A key House panel on Thursday debated the first draft legislation to replace Obamacare since Donald Trump became president, pledging to repeal his predecessor’s signature health care law.
The Energy and Commerce Health Subcommittee discussed drafts of four bills which each address piecemeal issues within the larger Affordable Care Act, including how to deal with people who have pre-existing health conditions, how much more to charge seniors compared to young people, and how to spur people to keep continuous coverage throughout their lives.
Many Republicans, including Committee Chair Rep. Greg Walden (R-Ore.), have said that they won’t put forward one major Obamacare replacement bill but will instead replace the law with a set of smaller measures.
The hearing comes as lawmakers on both sides of the aisle consider how to stabilize the insurance market while Republicans move forward on changes to the nation’s health insurance system. While some lawmakers have said they want to “repair” the ACA, House Speaker Paul Ryan said Thursday that fixing the country’s health care system means repealing and replacing Obamacare.
“The notion that this individual market is in a wonderful place is a fiction,” House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) said. “All you have to do is listen to the experts that are out there. It can’t survive the way it is today.”
Three of the four bills discussed Thursday had been introduced in previous years. The popularity of Obamacare’s requirement to guarantee coverage for people with pre-existing conditions may have prompted Republicans to propose the fourth bill, which does the same thing in a different way.
To cover those with existing health conditions, the proposal would encourage everyone to maintain health coverage throughout their lives — though the GOP is still figuring out how to do so. The idea is meant to bring more younger people into the insurance pool, driving down premium costs.
Another bill aims to decrease premiums by increasing Obamacare’s age rating band, allowing insurers to charge older people up to five times more than younger people. (The current band is three to one.)
But Democrats pushed back, arguing that changing the age rating policies would harm older people before they became eligible for federal health care under Medicare.
“Boy, have you really hit a nerve back in Florida,” said Rep. Kathy Castor (D-Fla.). “If you start tinkering here and asking my older neighbors to pay a whole lot more before they go into Medicare, that’s not smart.”
Other bills sought to clamp down on special enrollment periods — when people can sign up for coverage outside of the traditional open enrollment period — and grace periods, for when consumers haven’t paid their monthly premiums, in order to bring down costs for insurance companies, who have pushed similar ideas.
A key problem with Republican plans to repeal and replace Obamacare is what happens to insurance markets in the meantime, and how to encourage insurers to participate during a time of uncertainty.
Rep. Michael Burgess (R-Texas) said the reforms discussed at Thursday’s House hearing could be implemented quickly in order to stabilize the market.
“While we are committed to large-scale reform, real people are struggling as we speak and we are not waiting to take action,” said Burgess, who chairs the health subcommittee.
A challenge for quick action may be reconciling the House’s legislation with proposals in the Senate, such as a bill from Sens. Bill Cassidy (R-La.) and Susan Collins (R-Maine) that allows states to keep existing Obamacare exchanges.