Republicans to introduce health reform plan that would establish state health insurance exchanges, provide tax credits

Congressional Republicans are releasing two health care reform proposals -- one from conservatives and one from moderates -- as alternatives to plans by Democrats, CQ Today reports (Wayne, CQ Today, 5/19).

Conservative Plan

Conservative Republicans -- led in the Senate by Sens. Tom Coburn (Okla.) and Richard Burr (N.C.) and in the House by Reps. Devin Nunes (Calif.) and Paul Ryan (Wisc.) -- on Wednesday will introduce the Patients' Choice Act, which would establish State Health Insurance Exchanges, where U.S. residents could shop for private insurance. The legislation also would give $5,710 tax credits to families and $2,290 tax credits to individuals to help pay for health insurance (Haberkorn, Washington Times, 5/20). The credits would be funded by taxing employer-provided health benefits (CQ Today, 5/19). Under the plan, U.S. residents could keep their current coverage if they choose and the plan would not require individuals to have insurance. Coverage also would be portable, allowing people to keep their coverage when switching jobs.

States would provide direct oversight of health insurers and providers to ensure equal benefits (Washington Times, 5/20). The bill also would create private insurance options through Medicaid and would require higher-income Medicare beneficiaries to pay higher premiums for the Medicare prescription drug benefit (CQ Today, 5/19). The measure also would establish a system of health coverage auto-enrollment at emergency departments, motor vehicle departments and other locations.

According to the AP/Washington Post, the group, unlike some Senate Republicans, does not want to work with congressional Democrats on their plans for health care reform legislation. Of the proposals being developed by Democrats, Burr said, "I think within two hours of seeing it we'll be able to tell people why it won't work." Burr and Coburn believe that congressional Democrats only will approve legislation that includes a public option, which is not included in their proposal (Werner, AP/Washington Post, 5/19).

Moderate Plan

The Medical Rights Act -- under development by moderate House Republicans led by Rep. Mark Kirk (Ill.) -- would guarantee that the government would not be able to interfere with medical decisions made by physicians and patients. The measure is scheduled to be released during a press conference on Wednesday.

According to Kirk, the measure would make changes to the private insurance market and medical lawsuits to help reduce the cost of health coverage. The bill also would expand the number of public health clinics, increase the use of electronic health records and strengthen state-run high-risk insurance pools, according to Kirk. The proposal does not include a public option or an individual mandate that U.S. residents obtain health coverage.

While the cost of the plan is unknown, it would be "extra low compared to where the president's going," according to Kirk (CQ Today, 5/19).

Opinion Piece

A new Republican proposal for health care reform is "remarkably different" from current Democratic approaches in which "Congress could regulate its way to a government-dominated market," Galen Institute President Grace-Marie Turner and American Enterprise Institute scholar Joseph Antos write in a Wall Street Journal opinion piece. According to Turner and Antos, Republican senators on Wednesday will "introduce a bill that moves away from federal centralization." They write that the bill -- called the Patients' Choice Act -- "provides a path to universal coverage by redirecting current subsidies for health insurance to individuals," while also guaranteeing access to insurance for U.S. residents with pre-existing conditions. According to Turner and Antos, the plan functions by redistributing the $300 billion annual tax subsidy for employment-based health insurance to individuals as "refundable, advanceable tax credits." They conclude that the plan will put physicians and patients in control of the health care system (Turner/Antos, Wall Street Journal, 5/20).