


GOP leaders unveil rough outline on health care plan

At a closed-door meeting in the Capitol basement, House Speaker Paul Ryan, R-Wis., and other party leaders described a broad vision for voiding much of President Barack Obama’s 2010 statute and replacing it with conservative policies. It features a revamped Medicaid program for the poor, tax breaks to help people pay doctors’ bills and federally subsidized state pools to assist those with costly medical conditions in buying insurance.
One option being pushed by Ryan and other leaders would replace the tax increases in Obama’s law with new levies on the value of some employer-provided health plans — a political no-fly zone for Republicans averse to tax boosts.
“You have to legislate with a sense of political reality,” said Rep. Tom Cole, R-Okla., who said backing that proposal “would set up an ad against you from multiple directions” during upcoming elections.
The scant health care progress mirrors a lack of movement on other GOP issues.
No proposals have surfaced to pursue President Donald Trump’s campaign promises to build a border wall with Mexico or buttress the nation’s infrastructure, and Republicans have yet to coalesce around another priority, revamping the nation’s tax code.
Senate Republicans have criticized a House GOP plan to change how corporations are taxed. Trump has yet to produce a proposal he’d said would be released in weeks, drawing mockery from Democrats.
“At some point we need to move from imaginary made-up plans to things that you can read on paper,” said Sen. Mark Warner, D-Va.
The health care outline was aimed at giving Republicans something to exhibit during next week’s congressional recess. Ryan told reporters that Republicans would introduce legislation voiding and replacing Obama’s statute after Congress returns in late February.
Many Republicans took an upbeat tone after Thursday’s meeting, with Rep. Peter King, R-N.Y., saying, “We’re only 27 days into the new administration, so we have time.”
Lawmakers said they were awaiting official cost estimates from the nonpartisan Congressional Budget Office, which could ignite other battles if the price tag is disconcertingly high.
Obama’s law levied $1.1 trillion in taxes over a decade to finance its expanded coverage to millions. GOP leaders said some or all of those taxes could be repealed, with the revenue replaced by a new tax on health care that employees receive at work.
Two people familiar with the proposal said individuals would pay taxes on the value of such coverage above $12,000, and above $30,000 for families.
According to documents distributed to members, the expansion of Medicaid to millions of additional poorer people — almost entirely financed by federal taxpayers — would be phased out. In a compromise aimed at resolving a dispute, extra Medicaid money would flow to the 31 states that accepted that expansion and the 19 that didn’t, though it would end “after a certain date.”
After that, states would get more discretion to decide who would be covered by Medicaid. They’d also decide whether to receive federal Medicaid funds based on the fluctuating numbers of the program’s beneficiaries or a set annual amount.
The tax penalties Obama’s law levies on people who don’t buy insurance would be abolished, as would federal subsidies for most people buying coverage on the online exchanges the statute established. They would be replaced by tax credits for people who don’t have job- or government-provided health coverage and tax-advantaged health savings accounts.