BY ERIN MERSHON AND JOE WILLIAMS, CQ ROLL CALL
Utah Republican Sen. Mike Lee on Wednesday criticized a House proposal to include provisions that would “replace” the 2010 health care law in a repeal measure, calling it “a horrible idea.”
“If we load down the repeal discussion with what comes next, I think it’s going to make it a lot harder to get either one of them done,” Lee said during a reporter briefing sponsored by The Heritage Foundation. “We need to repeal it first before deciding what comes next. I think there is a lot of agreement among Republicans in Congress with regard to the repeal bill. There is a lot less agreement on what comes next.”
His comments come as House Republican leaders are emphasizing an ambitious agenda to include several “replacement” plans in that repeal measure, done through the budget reconciliation process, including provisions that would expand the use of health savings accounts, fund high-risk pools, and put in place tax credits for people who purchase insurance on the individual market, according to congressional aides, lobbyists and other sources off Capitol Hill.
House Speaker Paul D. Ryan is even making the case directly for including some revisions to the Medicaid program in the reconciliation measure. The plan would likely include transitioning to a “per beneficiary allotment” system that would be very similar to a per-capita grant approach, which provides funding to states directly tied to enrollee populations, according to lobbyists.
Several outside sources confirmed that House lawmakers are talking to the Senate parliamentarian to ensure those pieces can pass that chamber’s tough restrictions on reconciliation measures.
It’s an ambitious package of so-called replacement ideas, many of which Republicans have long suggested would be a viable alternative to the controversial health care law. GOP leadership in the House had been planning earlier this year to pass a relatively simple “repeal” measure as quickly as possible before turning to replacement policies. But after widespread concerns from both the House’s hard-line conservatives and some of its more moderate members, leadership has agreed to include replacement pieces like those outlined above, which Ryan has said the House will take up this spring.
Lee’s comments highlight how difficult it will be to get through any of those provisions in the Senate — where the GOP is already operating with a very slim margin of error. Republicans will likely be able to afford to lose just two votes on the package.
Several sources off the Hill confirmed that Senate offices were not on the same page as the House. Many said the chamber is likely to move forward with a plan to pass a reconciliation bill resembling the one the chamber passed last year, which was limited to repealing parts of the health care law and defunding Planned Parenthood.
The House committees of jurisdiction are not expected to hold hearings on the repeal and replacement measures until March, according to aides.
When asked about the plans, a Ryan spokeswoman directed CQ Roll Call to the Ways and Means and Energy and Commerce committees. Spokesmen for those panels did not immediately respond to requests for comment.
House GOP leaders will hold listening sessions next week with rank-and-file members to discuss topics including HSAs and Medicaid revisions.