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Tags: Troy | Obamacare | Republican | plan

American Health Policy Institute's Troy on GOP Healthcare Alternatives

By    |   Thursday, 02 April 2015 08:03 AM

Congress is in the midst of a two-week recess, or "district work period," but this does not prevent the staff from working intensively on such active issues as drafting alternatives to Obamacare in case legislative and judicial strategies should put the Republican Congress in a position of having to come up with what is sometimes referred to a constructive Republican alternative proposal.

With this in mind, Tevi Troy, president of the American Health Policy Institute, who served as Deputy Secretary of the Department of Health and Human Services (HHS) from 2007 to 2009, appeared on C-SPAN's Washington Journal April 1 to discuss the status of this work. The Institute was created by Troy and others a year ago to focus on issues related to employer-sponsored care.

He was interviewed by host Pedro Echevarria, who began by asking, "If the Supreme Court decides against the subsidies for Obamacare, are Republicans prepared for that?"

Troy pointed out that the subsidies are at stake only in states that did not create their own exchanges, but since only about 14 states did create exchanges, about 34 states would be ineligible for subsidies if the Court ruled for the plaintiffs. In that event, Troy said he didn't know what would happen but, "It seems to me the Republicans are better prepared than the Obama administration, which is claiming it's not making any contingency plans, because they're assuming they're going to win. Republicans, at least, are looking at a variety of plans." He referred to an "all-star" team of conservative intellectuals who have been writing in the Wall Street Journal about various options.

Accordingly, Troy divided the alternatives into three categories: 1) some kind of temporary transition to keep the subsidies going for a year or two to buy time, an idea associated with Sen. Ben Sasse, R-Neb.; 2) designing an "off ramp" that would lead to a replacement for Obamacare, which Troy called "highly unrealistic" while Obama is president; and 3) an idea from the think tank community, including Troy himself, predicated on "some kind of deal" to continue the subsidies in exchange for relief from some of the regulations, thus confronting the president with a choice that would include an option to continue the subsidy.

Echevarria asked for an example of what Republicans would ask for as relief. Troy mentioned the requirement that states provide a given level of benefits called "essential." He suggested that the evolution of the exchanges into de facto regulatory bodies goes beyond the scope of what they were supposed to do. He argued further that the additional regulations on the insurance raise the cost. Echevarria asked about the requirement that pre-existing conditions be covered, and at that point Troy said Republicans have merely talked about "unspecified regulatory relief."

Asked whether any of the proposals is on a "fast track," Troy said the thinking is still in "the idea phase," because the outcome of the King v Burwell case is still unknown. He conceded an advantage to the administration, which can have one policy, whereas Congress is reduced to "herding cats."

Troy declared that the Institute is testing the administration's pledge that, "If you like you plan, you can keep it."

(Archived video can be found here.)

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Congress is in the midst of a two-week recess, or "district work period," but this does not prevent the staff from working intensively on such active issues as drafting alternatives to Obamacare.
Troy, Obamacare, Republican, plan
Thursday, 02 April 2015 08:03 AM
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