GOP right: Where’s O-Care bill?

Top House conservatives are pressuring Republican leaders to bring an ObamaCare replacement bill to a vote by the August recess. 

Conservatives cheered when Majority Leader Eric Cantor (R-Va.) pledged a vote during the House GOP’s annual retreat in January, viewing the commitment as a central element of the party’s vow to be “the alternative party” and not merely stand in opposition to President Obama.

Yet 10 weeks later, party leaders have given no indication when they might present a plan or what form it will take.

{mosads}Conservatives like Rep. Steve Scalise (La.), chairman of the Republican Study Committee (RSC), are pushing for a vote by the time lawmakers leave town for five weeks at the end of July.

“At the end of the day, we feel it’s really important to bring a bill to the floor that is a true replacement to the president’s healthcare law,” Scalise said in a phone interview Tuesday. “Look, leadership’s come a long way in the last six months on that, and we’re continuing to talk to them to try to get to a point where we actually have a vote on the House floor by the August recess.”

Scalise wants the party to adopt a single, comprehensive replacement for ObamaCare, but party leaders have not signed off on that approach. In recent weeks, Rep. Paul Ryan (R-Wis.) has suggested the House might vote instead on a series of healthcare bills.

Speaker John Boehner (R-Ohio) has shied away from making any commitment at all, appearing to downplay the importance of holding a floor vote within a specific timeframe.

At a press conference last week, Boehner said Cantor and other top Republicans are “trying to build a consensus over what an alternative would look like.”

Asked when that bill might be ready, he replied, “We’re building a consensus. We’ll see.”

The deliberate pace of discussions has stirred fears among conservatives that a major healthcare bill may face the same fate as tax reform, another Republican priority that is unlikely to see a vote this year.

Many Republicans want to have a healthcare plan to present to voters at home and know it would be difficult to schedule a vote on major legislation during the heat of the election campaign in September.

“Part of the problem with Washington is it’s April, and Washington somehow thinks the election is like next week,” said Rep. Tim Huelskamp (R-Kan.), a foe of the leadership who voiced his frustration at a monthly conservative event last week.

“Our leadership promised us the American Health Reform Act, or something like that,” Huelskamp continued, referring to the RSC’s healthcare proposal. “Where’s the promise to follow through on that from January? I think this is an attempt to say what we’re for, but again two paragraphs is not a healthcare reform bill,” he said, in reference to the section of the Republican budget calling for a replacement for ObamaCare.

While conservatives have been pleading for a more aggressive Republican floor schedule, Boehner has signaled a more cautious election-year strategy that seeks to offer GOP proposals without subjecting members to contentious votes that would divert attention from Obama and the problems with the healthcare law.

Democrats, meanwhile, have mocked the GOP’s repeated efforts to repeal the law and criticized the party for failing to offer a replacement since it won the House majority in 2010.

Cantor’s office on Tuesday confirmed it is “still on track to get something done this year,” although a spokeswoman said no decisions had been made on when a proposal would be ready or whether it would take the form of a single bill or a series of bills.

Boehner spokesman Kevin Smith said the Speaker “is fully supportive of the majority leader’s effort to bring our members together around an alternative to ObamaCare.”

Rep. Tom Price (R-Ga.), a former RSC chairman who has been in the thick of health reform discussions, said he had initially hoped the party would have its alternative ready within the first half of the year but that “it’d certainly be before August.”

Individual lawmakers have presented a variety of proposals to replace ObamaCare, but the GOP is trying to rally around a single replacement for the first time. That plan is likely to feature long-standing Republican proposals on healthcare, like the expansion of health savings accounts, allowing people to buy insurance across state lines and the use of high-risk insurance pools to allow people with pre-existing conditions to access affordable insurance policies.

But the party is still trying to reconcile differences among the various approaches, and it must grapple with the disruption a new system could create for the millions of people who have used ObamaCare to enroll in Medicaid or sign up for insurance under its state and federal exchanges.

Cantor, along with Majority Whip Kevin McCarthy (R-Calif.) and the conference chairwoman, Rep. Cathy McMorris Rodgers (Wash.), have been meeting with committee leaders and other lawmakers on the project. Across the Capitol, Sens. Tom Coburn (R-Okla.), Orrin Hatch (R-Utah) and Richard Burr (R-N.C.) have already released their own plan.

And other Republicans, including Ryan and Sen. Marco Rubio (Fla.), may draft separate proposals as well.

While nearly every Republican in Congress remains publicly committed to repealing ObamaCare, outside healthcare experts say the party must recognize the reality that with so much of it in place, the law is unlikely to be fully scrapped, and almost certainly not before 2017.

“The word repeal will likely come to mean changing its function and ideology more than a wholesale capacity to revert to the state pre-[Affordable Care Act],” said Mike Leavitt, a former Utah governor and health secretary who advised GOP presidential nominee Mitt Romney’s campaign. “They won’t be able to go back and legislate from 2009.”

Avik Roy, another former Romney adviser who is now a senior fellow at the Manhattan Institute, said it remains possible Obama-Care will be fully repealed. But a better option for Republicans, he said, is to keep the law’s insurance exchanges but overhaul them so they are more market-oriented and can accommodate people who are currently on Medicare or Medicaid, a shift that he said would make those programs more fiscally sustainable.

“I don’t necessarily think the law is invulnerable to repeal and replace,” Roy said. But, he added, “on the range of possibilities, I believe it to be improbable.”