Conservative Groups Quietly Pursue New Obamacare Repeal Plan

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By Alex Ruoff

A coalition of policy experts from conservative think tanks and advocacy groups is quietly working to spur Congress to take another shot at overhauling Obamacare before the midterm elections.

The group, which includes former Sen. Rick Santorum (R-Pa.), has members from the American Enterprise Institute, the Heritage Foundation, and the Goldwater Institute who have met weekly since Republicans last gave up on trying to repeal the Affordable Care Act. They have met with Republican congressional aides and White House staff to discuss their ideas for turning the health law into a block grant program meant to give states far more control over health insurance regulations.

They plan to unveil a set of policy recommendations in coming weeks they hope will serve as the underpinnings of new legislation Republicans in Congress can rally around to make good on their promise to overhaul former President Barack Obama’s signature health law, members of the group told Bloomberg Law.

“Getting the policy right will be key,” Santorum told Bloomberg Law. “That was the problem last time.”

Those involved in the group told Bloomberg Law they expect the upcoming elections to put pressure on Republicans to pass legislation addressing insurance premiums this year.

“Members want to talk tax reform and immigration, but what their constituents are talking about is health care,” Grace-Marie Turner, president of the Galen Institute and a central figure in the group, told Bloomberg Law. “They’re asking: ‘What are you doing about Obamacare?’”

The policy recommendations will take a similar approach to tackling the health law as the last ACA measure the Senate considered, named Graham-Cassidy after Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), two of its main advocates. Like Graham-Cassidy, the group’s policy recommendations will look to convert the ACA’s insurance subsidies and added Medicaid funding into block grants, Turner said.

The group will recommend a new approach to how the funds are doled out to states and how state regulators can control insurance policy design, she said. Turner said she couldn’t fully detail the policy recommendations because they’re still being debated.

The group is also considering more tax breaks for people who put money into health savings accounts, Rea S. Hederman Jr., executive director of the Economic Research Center and vice president of policy for the Buckeye Institute, told Bloomberg Law.

Repeal is Dead

The group, which informally refers to itself as the Health Policy Consensus Group, faces an uphill battle in getting lawmakers on board.

Republican leaders have dismissed calls for making another attempt to repeal and replace the ACA since the last effort failed. Republicans have one fewer vote in the Senate since they fell one vote short of passing their ACA overhaul legislation, and Sen. John McCain (R-Ariz.) — who cast a deciding vote sinking the effort — has been absent from Washington for months while undergoing cancer treatment.

Even some of the most-ardent Senate Republicans have moved on from the issue. A spokesman for Cassidy told Bloomberg Law in email the freshman senator’s repeal proposal “is dead.”

“Our focus is on new solutions and new ideas that lower costs for families and reflect the latest developments in the health-care marketplace,” he said.

Conservative policy experts also have little time to get congressional Republicans on board with their plan. Lawmakers are preparing to pass a budget bill that won’t trigger the same budget gimmick Republicans tried to use last year to pass their previous repeal bills using a simple majority.

Reviving Repeal

However, one major drawback of the previous repeal attempts is gone: the ACA’s penalty for Americans who fail to have health insurance coverage and the impact of ending it.

Republicans ended the penalty as part of tax reform, a move congressional researchers warned would increase the number of uninsured Americans by four million next year and 13 million in 2027. Democrats in Congress and other ACA supporters hammered Republicans over estimates that their repeal bills would leave as many as 27 million Americans without health insurance.

With the mandate gone, estimates about the impact of any ACA repeal bill will be far lower, Ramesh Ponnuru, a visiting fellow at the American Enterprise Institute and a senior editor at National Review, told Bloomberg Law.

“The number one argument against what Republicans wanted to do was it going to take insurance away from 20 to 30 million people, and the vast majority of that coverage loss was due to the individual mandate,” Ponnuru said. “Well, that coverage hit is behind them now.”

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