Tuesday, February 16, 2010

The Republican Way With Health Reform

In a letter to the White House dated February 8, House Republican leaders Representatives John Boehner of Ohio and Eric Cantor of Virginia make scrapping the two bills approved in the House and Senate and starting over again as a condition for them to participate in President Barack Obama’s February 25 televised summit on health care. Republicans claim that the health care reform process has “excluded” them and their proposals. We have discussed some of these proposals before here. And just what are the Republicans’ proposals for health reform and would they achieve the President’s stated goals to expand affordable, portable health insurance coverage to as many Americans as possible?

The Republican proposals include creating new state high-risk pools or reinsurance, a measure we explored previously here. Tort-reform, or capping noneconomic damages for medical malpractice (discussed previously here).is a very popular Republican reform option. Shifting responsibility to the states by encouraging them to establish health insurance exchanges and insurance regulatory reform. One of our recent posts reviewed some of the states’ solutions.

One specific piece of Republican-proposed legislation, proposed by Sen. Tom Coburn (Okla.) and Rep. Paul Ryan (Wisconsin) is the Patient’s Choice Act (S.1099 and H.R. 2520) introduced last spring, and, most recently in a new incarnation from Rep. Ryan as the Roadmap for America’s Future (H.R. 4529, introduced on Jan. 27, 2010).

The Patient’s Choice Act would eliminate the federal tax subsidy for employer-sponsored health insurance and replace it with a a refundable tax credit ($2,290 for individuals and $$5,710 for families) to purchase coverage in the individual market. Under this legislation, many people who would lose employer coverage would be unable to find affordable, comprehensive coverage on their own, the nonprofit Center on Budget and Policy Priorities concluded recently. Neither of these Republican bills would address the problems in the individual health insurance market.

“Unfortunately, the Coburn-Ryan plan would likely make comprehensive, affordable coverage less available to many who now have it while failing to significantly reduce the number of uninsured Americans,” the CBPP noted.

The Patient’s Choice Act AND the Roadmap for America’s Future, both would replace guaranteed Medicare benefits for all persons currently under age 55 and replace it with a voucher for individuals to buy health insurance. The bills also would eliminate the federal and state-funded Medicaid programs that provide health care for low-income individuals and replace it with tax credits and subsidies to buy individual health insurance. The long-term care component of the Medicaid program would be changed to a fixed dollar amount block grant to the states.

Paul Krugman, an economist and professor at Princeton University, in an Op-Ed piece in the February 11 New York Times, remarked that while the Republicans object vociferously in public to proposed reductions in Medicare payments for Medicare Advantage plans, they work to cut the successful, and popular, public health care safety net for elderly and disabled—Medicare.

Judge for yourselves how earnest the Republicans are to work with the Democrats and the President to craft “meaningful” health care reform to benefit the most Americans.


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