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Republicans’ agenda for repeal of Affordable Care Act

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J. Scott Applewhite AP Ever since Republicans declared their intention to “repeal and replace” the Affordable Care Act, their agenda and rhetoric have tended to be heavy on repeal, light on replace. That’s often been to the dismay of health policy wonks, who want to hear more about not just what Republicans would do to get rid of the health reform law, but how they would fix our health care system. “Republicans may have convinced the public that President Obama’s national health care law will make things worse, but they have yet to adequately explain how they’d make things better,” the Washington Examiner’s Philip Klein wrote this summer.

Wednesday afternoon, Rep. Joe Pitts (R-Penn.) did some of that explaining, briefing reporters on what that plan looks like and when we’ll see it. He chairs the Energy and Commerce Health Subcommittee and says that, shortly after the Supreme Court rules on the health reform law, Congressional Republicans will introduce legislation to replace the Affordable Care Act.

The timing is partially about legislative opportunity: It’s possible, albeit unlikely, that after the Supreme Court rules, we’ll no longer have the health reform law. It’s also about optics: No matter what the Court rules, there will be buzz on the health care law when Court decides.

“We’ll have a window of opportunity with everyone looking to explain the Affordable Care Act,” says Pitts. “It’s not fully implemented yet...We’ll use this opportunity, this window, to discuss the full ramifications of the ACA and what we would replace it with.”

The plan, which Pitts says will be fleshed out in coming months, sounds pretty similar to other Republican proposals on health care, such as that of former Massachusetts governor Mitt Romney. The Republican presidential candidate would allow insurers to sell across state lines, let insurance plans pool across state boarders and extend the tax deductible treatment of employer-sponsored health insurance to plans bought on the individual market. The goal is to increase competition between insurance companies, driving down prices in the process.

“That is something we would hope that we can design it so health insurance is affordable for everyone,” he explained.

The plan likely won’t win any hearts and minds; with the ideas mostly familiar ones that most health policy analysts have had a lot of time to think about. The Congressional Budget Office has scored similar proposals before, and says they do help on cost, but don’t do much in the way of increasing coverage. What it does tell us though, is not to expect anything particularly aggressive or surprising from House Republicans on health care repeal this year, nothing like Jon Huntsman’s plan to end tax deductions for health insurance altogether. Instead, we can expect the health policy ideas we’ve heard about before to make a second entrance as Republicans move forward on their replace agenda.

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