When the Supreme Court last week heard arguments in the 26-state legal challenge to Obamacare, Georgia was well-represented. There was Sam Olens, who as our attorney general is one of the plaintiffs. And there was Tom Price, a leader in the effort to repeal and/or replace the law, however the justices rule.
“It was really uplifting, actually,” Price, a fourth-term congressman from Roswell and the fifth-ranking Republican in the House, said in a phone interview. “I think [the justices] were giving it the serious consideration that it warrants.”
Price, who previously practiced medicine, not law, stopped just short of predicting the outcome: “My suspicion is this will be ruled unconstitutional, but I’m not a court watcher so that may be more hope than fact.” Either way, he’s ready.
Price’s updated bill begins by repealing the Patient Protection and Affordable Care Act, a.k.a. Obamacare, in case the Supreme Court leaves all or part of it intact. Then it moves on to correct the inequity in the way tax law treats health insurance. Individuals who buy their own insurance would get the same tax deduction as employer-sponsored plans.
Low-income Americans could receive the tax benefit as a credit both refundable — meaning they’d get it even if they didn’t pay income tax — and advanceable — meaning it could be paid directly to the insurer, rather than the insured person fronting the money. It would also allow people to opt out of government programs such as Medicaid and Medicare and receive a tax credit toward a private plan.
Missing is a legal requirement to buy health insurance, just incentives that mean “you’d be foolish to not get covered,” Price said.
Next, the bill tackles two other problems: portability and pre-existing conditions. Regarding the former, Price said his bill “makes it so that everybody owns their health coverage regardless of who’s paying for it — your employer, the government, or you. If you change or lose your job, you just take it with you. Losing your health insurance when you change your job, when the employer is using your money out of your paycheck, just doesn’t make sense.”
For pre-existing conditions, the bill again mimics the advantages now given only to big employers. It allows states, small businesses and other entities (e.g., churches or trade associations) to form risk pools large enough that people with chronic health problems won’t be turned away.
“The vast majority of high-risk pools at the state level don’t work, because you take all the sickest people and throw them in a pool and — surprise, surprise — their costs are greater,” he said. “We believe any individual ought to be able to access a pool of millions of people.”
In doing so, the bill “would create a market for a new product that doesn’t exist now because it’s against the law to do what we propose to do.”
Another key element of the bill is a tort reform authored by Phil Gingrey, another Georgia doctor-turned-congressman.
Price said defensive medicine — procedures doctors order to avoid being sued — accounts for a quarter of U.S. health costs, or some $600 billion a year. To reduce that figure, the bill proposes administrative health courts in which experts and specialized judges handle malpractice claims. It also creates a “safe harbor” for doctors who follow industry-standard guidelines for treating a particular ailment.
To allay concerns tort reform is up to the states, not Washington, the bill limits the safe harbor provision to patients with a “nexus with the federal government.” That means they are covered by a federal program (Medicare, the military’s Tricare, etc.) or a big employer whose plan is governed by the federal ERISA law.
“That gets you about 85 percent of the population or even more,” Price said. “So we believe that in and of itself would change the dynamic, and make it such that states could adopt fill-in measures.”
Democrats often claim GOP opponents of Obamacare offer no alternative. Price’s bill dispels that notion. He has little confidence Democrats will now entertain his 32-month-old bill. But …
“That’s not to say, if the Supreme Court throws it out, there couldn’t be a change of heart,” Price allowed, “and I would welcome that with open arms.”
– By Kyle Wingfield