“As the fate of the Affordable Care Act (ACA) is debated privately by Supreme Court justices over the upcoming weeks, bills containing “Obamacare” alternatives are waiting and ready in Congress, regardless of what the Supreme Court decides.
Following 3 days of oral arguments on Obama’s healthcare reform law, legal and healthcare policy experts are combing through the court transcripts and looking for clues as to how the court will rule. Many say the pointed and at times surprising questioning from the justices indicates a deep skepticism of the law, while others say oral arguments are not indicative of how individual justices will ultimately rule.
Whether the law is overturned or upheld, or pieces of it are stripped away, several members of Congress have their healthcare reform alternatives ready to go.
On Thursday, the House approved a budget proposal from Rep. Paul Ryan (R-Wis.), which would eliminate Obama’s healthcare reform law and structure Medicare in a manner similar to Medicare Advantage plans. Medicare beneficiaries could choose between traditional fee-for-service Medicare and several private insurance plans once they become eligible for coverage.
Once a beneficiary chooses a plan, the government would send that plan a “premium support” payment in an amount that would cover a basic health insurance plan. Beneficiaries who wanted a more generous plan would pay the difference.
The Ryan budget proposal is almost certain to be defeated in the Democratic-controlled Senate.
Rep. Paul Broun, MD (R-Ga.), has a proposal he’s calling the Patient OPTION bill, which would repeal the ACA and transform Medicare from what he calls “socialized medicine” into a premium support system, which people would have a choice of opting out of.
The bill would also make healthcare expenditures — including health insurance — fully tax deductible, and it would create tax incentives for physicians who provide free care to needy patients.
“Americans have loudly voiced that they want a do-over on Obamacare,” Broun wrote in an opinion column published in the Washington Times. “My OPTION Act is just that, providing access to the affordable care that so many people need, while adhering to the Constitution and strengthening the free market. It completely removes government from the doctor-patient relationship. It is also the only bill to give the patient full control of their coverage — even if they are on Medicare.”
Senate Minority Leader Mitch McConnell (R-Ky.) — who was in the Supreme Court for Tuesday’s oral arguments on the individual mandate — took to the Senate floor later in the week and reiterated that Republicans fully plan to repeal and replace the law. He didn’t mention that the Supreme Court might decide to repeal the whole law.
“It should be replaced with common-sense reforms that lower costs and that Americans actually want — reforms that protect jobs and state budgets, reduce the deficit, reform entitlements, and strengthen Medicare, ” McConnell said.
While Republicans are crafting limited-government alternatives to the Affordable Care Act (ACA), some on the other side of the political spectrum are trumpeting a single-payer, government-run system as the preferred alternative to the ACA.
Early in the healthcare reform debate, many Democrats wanted a government-run plan — referred to as the “public option” — included in the ACA. A House committee even passed a version of the ACA that contained a Medicare-for-all type plan. However, the public option wasn’t politically popular with some Democrats, and it was wildly unpopular among Republicans, so that provision was eventually removed.
What passed instead was a healthcare system that continues to rely on the private insurance industry as well as public insurance programs — like Medicare and Medicaid — in their current forms.
The irony is that while the public option wasn’t popular enough to pass, no one disputes the Supreme Court wouldn’t be considering the case if a single-payer plan had passed, because expanding Medicare and taxing everyone more would have been well within the powers of Congress.
Rep. Dennis Kucinich (D-Ohio), a single-payer advocate, is calling for a Medicare-for-all system regardless of how the Supreme Court votes in June.
“Whether the Supreme Court upholds the law or strikes it down, single-payer is the only alternative that can meet our nation’s needs,” Kucinich said in a press release.
Kucinich’s bill, titled “Medicare for All,” would “cover everyone in the U.S. for all medically necessary services with no copayments, premiums, or deductibles, for the same amount we currently pay for healthcare.””