WASHINGTON — Two Republican senators said Monday that they’ll propose legislation that lets states keep former President Barack Obama’s health care overhaul or opt for a new program providing trimmed-down coverage.
The plan by Sens. Bill Cassidy of Louisiana and Susan Collins of Maine would retreat from years of GOP cries to repeal Obama’s law and replace it with a still undefined Republican alternative. It comes as GOP lawmakers face pressure from President Donald Trump to quickly void and replace the health law and as Republicans continue hunting for a proposal that would unite them.
“It has been a Republican principle that power is best held by individuals and states, not the federal government,” Cassidy told reporters.
Trump has said he wants to keep some of the Obama overhaul’s consumer protections, like requiring insurers to cover people with pre-existing medical problems. Collins and Cassidy said their bill preserves many of those.
But Trump and congressional GOP leaders have not suggested letting states retain the entire statute. Such a proposal could dismay conservative voters who for years have viewed Republican calls to repeal the law as a top-tier promise and goal.
Cassidy said he’s discussed the proposal with Senate Majority Leader Mitch McConnell, R-Ky., who he said is “waiting to see how this plays out.”
Collins said the bill is still being written but would protect families and give insurers time to transition to new programs. She said if Republicans don’t advance legislation that serves as a starting point for the health care debate, “Then we will fail the American people.”
Senate Minority Leader Chuck Schumer, D-N.Y., said the GOP measure would reduce care and drive up medical costs for consumers.
“Ultimately, this proposal is an empty facade that would create chaos — not care — for millions of Americans,” he said.
House Speaker Paul Ryan, R-Wis., planned to meet late Monday with Vice President Mike Pence and top administration officials to discuss health care. Later this week, congressional Republicans will stage a retreat in Philadelphia at which health care will be a chief topic.
Cassidy described the senators’ proposal as a way to help Republicans overcome a key obstacle: To enact a full replacement for Obama’s law, they will need 60 Senate votes in a chamber they control by just 52-48.
“If you can say to a blue-state senator who’s really invested in supporting Obamacare, you can keep Obamacare but why force it upon us, we think that helps us get to 60,” Cassidy said, using the law’s nickname.
If states decided against keeping Obama’s statute, the senators’ proposal would let them adopt a program that charges consumers a high deductible and helps cover some basic medical services like emergency care and prescriptions.
Insurers would not be allowed to refuse coverage to people with pre-existing medical problems, and money states would get under existing law would instead go to patients in the form of a tax-advantaged health savings account they’d use to pay for care. People could also choose to buy more extensive coverage.
States could also completely design their own program but would receive no federal payments if they did.