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Finding Republican Ideas In A Democratic Health Care Bill

February 9, 2010 - by Eric Naing

President Obama is asking Republicans what ideas they have to reform health care, but as Ezra Klein points out, many of their ideas are already in the existing Senate health care bill (H.R.3590).

As Donny mentioned, President Obama plans to hold a health care summit this month with Congressional Republicans. Speaking to CBS News anchor Katie Couric, Obama said, "I want to consult closely with our Republican colleagues. What I want to do is to ask them to put their ideas on the table.”

Using the GOP’s “Solutions for America” website, Klein pinpoints six ideas espoused by Republicans that Democrats have already adopted. Here’s a closer look at where these ideas are in the Senate health care bill, including links to the exact legislative text so you can read them in the context of the overall bill:

  • Conservatives argue that regulation of insurers can be too harsh in certain states and that the insurers should be allowed to sell policies across state lines. Klein says this idea lives on in Section 1333 of the bill, which allows for the creation of “Health Care Choice Compacts.” Under these compacts, a group of states could allow one insurer from any of those states to sell policies in all of them.
  • A second tenet of the GOP’s health care reform plan is to “allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.” As Klein says, this is exactly what the exchanges in Section 1312 of the bill are supposed to do or as the bill says, insurers have to consider everyone covered by a plan in “a small group market” “to be members of a single risk pool.”
  • The third GOP idea is to allow states to adopt their own innovations in lowering health care costs. This idea too is in the bill under Section 1332, Klein accidentally points to Section 1302. Under this section, states can apply for a waiver exempting them from the demands of the bill if certain requirements are met.
  • The fourth and final idea from the GOP website is to simply “end junk lawsuits.” The issue of malpractice is a controversial and highly partisan one and though the bill addresses it, Klein concedes that this might not be enough for conservatives. In Section 6801, states are encouraged “to develop and test alternatives to the existing civil litigation system,” the more promising of which should be evaluated by Congress.
  • Klein also throws in a couple ideas not mentioned on the GOP’s website, one of which is to cap or repeal the tax break for employer-sponsored insurance. He says the Senate bill accomplishes this through its excise tax on so-called “Cadillac” insurance policies or as they’re defined in Section 9001, “high cost employer-sponsored health coverage.” This provision is one of the main reasons the House is reluctant to vote for the Senate bill. Labor unions in particular oppose taxing high cost insurance policies.
  • The final GOP idea Klein points to is the fact that this bill is a private market plan. In a Democratic dream world, this bill would create a single-payer system where the government was the sole provider of health insurance. This idea was ruled out immediately and in its place, concepts were enacted like the exchanges in Section 1312 where the private insurance industry still maintains power.
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