House Republican leaders plan to unveil on Thursday elements of their plan to repeal and largely replace portions of the Affordable Care Act.
House Majority Leader Kevin McCarthy (R-Calif.) told reporters Wednesday that committee leaders will brief GOP lawmakers on some specific proposals at a closed-door meeting scheduled for Thursday morning. The meeting comes as leaders are working to rally sharply divided GOP members around a single plan to remake the health-care law.
Asked whether leaders planned to announce specific elements of the repeal-and-replace plan that will be included in upcoming legislation McCarthy said, “Yes.”
McCarthy did not say which elements of the plan would be detailed at the meeting. But House Ways and Means Committee Chairman Kevin Brady (R-Tex.) said he plans to discuss both repealing the law and ways to give states greater control over health-care decisions.
“I’ll be visiting about the areas in my jurisdiction,” Brady said. “Health savings accounts, individual credits so people can buy the plan that’s right for them that’s portable.”
A senior GOP aide said Wednesday that lawmakers would be presented with a menu of replacement items such as tax credits for purchasing insurance, health savings accounts, “high-risk pools” for the chronically sick, and major Medicaid reforms, as well as potential ways those elements could be passed into law.
But not all of those possible pieces have widespread support among Republicans, who will need to produce 218 votes among their 239 members. Among the most controversial are the tax credits, which under the framework backed by House Speaker Paul D. Ryan (R-Wis.), could be refunded to taxpayers much like the existing Obamacare tax subsidies — even to low-income Americans who would owe no tax.
Many conservatives have grown tired of waiting for House leaders to follow through on their campaign promises to repeal the ACA. Members of the influential House Freedom Caucus announced their own repeal legislation Wednesday to roll back most of the law and move millions of Americans into health savings accounts (HSAs).
“We were tired of waiting,” said Rep. Jim Jordan (R-Ohio) at a news conference on the legislation, “and that’s why we said: ‘Let’s go. Let’s go now.’ ”
Their plan, introduced by Rep. Mark Sanford (R-S.C.) and Sen. Rand Paul (R-Ky.), would end Medicaid expansion, decouple health insurance from employers, offer a tax credit of up to $5,000 to fund HSAs, and eliminate most regulations on what health plans must cover. Insurers would be able to sell policies across state lines; regulations that mandate birth-control coverage would be nixed.
“What if 30 percent of the public had health savings accounts?” Paul asked. “What do you do when you use your own money? You call up doctors and ask the price. . . . If you create a real marketplace, you drive prices down.”
The hard-line conservatives’ rationale for backing the bill is partly that it exists, while at this point the frequently re-branded plan from GOP leadership does not.
“There seems to be a coalescing around principles; I don’t think it’s gotten deep in the weeds about what it will actually include yet,” Sanford in an interview about the larger GOP effort.
House leaders hope to prove Thursday that they, too, can provide details.
House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) defended the pace of the repeal effort. He said that it took time to make sure members had a chance to weigh in on a plan and the Thursday meeting should clear up some of their concerns.
“I think they’ll come away well-informed with what the options are and have a chance to give us their feedback before we move to the next step, which would be a hearing, markup, whatever between now and the end of March,” Walden said. “We’ll have some options available for people to look at.”
Those options may not be enough to appease a growing number of Republicans who insist the repeal bill should go at least as far as a measure approved by Congress in 2015. That effort ended with a veto from President Barack Obama, but GOP leaders touted it as proof of what could be possible with a Republican president.
“The 2015 resolution is the floor,” said Rep. Scott Perry (R-Pa.) at a roundtable for reporters Tuesday. “We all approved of that in 2015. There should be no reason we can’t approve of that again.”