GOP seeks coverage choices in health law they hate

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WASHINGTON (AP) — At the prodding of business
organizations, House Republicans quietly secured a recent change in
President Barack Obama’s health law to expand coverage choices, a
striking, one-of-a-kind departure from dozens of high-decibel attempts
to repeal or dismember it.
Democrats describe the change involving
small-business coverage options as a straightforward improvement of the
type they are eager to make, and Obama signed it into law. Republicans
are loath to agree, given the strong sentiment among the rank and file
that the only fix the law deserves is a burial.
"Maybe you say it
helps (Obamacare), but it really helps the small businessman," said Rep.
Phil Roe, R-Tenn., one of several physician-lawmakers among Republicans
and an advocate of repeal.
No member of the House GOP leadership
has publicly hailed the fix, which was tucked, at Republicans’ request,
into legislation preventing a cut in payments to doctors who treat
Medicare patients.
It is unclear how many members of the House
rank and file knew of it because the legislation was passed by a highly
unusual voice vote without debate.
Several lobbyists and
Republican aides who monitored the issue said the provision reflects a
calculation that no matter how hard the party tries, the earliest the
law can be repealed is after Obama leaves office in 2017. In the
meantime, according to this line of thinking, small-business owners need
all the flexibility that can get to comply with it.
One
repeal-favoring Republican lawmaker took a similar view. "I was brought
up in a family of 12. My mother taught me to be patient," said Rep. Tom
Reed of New York, who backed a stand-alone bill to make the same change.
The
provision itself was relatively minor. It eliminated a cap on
deductibles for small group policies offered inside the law’s health
care exchanges as well as outside; the cap was set at $2,000 for
individuals and $4,000 for families.
Republicans said they sought
it so small businesses can offer high-deductible plans that could be
purchased by individuals who also have health savings accounts. These
tax-preferred accounts are a long-time favorite of many Republicans, who
say they give consumers greater control over their own health care.
The
health law contains no deductible caps for individual plans or those
offered by large employers, and the Department of Health and Human
Services already had waived them for small businesses through 2015. The
legislation means they will never go into effect.
As yet, there is
no indication the change in course heralds any sort of significant
pre-election change in attitude by Republicans, who last week engineered
their 52nd vote in the House to repeal or dismember the law. They have
said they intend to make its elimination a key element in the November
election.
At the same time, though, administration officials
announced last week that more than 7 million people have signed up for
coverage. Democrats hope to counter demands for repeal by challenging
critics to explain why they want to eliminate some of politically
popular provisions such as guaranteed of coverage for pre-existing
condition or plans without a lifetime cap in coverage costs.
Fittingly
in an era of divided government, now that the change has been made,
officials in both parties are once more at odds, each describing it as a
victory for their side in a ceaseless political struggle.
Asked
if the legislation strengthened the law, Senate Majority Leader Harry
Reid, D-Nev., said, "I would hope so. I believe that" it does. He added,
"So there are changes being made. But the Republicans have to get over
if they hate ‘Obamacare’ and are going to repeal it," he added.
Rory
Cooper, a spokesman for House Majority Leader Eric Cantor, R-Va., said,
"This is another in a series of changes to Obamacare that the House has
supported to help save Americans from being harmed by the law, and
we’re glad to see the President signed it into law." Cantor was involved
in negotiations on the legislation, which were overseen by Speaker John
Boehner, R-Ohio, and Reid.
While Cooper described the change
merely as one of several designed to prevent harm, the episode marks the
first time Republicans have agreed to make it easier for anyone to
obtain coverage under the law.
According to a list maintained by
the office of the House Republican whip, Rep. Kevin McCarthy of
California, five of the eight previous changes signed by Obama reduced
funding; one repealed a minor voucher provision; one jettisoned a
section dealing with home care for the elderly; and the other eliminated
a tax reporting requirement.
In this case, though, large business organizations that support repeal pressed Republicans to make the
change.
"Repealing
the annual limitation on deductible would free up an important "lever"
that employers need as they struggle to design affordable plans that
meet the requirements" of the law, R. Bruce Josten, executive vice
president at the U.S. Chamber of Commerce, wrote senior lawmakers. He
expressed satisfaction with HHS’ waiver, yet added, "a more permanent
and predictable solution is critical."
Democrats said the
now-defunct limitation was inserted into the original law in an
unsuccessful attempt to win the vote of former Republican Sen. Olympia
Snowe of Maine. She supported the bill in the Senate Finance Committee
but opposed it on the Senate floor.
Copyright 2014 The Associated Press. All rights
reserved. This material may not be published, broadcast, rewritten or
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