House Republicans have drafted an alternative healthcare bill that would reward states for reducing the number of uninsured, limit damages in medical malpractice lawsuits and allow small businesses to band together and buy insurance exempt from most state regulation.
The House GOP bill is 230 pages long, compared with Democrats’ 1,990-page measure. It has no requirement for people to buy insurance and no prohibitions against insurance companies denying coverage to people with pre-existing medical conditions.
The Republican bill promises to lower healthcare costs and expand insurance coverage without raising taxes, cutting Medicare benefits for seniors, adding to the nation deficit, intervening in the doctor-patient relationship or instituting a government takeover of healthcare. It would not expand Medicaid or offer federal subsidies to low- and middle-income people to help them buy insurance.
People with pre-existing medical conditions would pay up to 50 percent more than average for insurance coverage under a draft version of House Republicans’ healthcare plan. According to a draft released Tuesday, “states would face a massive, partially funded mandate to subsidize high-risk insurance pools to cover people denied coverage by insurance companies with ‘a stable funding source.’ Those rates would be capped at 50 percent higher than average premiums for standard-risk insurance in a given state.”
Congress is wrangling over how much coverage to provide for immigrants who have settled in the country legally. Many Democrats want all legal permanent residents to be able to participate in proposed health insurance exchanges and received subsidized coverage if they qualify, but Republicans favor excluding immigrants who have been legal permanent residents for less than five years. They argue that maximizing restrictions on legal and illegal immigrants will save money and prevent healthcare benefits from becoming a magnet that draws new migrants to the United States. Proponents, however, say such exclusions tend to defeat the cost-saving purposes of universal coverage.
The Congressional Research Service (CRS) said “that ‘vexing’ questions might be raised for lawmakers if illegal immigrants are barred from a new health insurance system, including whether they could be denied needed medical care.” In a report, the CRS “raises the prospect that illegal immigrants could find a new spotlight on their legal status if everyone else is required to hold healthcare insurance but they are not.”
The House healthcare reform bill includes a provision which would create a federal long-term care benefit, the premiums of which would be deducted from the employers of participating companies. A Wall Street Journal article notes that employees would be able to opt out, but the benefit would only go to those who had been paying into the system for at least five years. Some Democrats are pushing to get the program into the Senate bill, but Democratic centrists worry it could add to the deficit.
Meanwhile, the U.S. Chamber of Commerce has launched a multimillion dollar national cable and local advertising drive in 19 states and 46 media markets that’s aimed at blocking passage of the House healthcare reform bill which is slated to be voted on this weekend. The coalition, Employers for a Healthy Economy which also includes such big groups as the National Association of Manufacturers, the National Association of Wholesaler-Distributors and the National Retail Federation, intends to have the ads air through Sunday, but might extend the buy if the vote on the House bill is delayed past this weekend. The business community is especially worried about two parts of the House bill: its robust public option and a new ‘pay to play’ mandate that would require companies to either provide insurance to employees or pay a penalty of 8 percent of their total payroll.