked like “just another repeal proposal, another attempt to raise taxes on the middle class, to keep uninsured Americans with pre-existing conditions locked out of the market, to raise costs on seniors, and to take away Medicaid from the millions of Americans who stand to gain coverage, thanks to the expansion that was part of the Affordable Care Act.”
It also would give insurance companies the power to deny people coverage because of pre-existing conditions and charge women more than men, Carney said, adding: “We strongly believe that’s the wrong course of action.”