Well, the House Republicans do. And it's not so much reform, really. The Senate Republicans are still apparently planning to rely on their fallback position of obstructing the Democrats, but the Republicans finally put their "eight or nine" ideas to paper [sub. req].
Under the GOP plan, insurance companies would still be allowed to exclude anyone with a pre-existing medical condition from coverage, there would be no national insurance exchange and businesses would not face any mandate to provide insurance nor individuals to buy it. Boehner also left out tax credits to help the poor and middle class buy insurance — a central pillar of most GOP reform proposals and a key feature of a four-page outline Republican leaders released in June.
You can read the entire draft [pdf].
It also explicitly excludes undocumented workers from any and all of the "reforms," and reiterates again the Hyde Amendment, restricting abortion coverage. It would also expand state-based high-risk insurance pools, the one idea that Boehner pointed to as "innovative." But just a note about those pools--they already exist, as Karen Tumulty points out:
[W]hen you look at what the House Minority Leader is describing as an "innovative" solution, you've got to wonder.
Specifically, he points to the kind of high-risk pools that many states have established for those who find themselves uninsurable as a result of a serious illness. That is not a new idea--some states have had these pools for three decades--or a solution for many. These pools already exist in more than 30 states, but they tend to be too expensive for those with limited means to buy into. And often, people cannot get into them for as long as a year after they apply.
When my brother developed kidney disease and his health insurance refused to pay to treat it, I looked into Texas' high-risk pool and discovered it would be far out of his reach, with premiums that typically run twice as expensive as regular insurance policies. California's high-risk pool has been a disaster, covering only 2% of the medically uninsurable.
So the primary "innovative" idea in the bill has already been tried and has proven lacking. But what the bill doesn't do is more to the point. And here's where we get to the mysterious case of the disappearing WSJ story. As Darcy blogged last night, the Wall Street Journal had the most honest summary of the bill in its headline: "GOP Health Bill Gives Insurers More Leeway" and in its lede.
A House Republican health-care bill wouldn't seek to prevent health-insurance companies from denying sick people insurance, Minority Leader John Boehner said Monday.
That's hardly reform, though the insurance companies will certainly love it. HCAN sums it up.
The Republican bill runs the table on provisions that will increase insurance company profits.
- Make more money by denying care? Check.
- Make more money by ending insurance policies when someone gets sick and actually needs to use the care they paid for? Check. (At least according to the original version of the Wall Street Journal article.)
- Allowing insurers to move to the least-regulated states and sell their junk insurance to the rest of the country? Check.
There's no attempt to expand coverage to people who are dying without it, that would be too costly. And no attempt to shield people from insurance company abuses like denial of care.
Maybe they'd have been better off just following the Senate Republicans' plan of just saying "no" without actually putting something this embarrassing out there. Maybe they figure they can get even more money out of the industry by kissing up to it with this "legislation."