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House GOP Aims to Have Obamacare Replacement Ready for Trump

By Joe Williams, CQ Roll Call

December 15, 2016 -- House Republicans hope to be ready in January with a new system to replace President Barack Obama's health care law, according to Ways and Means Chairman Kevin Brady. But he declined to provide specifics Thursday.

GOP lawmakers on the panel are in the midst of a two-day policy discussion focused on taxes and health care. 

Republicans "are here in the Capitol while Congress is adjourned for the holidays to make sure we have ready for our new president and administration, the American people, a health care plan that is dramatically different than Obamacare," the Texas Republican told reporters during a break in the closed-door meeting.

Senate Majority Leader Mitch McConnell of Kentucky on Monday said Republicans would aim to pass repeal legislation through a budgetary tactic known as reconciliation early next year. That method only requires 51 votes in the Senate, as opposed to the typical 60.

Brady criticized Democrats for spreading assertions that 22 million individuals who currently receive coverage under the law will lose their health insurance plan following repeal.

"The Republicans will provide an adequate transition period to give people peace of mind that they will have those options available to them as we work through this solution," he said, but declined to describe the length of the transition period the GOP is considering.

A number of interest groups—including organizations representing hospitals, insurers and actuaries—have warned that passing repeal legislation without a replacement in place could destabilize the insurance markets.

Brady did not discuss any details regarding what would be in the replacement plan that Republicans were working on. Any proposal will likely face criticism from conservatives, as there remains little consensus within the GOP on a replacement system.

And some Republicans criticize the high deductibles that have become more common in the current health insurance marketplaces for individuals who buy coverage without help from their employers.

"What would a replacement look like that actually provides meaningful coverage and protects against medical bankruptcy?" a Senate GOP aide mused to reporters Thursday. "With a $6,000 deductible, is it even meaningful to have insurance?"

Brady was asked Thursday whether he would support so-called first-dollar coverage, a type of policy in which an insurer typically covers medical costs from the initial service without making people pay a deductible first. Brady said Republicans were looking at all options.

"We're giving very serious thought to how to provide the best health care and freedom possible," he said.

One lingering question is how the GOP might look to stabilize the insurance marketplace after repeal. House Republicans, for example, are in the midst of a lawsuit with the Obama administration over the law's cost-sharing subsidies for very low-income people. The subsidies reduce out-of-pocket costs, such as deductibles, for people whose income is no more than 2.5 times the federal poverty line. A federal court ruled on the case earlier this year that those payments were illegal, but a federal appeals court recently granted the GOP's request to delay action on the case until next year.

"If the lawsuit is withdrawn and the lower court ruling stands, then insurers will no longer be getting paid for the cost-sharing subsidies, and that could cause severe market disruption very quickly. So I don't know what the solution is to that," a House Democratic aide said Thursday.

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