The Affordable Care Act should be repealed in August and replaced with a new system that lifts national consumer protections and gives control of health care to the states, according to a proposal by a conservative group released Tuesday.
The proposal risks irking centrist Republicans who want to focus on other subjects. Republican leaders have said they have no appetite for another push to repeal the ACA before the November midterm elections unless such a bill clearly has the votes to pass.
Republicans faced a series of obstacles—including internal division and unified Democratic opposition—as their effort to repeal the ACA collapsed last year. There is little evidence those dynamics in Congress have changed.
Still, the proposal’s release reflects the continuing eagerness of conservatives to topple the ACA, a longtime Republican promise whose window could close if Democrats make gains in the midterms as expected. But right-leaning groups are already at odds over the proposal, which drew swift condemnation from some organizations that said it retains too much of the health law’s spending.
“This plan keeps most if not all of Obamacare’s spending, most if not all of Obamacare’s taxes, and the regulations that Heritage’s own research indicate are the prime drivers of premium increases under Obamacare,” said Chris Jacobs, founder and CEO of Juniper Research Group, a conservative consulting firm. “That’s not freedom, that’s not flexibility, and that’s not federalism.”
Advocacy groups that support the Obama-era health law also went on the attack. “Republican politicians should denounce this new effort, end their war on our health care, and get to work on bipartisan solutions to bring down costs and protect our care,” said Brad Woodhouse, campaign director of Protect Our Care, which backs the ACA.
The conservatives’ proposal would drive control of health care almost entirely to the states, reversing the ACA’s federal mandates that seek to provide basic minimum benefits and consumer protections, which Republicans argue limit people’s choice.
Under the conservative plan, states would receive ACA money in the form of block grants to help low-income consumers buy coverage. Health savings accounts, which let people set aside tax-free money for medical expenses, would be expanded. Insurers could give discounts to people who are young or maintain continuous coverage.
The proposal, which echoes provisions of a bill offered last year by Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.), comes from the Health Policy Consensus Group, which includes representatives from such conservative think tanks as the Heritage Foundation, American Enterprise Institute, Galen Institute and the Manhattan Institute. The group has been meeting weekly for nine months.
The Hoover Institution on Wednesday will host a coalition of think tanks and governors, including Republican Gov. Matt Bevin of Kentucky and former GOP Sen. Rick Santorum of Pennsylvania, in Washington to discuss the proposal.
Centrist Republicans, however, haven’t been pushing a new repeal effort as part of their campaigns, especially as polls suggest the health-care issue is favoring Democrats more than in recent elections.
“Moderate Republicans are like, ‘Can’t we just let this go?’” said Simon Haeder, assistant public policy professor at West Virginia University. “It puts them in a terrible spot. They’re in a situation where if they don’t go along with them, they have to worry about making it through a primary, because these groups are well-resourced.”
Democrats face their own divisions over health care, with some liberals pushing for a sweeping “single-payer” plan and others arguing for a more limited option, such as an expansion of Medicare, that may be more palatable to centrist voters.
The block grants would be the backbone of the conservative plan. Half of the grant funding would go toward supporting the purchase of private health coverage, and half toward helping low-income Americans get coverage, although the two categories would likely overlap. The grants would ban states from using the money to fund abortions, according to the draft proposal. Medicaid expansion would also be repealed, and people on Medicaid would be able to buy private insurance coverage.
“The solution to the problem is to put program direction to states, and the federal government provides resources in a defined way,” said Yuval Levin, vice president at the Ethics and Public Policy Center. He is part of the group making the health-care proposal.
Liberals say moves to reverse the ACA, also known as Obamacare, hurt consumers by weakening or removing health coverage from many people.
“It’s just the monstrosity of Trumpcare,” House Minority Leader Nancy Pelosi (D., Calif.) said recently. “What they’re doing continues to drive up premium costs with their senseless sabotage.”
The conservative groups argue that this could be Republicans’ last chance to deliver on the eight-year GOP promise to end the ACA. That is a better electoral strategy, conservatives say, than moving toward Democratic positions or changing the subject.
The latest plan is one front of a continuing assault on the ACA by Republicans and conservatives in the aftermath of the failed previous effort to repeal it. While the Justice Department has asked a court to toss out key provisions of the health law, the 20 GOP state attorneys general in the lawsuit want the court to end the law altogether.
Some Republicans, including Sen. Ron Johnson (R., Wis.), have voiced interest in a repeal, and others have talked about passing a health-care package in coming months. Health and Human Services Secretary Alex Azar, in testimony last week, said he would work with Congress should lawmakers decide to modify or repeal the ACA.
Originally Posted by: WSJ.com
Written by: Stephanie Armour
Link to Original Article: https://www.wsj.com/articles/conservatives-make-new-push-to-repeal-affordable-care-act-1529400721?shareToken=st96892cfbaed14966aa4637144a8c5add&ref=article_email_share