NEW YORK (MainStreet) Senate Republicans revealed their vision for health care yesterday in a proposal drafted by Senators Orrin Hatch (Utah), Tom Coburn (Okla.) and Richard Burr (N.C.) as a legislative blueprint for conservative reform. Unsurprisingly, as its first order of business, the Patient Choice, Affordability, Responsibility and Empowerment Act (P-CARE) repeals President Barack Obama's health care law in its entirety.
It then spends eight pages largely putting that law back together. Rather than overhaul health care in a new direction or return us to the free market free for all, the Senate Republicans' plan is essentially a series of adjustments to the Affordable Care Act, revealing in some measure just how far the health care debate has moved since 2009.
The proposal keeps many of the most popular parts of Obamacare intact, including the bar on lifetime limits and the rule allowing adult children to stay on their parents' insurance until age 26, although it abandons issues unpopular with conservatives such as plan regulation and the birth control mandate.
Senate Republicans would also keep the current law's restrictions on charging higher premiums based on age, although in somewhat looser form. Under Obamacare, insurers can charge older customers a maximum of three times as much as they do the young. The P-CARE proposal would increase that ratio to five, with an option for states to opt out of the requirement altogether if they choose.
As far as the essential "three pillars" of Obamacare, the proposal focuses on modifying rather than abandoning them. Tax credits to purchase insurance remain a part of the system, as does a variation on banning pre-existing conditions.
Instead of the individual mandate, which would no longer exist, the new plan would solve insurance death spirals with "continuous coverage protection."
Continuous coverage would ban private insurance companies from denying coverage based on pre-existing conditions if, and only if, the consumer were already "continuously enrolled in a health plan" for at least 18 months. It would require insurers to offer those plans at "a standard rate" and allow a one time enrollment period during which everyone could purchase plans regardless of coverage or pre-existing conditions.