GOP Continues Efforts To Dismantle Provisions of Health Reform Law

Republican leaders on several key House committees have started taking steps to dissect the federal health reform law, complicate its implementation and develop proposals to replace the overhaul, The Hill's "Healthwatch" reports (Pecquet, "Healthwatch," The Hill, 1/23).

Soon after the House approved a bill (HR 2) last week to repeal the reform law, the chamber passed a resolution (H Res 9) that would guide GOP leaders of four influential committees on how to develop alternative legislation to replace the reform law (Haberkorn, Politico, 1/20).

Rep. Trey Gowdy (R-S.C.), chair of the House Oversight and Government Reform Subcommittee on Health Care, said he intends to conduct a hearing by the end of February as part of his panel's investigation into waivers from certain health reform law requirements that the Obama administration has granted (Pecquet, "Healthwatch," The Hill, 1/23).

Details of Waivers

Last year, the Obama administration granted 222 waivers to businesses that offer low-cost health plans, or "mini-med" plans, exempting them for one year from a provision in the reform law that prohibits caps on health benefits. An estimated 1.4 million U.S. residents are covered under such plans.

Critics argued that concessions to overhaul measures would weaken the law (California Healthline, 12/10/10).

Gowdy said that if there are exemptions, it would be fair to ask administration officials about "the process by which those exemptions were sought and given." He added that he also would conduct investigations and hearings into fraud and abuse in government health programs.

Concerns about the waivers were noted in a letter that Republicans on the House Energy and Commerce Committee sent to HHS officials last week (Pecquet, "Healthwatch," The Hill, 1/23). The waivers also were mentioned in the GOP's weekly radio and Internet address, which Sen. John Barrasso (R-Wyo.) delivered on Saturday, Politico reports.

Barrasso criticized the waivers as "special Washington waivers," adding, "While the administration is forcing most Americans to accept the new law, over one and a half million Americans now get a free pass. ... Many of these waivers have gone to labor unions who supported the law in the first place, but now don't want to live under it" (Nather, Politico, 1/23).

On Friday, HHS Secretary Kathleen Sebelius rejected those criticisms, calling them "pretty ludicrous," The Hill's "Healthwatch" reports.

In an interview with The Hill, Sebelius said, "I find it ironic that people who are always demanding flexibility from the federal government are now criticizing flexibility in the federal government," adding that the waivers were "granted on the basis that we don't want to disrupt the marketplace. We don't want to take away people's health insurance before they have some realistic other choices" (Millman, "Healthwatch," The Hill, 1/23).

Medical Liability, Tort Reform Among Potential GOP Proposals

The "broad outlines" of House Republicans' plans to replace the overhaul are emerging, Politico reports.

According to Politico, the GOP's replacement plan is expected to "lean heavily on GOP standbys," such as cutting costs through medical malpractice reform, utilizing small-business purchasing deals to lower premium costs and shifting people with pre-existing medical conditions into high-risk insurance pools (Nather/Budoff Brown, Politico, 1/24).

On Thursday, the House Judiciary Committee dedicated its first hearing to medical liability reform, indicating that it is likely to feature prominently in the GOP's replacement legislation, MedPage Today reports. Although the health reform law addresses medical liability insurance by allocating $50 million in grants for future demonstration projects, physicians contend that the provision does not adequately resolve the problem and are calling for caps on the amount of noneconomic damages a jury can award (Walker, MedPage Today, 1/21).

Republicans Seek Senate Vote on Repeal

Meanwhile, Senate Republicans are seeking a vote in the Senate on House-passed legislation that would repeal the federal health reform law, the AP/Boston Globe reports (Daniel, AP/Boston Globe, 1/23).

Most lawmakers would consider the vote symbolic, as Republicans control only 47 seats in the Senate and likely would need 60 votes to pass the measure (Wyatt, New York Times, 1/23). Senate Majority Leader Harry Reid (D-Nev.) said the chamber would not vote on repeal.

However, Minority Leader Mitch McConnell (R-Ky.) pledged to force a vote. Sen. John McCain (R-Ariz.) said, "We have to have a vote on repeal so that everybody is on record whether they want to repeal."

Sen. Richard Durbin (D-Ill.) said Republicans could force a vote by offering an amendment on the floor (AP/Boston Globe, 1/23).