Republicans Release Alternative Healthcare Bill As Senate Democrats Scrap Deadline

Washington, D.C. (AHN) - House Republicans late Tuesday unveiled a healthcare proposal that is expected to be cost less than Democratic bills but does not prevent insurance companies from refusing coverage for pre-existing conditions. The same day, House Democrats moved closer to beginning debate this week by filing a manager's amendment, but Senate Democrats for the first time conceded that a bill may not be passed this year.

The proposal from the GOP does not aim to directly expand coverage for the 47 million uninsured Americans, seeking instead to achieve that goal by lowering costs of healthcare.

It offers incentives to states that successfully implement programs reducing the costs of premiums and the number of uninsured. It also rewards people who use health savings accounts, and introduces medical malpractice reforms to "end costly junk lawsuits."

The measure does not require employers to provide insurance for workers, but "gives employers greater flexibility to financially reward employees who adopt healthier lifestyles." It explicitly bans the use of federal funds for abortions, makes no cuts to Medicare, and does not provide subsidies for low-income families to buy insurance.

It does not prohibit insurers from declining coverage because of pre-existing conditions, but "creates Universal Access Programs that expand and reform high-risk pools and reinsurance programs to guarantee that all Americans, regardless of pre-existing conditions, have access to affordable care."

Republicans gave no estimate of how much their proposal would cost, choosing to highlight reports that the final House Democratic bill for floor debate would cost $1.3 trillion. With not enough votes, their measure is not expected to be passed.

"Republicans have outlined a plan to lower costs and expand access at a price our nation can afford," House Minority Leader John Boehner (R-OH)said in a floor speech. "This includes letting families buy health insurance across state lines, allowing small businesses to pool together and offer health insurance to their employees at much lower costs, just like big businesses and unions can today."

House Democrats released an $894 billion healthcare bill last Thursday that provides coverage to up to 96 percent of Americans and reduces the deficit by $30 billion over a decade.

But reports, citing spending that was left out of the released version, had put the cost of the measure around the trillion-dollar mark, way above the $900 billion over 10 years that President Barack Obama had requested.  The nonpartisan Congressional Budget Office (CBO) has only provided an initial estimate of the cost of the bill, which is expected to be introduced to the full floor after the 72-hour window required for public review.

The manager's amendment filed by Democrats strengthens provisions against anti-trust exemptions for insurers, and gives states $1 billion to prevent insurers from price gouging. It does not address concerns from some Democrats about the bill's weak language on abortion, but add requirements before immigrants can avail of funds, and prohibits illegal aliens from taking part in a nationwide high-risk pools.

The amendment does not appear to address concerns from Progressives, who make up the largest caucus in Congress. The House Democratic bill for debate has a public option that allows doctors to negotiate payment rates. Progressives had opposed the centrist approach, pushing for a government program based on Medicare provider payments and negotiated rates would "weaken" reform.

With the changes, the bill "makes coverage more affordable for all, and creates new consumer protections that will end discrimination by insurance companies against the sick and cap what Americans pay out-of-pocket," Speaker Nancy Pelosi (D-CA) said in a statement.

Pelosi added that her chamber "will soon act," but her Senate counterpart was less sanguine, admitting for the first time that healthcare legislation may not be passed this year.

Senate Majority Leader Harry Reid (D-NV) last week moved closer to holding floor debate on his chamber's healthcare bill, sending a measure merged from the bills of the late Ted Kennedy and Finance Committee Chairman Max Baucus (D-MT) to the CBO for scoring.

He also announced that the legislation would include a public option that will allow states to opt out, as well as non-profit insurance cooperatives, a key element of the bill reported out by the Finance Committee.

But Reid on Tuesday said in a press conference that passing a bill may be unlikely this year, "We're not going to be bound by any timelines. We want quality legislation and we're going to do that. We're going to do this legislation as expeditiously as we can and as fairly as we can."

Asked the earliest time he expects his chamber to begin debate on the measure, Reid said, "I have talked to [CBO Director] Doug Elmendorf. We talk weekends, nights... but we're doing this just as quickly as we can. [CBO is] doing their very best."

The Senate holds a three-day recess during Veteran's Day, and another week-long break for Thanksgiving.

Apart from the delay spent waiting for the CBO score, Senate Democrats have yet to gather the minimum 60 votes to overcome GOP filibusters on a healthcare bill.  Democrats hold a 60-vote majority in the chamber but the number includes two independents who caucus with them: Sens. Joe Lieberman (I-CT) and Bernard Sanders (I-VT). Lieberman has pledged to join the Republican filibuster if the bill includes a public option.