Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
May 23 — Two Republican lawmakers May 23 unveiled legislation intended to be an alternative to the Affordable Care Act.
The bill, sponsored by Sen. Bill Cassidy (R-La.) and Rep. Pete Sessions (R-Texas), wouldn't fully repeal the ACA, which is a different approach than other Republican-backed efforts. However, it still would remove the law's mandates over employer and individual insurance coverage. Cassidy and Sessions named their bill the World's Greatest Healthcare Plan, and it comes as a House Republican task force closes in on releasing its own ACA replacement plan.
However, there's a significant difference between the two efforts.
Members of the task force have said the plan that eventually emerges from their planning sessions will be just a white paper, while Cassidy and Sessions have an actual bill. House Republicans have said on multiple occasions they don't see an immediate need to publish a bill, because it would just get vetoed, just like the ACA-repealing budget reconciliation legislation (06 HCDR, 1/11/16).
Cassidy and Sessions said they are aware of that distinction, and emphasized their bill was intended to be complementary to the task force effort.
“It's just that instead of principles, we're dropping a bill,” Sessions said. “I don't know why every idea would be stepping on anybody's toes. This is complementary.”
Even before the official May 23 rollout, Cassidy told Bloomberg BNA that having legislative language is “critical.”
“No more will Democrats be able to promote the canard that we have not proposed a bill,” Cassidy said during a May 19 conversation in the Capitol. “I’m not fighting with the House. We just want to advance the idea [of an ACA replacement], and having legislative language is significant.”
Both Cassidy and Sessions previously sponsored ACA replacement bills.
The lawmakers acknowledged the current political situation makes it impossible that the bill will pass any time soon. However, with an eye on the elections, Cassidy said he has reached out to the presidential campaigns, though he declined to provide specifics.
“The only way we’re going to be able to totally repeal and replace now is if we keep the House, have 60 Republicans or enough Democrats to vote with us [in the Senate], or a Republican president,” Cassidy said. “If we get that, we will go the whole way, but we can’t kind of not do anything, waiting for those stars to align.”
Having concrete legislative language in place could be helpful if Republican front-runner Donald Trump were to become president, and even Democratic front-runner Hillary Clinton has said she wants to make changes to the ACA, Cassidy said. Still, he acknowledged the Trump campaign and its voters have been anything but traditional.
“I don’t know that his voters care about solid detailed proposals,” Cassidy said. “This bill takes power away from vested interests and gives it back to the patients, so his instincts will be to like this bill. Whether it helps him? I can’t answer that, but he’s gone pretty far without being too specific.”
The central element of the bill is a $2,500 tax credit to every citizen who enrolls in the plan. The tax credit would be a flat sum, rather than income-adjusted like those offered under the ACA, so that lower-income individuals wouldn't receive more. The credit would give patients much more flexibility with how they can spend their money, said Sessions and Cassidy. The credit could be assigned to an employer, transferred to a new type of health savings account or advanced for annual distribution.
People who are covered under an ACA exchange plan would be able to keep their current coverage, the lawmakers said. States and individuals would be able to opt out of the ACA and enroll in the plan offered under the bill. Individuals could also choose not to buy insurance, without any penalty. Employers may elect to remain in the current system if they wish. However, those companies will be subject to existing penalties under the ACA.
According to a summary, the bill would also keep in place “essential consumer protections, which include guaranteed issue, guaranteed renewability, and the prohibition on discriminating against those with pre-existing conditions.”
The bill hasn't been scored by the Congressional Budget Office, but the lawmakers expect it to be budget neutral.
To contact the reporter on this story: Nathaniel Weixel in Washington at email@example.com
To contact the editor responsible for this story: Brian Broderick at firstname.lastname@example.org
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)