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Health-Care Overhaul 2010

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Republicans plan to stress private-sector alternatives to the president's plan

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One challenge for Republicans at the summit will be to convince people that they are taking on the system's major problems, just in a different way. Instead of expressly banning insurance companies from denying people coverage, the Republican plan would give more money to high-risk pools that operate in most states and cover people who cannot get insurance companies to sell them plans.

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Another of the core Republican ideas, allowing individuals to buy health insurance across state lines, also has proved controversial among health-care experts. The idea would be to allow people who live in states with heavy insurance regulation to shop for policies in states with fewer rules. The CBO estimates this idea would save money for people who are healthy, but might increase costs for people who are older or already have illnesses.

Democrats proposed fewer border restrictions in their plan, but each state would effectively create minimum benefit standards.

Republicans do back some ideas also supported by Democrats, including allowing young adults to stay on their parents' plans and providing incentives to small businesses to provide coverage to employees. But more broadly, Republicans want to move the health-care system to an individual-based model, allowing people to shop for their own care.

Democrats, by contrast, are more focused on working through the existing employer-based system, although Obama's plan would create a individual insurance market for people who don't have access to coverage at work.

One Republican attendee at the summit will be Sen. John McCain (Ariz.), who is not a prominent voice in the congressional health-care debate but who offered an ambitious health-care plan as the 2008 GOP presidential nominee. McCain's plan envisioned a broad shift away from employer coverage to individual coverage, spurred by ending the tax exemption for employer-provided health benefits. Obama strongly opposed ending the exemption.

GOP lawmakers think Thursday's summit will support their belief that a more gradual approach than the one most Democrats are embracing will win favor with the public.

"We don't need a big comprehensive bill that turns 17 percent of the economy upside down and cuts Medicare and raises premiums and raises taxes and transfers big cost to states," said Sen. Lamar Alexander (R-Tenn.). "We need to set reducing health-care costs as our goal and move step by step toward that goal to re-earn the trust of the American people."


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