Republican Leader Press Office

From the New York Times

G.O.P. Counters With a Health Plan of Its Own


By ROBERT PEAR and DAVID M. HERSZENHORN

WASHINGTON — House Republicans have come up with an answer to Speaker Nancy Pelosi, drafting an alternative health care bill that would reward states for reducing the number of uninsured, limit damages in medical malpractice lawsuits and allow small businesses to band together and buy insurance exempt from most state regulation.

In its opening section, the Republican bill, which has no chance of passing, promises to lower health care costs and expand insurance coverage “without raising taxes, cutting Medicare benefits for seniors, adding to the national deficit, intervening in the doctor-patient relationship or instituting a government takeover of health care.”

The bill defines the differences between Republicans and Democrats, who intend to take up their bill on the House floor this week, after resolving intramural disputes over abortion and immigration.

The Republican bill differs from the Democratic measure in that it would not require people to obtain insurance or require employers to offer it. It is almost surely cheaper than the House Democrats’ bill because, unlike that proposal, it would not expand Medicaid or offer federal subsidies to low- and middle-income people to help them buy insurance. Nor would the Republican bill impose new taxes.

The House Republican bill would not explicitly prohibit insurers from denying coverage to people because of pre-existing medical conditions, even though many Republicans have said they agree with Democrats that the federal government should outlaw such denials.

House Republicans completed work on their measure as Senate Democratic leaders acknowledged that Senate floor debate on their bill was likely to slip to December, making it virtually impossible for Congress to achieve President Obama’s goal of enacting major health legislation this year.

If Congress is still wrangling over the legislation next spring, many of the 2010 midterm elections could turn into referendums on Mr. Obama’s health policies.

Pressed about the timetable, the Senate majority leader, Harry Reid of Nevada, declined to predict when Congress might complete a bill.

“We’re not going to be bound by any timelines,” Mr. Reid said at a news conference. “We need to do the best job we can for the American people.” He said that the bill would be posted on the Internet and that lawmakers would have ample time to study it.

Senate Democratic aides said it was still possible, but increasingly unlikely, that Congress would send a bill to Mr. Obama by Christmas.

The House Republican leader, Representative John A. Boehner of Ohio, said his bill would “lower costs and expand access at a price our nation can afford.”

In a few ways, the House Republican bill resembles the one headed for the House floor. It would allow young adults to stay on their parents’ health plans at least through age 24, compared with 26 under the Democrats’ bill.

House Republicans, like the Democrats, would prohibit insurers from imposing annual or lifetime limits on spending for covered benefits. And they would prohibit insurers from canceling or rescinding coverage after a person became sick unless the person had intentionally concealed “material facts” about a medical condition.

Democrats, who have been hearing unofficial accounts of the Republican bill, said it was too little too late.

Representative Christopher S. Murphy, Democrat of Connecticut, said the Republican bill would perpetuate the status quo for people with pre-existing conditions. And for millions of people who would still be unable to afford insurance, he said, the Republican message was, “Sorry, you’re out of luck.”

Reid H. Cherlin, a White House spokesman, said the House Republican bill “does nothing to provide more stability and security for people with insurance.”

The bill would offer $50 billion in federal “incentive payments” over the next 10 years to states that reduce the cost of health insurance or the proportion of their residents who are uninsured.

The bill would also make it easier for insurers to sell insurance across state lines. Policies would be subject to laws in a company’s home state, but would be exempt from many of the consumer protection laws, rating rules and benefit mandates in other states where the company sold coverage.

Republicans would also allow small businesses to pool their insurance buying power through “association health plans,” sponsored by trade and professional associations and chambers of commerce. These plans would have “sole discretion” over what services to cover.

Consumer groups, state officials and Blue Cross and Blue Shield executives have historically opposed such association health plans, saying they could engage in risky practices free from state regulation.

The House Republican bill would offer $15 billion to states to establish high-risk pools, for people who could not otherwise obtain coverage, and reinsurance programs, under which states act as a backstop to private insurers. Under a reinsurance program, a state pays a large share of the cost if claims — for an individual or a group — exceed some threshold.

The House Republican whip, Eric Cantor of Virginia, said high-risk pools and reinsurance programs would “guarantee that all Americans, regardless of pre-existing conditions or past illnesses, have access to affordable care.” Health policy experts say insurers can lower premiums if state reinsurance programs protect them against the risk of catastrophic costs.

In addition, the House Republican bill would impose new restrictions on consumer lawsuits against doctors, hospitals and makers of drugs and medical devices. In general, such lawsuits would have to be filed within three years after an injury became evident.

The bill would set a $250,000 limit on noneconomic damages, for physical and emotional pain and suffering. It would establish new hurdles for consumers to obtain punitive damages and would limit contingency fees for plaintiffs’ lawyers.