A Senate committee chairman with Obamacare jurisdiction offered the most detailed plan we’ve seen since the election to repeal and replace the ACA, on the floor of the Senate Tuesday afternoon.
Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-TN), who has long advocated for a “simultaneous” approach to scrapping and replacing the Affordable Care Act, said that Republicans should be focused on repairing Obamacare’s exchanges while building a new system to deliver health care to the American people.
It’s still unclear whether Alexander’s plan has the blessing of leadership, nor is it clear whether the GOP will follow through with it ultimately, but Alexander’s speech gives real insight into how a powerful and respected Republican chairman is trying to get his party to think about repealing and replacing Obamacare and what he thinks Republicans should be doing to build their own system.
Here’s what you should know.
Alexander only wants to see Obamacare repealed once “there are concrete, practicable reforms in place.” “It’s not about developing a quick fix. It’s about working toward a long-term recovery that works for everyone,” Alexander said.
Alexander said that he wants to first “rescue” the current Obamacare exchanges because people are still on them. “First we’ll offer a rescue planning so that the 11 million Americans who buy insurance how on the exchanges can continue to do so while we build a better set of concrete, practical alternatives.” To do that, Alexander wants “Congress and the president to take action before March 1, which is when insurance companies begin to decide whether they will offer insurance on these markets during 2018. In general, the goal is to get as close as possible to allowing any state-approved plan to count as health insurance under Obamacare rules while we are transitioning to a new system.”
During the transition, Alexander said Republicans should continue the cost-sharing subsidies that insurers get for covering low-income people on the exchanges. He also advocated “repeal [ing] the individual mandate when new insurance market rules are in place” and giving individuals the opportunity to use their Obamacare subsidies to purchase health insurance outside of the Obamacare exchange.
Alexander also said Republicans would then go to work on building a new health care system. “I say systems, not one system. If anyone is expecting Senator McConnell to roll a wheelbarrow on to the Senate floor with a Republican health care plan they’re going to be waiting a long time because we don’t believe in that. We don’t want to replace a failed Obamacare federal system with a failed — with another failed federal system. We want to create many systems across this country step by step … we’ll do this by moving more health care decisions out of Washington and into the hands of states and patients.”
Alexander also promised that replacing Obamacare would not make changes to Medicare nor would the bill be used to take away protection for people who have pre-existing conditions. The replacement would also allow people to stay on their parent’s plans until they’re age 26, Alexander said.
Alexander wants states to be able to expand Medicaid, but he doesn’t want them to have to bend over backwards to get waivers from the Trump administration.
“We will give states more flexibility to offer those 62 million citizens more options by making federal Medicaid waivers more flexible,” Alexander said.
In order to build a new system, Alexander advocated Wednesday to expand health savings accounts and “eventually provide tax credits to help lower-income Americans buy insurance. ” Alexander would then give states more “flexibility” “to further innovate to build more modern health systems.”
To guarantee that employers get a break from Obamacare, Alexander wants Republicans to repeal “Obamacare’s employer mandate penalty.”
“We will allow states to determine the so-called essential health benefits and thereby lower costs for small businesses,” Alexander said. “We’ll repeal Obamacare’s restrictions on grandfathered health plans, on wellness benefits, on small group plans and provide more flexibility for small businesses.”