Thanks to John Boehner and The New York Times
WOW, did I really just thank The New York Times?
G.O.P. Counters With a Health Plan of Its Own
By ROBERT PEAR and DAVID M. HERSZENHORN
WASHINGTON — House Republicans have come up with an answer to SpeakerNancy Pelosi, drafting an alternative health care bill that wouldreward states for reducing the number of uninsured, limit damages inmedical malpractice lawsuits and allow small businesses to bandtogether and buy insurance exempt from most state regulation.
In its opening section, the Republican bill, which has no chance ofpassing, promises to lower health care costs and expand insurancecoverage “without raising taxes, cutting Medicare benefits for seniors,adding to the national deficit, intervening in the doctor-patientrelationship or instituting a government takeover of health care.”
The bill defines the differences between Republicans and Democrats, whointend to take up their bill on the House floor this week, afterresolving intramural disputes over abortion and immigration.
The Republican bill differs from the Democratic measure in that itwould not require people to obtain insurance or require employers tooffer it. It is almost surely cheaper than the House Democrats’ billbecause, unlike that proposal, it would not expand Medicaid or offerfederal subsidies to low- and middle-income people to help them buyinsurance. Nor would the Republican bill impose new taxes.
TheHouse Republican bill would not explicitly prohibit insurers fromdenying coverage to people because of pre-existing medical conditions,even though many Republicans have said they agree with Democrats thatthe federal government should outlaw such denials.
HouseRepublicans completed work on their measure as Senate Democraticleaders acknowledged that Senate floor debate on their bill was likelyto slip to December, making it virtually impossible for Congress toachieve President Obama’s goal of enacting major health legislationthis year.
If Congress is still wrangling over the legislationnext spring, many of the 2010 midterm elections could turn intoreferendums on Mr. Obama’s health policies.
Pressed about thetimetable, the Senate majority leader, Harry Reid of Nevada, declinedto predict when Congress might complete a bill.
“We’re notgoing to be bound by any timelines,” Mr. Reid said at a newsconference. “We need to do the best job we can for the Americanpeople.” He said that the bill would be posted on the Internet and thatlawmakers would have ample time to study it.
Senate Democraticaides said it was still possible, but increasingly unlikely, thatCongress would send a bill to Mr. Obama by Christmas.
TheHouse Republican leader, Representative John A. Boehner of Ohio, saidhis bill would “lower costs and expand access at a price our nation canafford.”
In a few ways, the House Republican bill resemblesthe one headed for the House floor. It would allow young adults to stayon their parents’ health plans at least through age 24, compared with26 under the Democrats’ bill.
House Republicans, like theDemocrats, would prohibit insurers from imposing annual or lifetimelimits on spending for covered benefits. And they would prohibitinsurers from canceling or rescinding coverage after a person becamesick unless the person had intentionally concealed “material facts”about a medical condition.
Democrats, who have been hearing unofficial accounts of the Republican bill, said it was too little too late.
Representative Christopher S. Murphy, Democrat of Connecticut, said theRepublican bill would perpetuate the status quo for people withpre-existing conditions. And for millions of people who would still beunable to afford insurance, he said, the Republican message was,“Sorry, you’re out of luck.”
Reid H. Cherlin, a White Housespokesman, said the House Republican bill “does nothing to provide morestability and security for people with insurance.”
The billwould offer $50 billion in federal “incentive payments” over the next10 years to states that reduce the cost of health insurance or theproportion of their residents who are uninsured.
The billwould also make it easier for insurers to sell insurance across statelines. Policies would be subject to laws in a company’s home state, butwould be exempt from many of the consumer protection laws, rating rulesand benefit mandates in other states where the company sold coverage.
Republicans would also allow small businesses to pool their insurancebuying power through “association health plans,” sponsored by trade andprofessional associations and chambers of commerce. These plans wouldhave “sole discretion” over what services to cover.
Consumergroups, state officials and Blue Cross and Blue Shield executives havehistorically opposed such association health plans, saying they couldengage in risky practices free from state regulation.
TheHouse Republican bill would offer $15 billion to states to establishhigh-risk pools, for people who could not otherwise obtain coverage,and reinsurance programs, under which states act as a backstop toprivate insurers. Under a reinsurance program, a state pays a largeshare of the cost if claims — for an individual or a group — exceedsome threshold.
The House Republican whip, Eric Cantor ofVirginia, said high-risk pools and reinsurance programs would“guarantee that all Americans, regardless of pre-existing conditions orpast illnesses, have access to affordable care.” Health policy expertssay insurers can lower premiums if state reinsurance programs protectthem against the risk of catastrophic costs.
In addition, theHouse Republican bill would impose new restrictions on consumerlawsuits against doctors, hospitals and makers of drugs and medicaldevices. In general, such lawsuits would have to be filed within threeyears after an injury became evident.
The bill would set a$250,000 limit on noneconomic damages, for physical and emotional painand suffering. It would establish new hurdles for consumers to obtainpunitive damages and would limit contingency fees for plaintiffs’lawyers.
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