GOP Unveils Health Care Bill

MICHELE NORRIS, host:

This is ALL THINGS CONSIDERED from NPR News. Im Michele Norris.

ROBERT SIEGEL, host:

And Im Robert Siegel.

House Republicans are doing something we havent yet seen in this years health care debate. They are drafting their own alternative bill. The Republican version is not final yet.

But NPRs Julie Rovner got her hands on a draft and she joins us now to discuss what it does and what it does not contain. Welcome once again, Julie.

JULIE ROVNER: Nice to be here.

SIEGEL: First, whats the headline? Is there a theme to this bill?

ROVNER: Yes, there definitely is. On the very first page of its 230 pages -and thats compared to the nearly 2,000 pages of the Democratic plan - the Republican bill notes that it does not raise taxes. It does not cut Medicare. It does not add to the federal deficit. And it does not have the government take over the health care system.

SIEGEL: So, there are lots of things it doesnt do. What does it do?

ROVNER: Well, if you followed health care in the House for the last dozen years or so, its kind of a greatest hits for Republicans. Theyve included several bills that passed the House repeatedly when the Republicans were in charge, but never got through the Senate. Things like capping damage awards and malpractice suits, establishing small business pools called Association Health Plans.

Then they also included expansions of tax deductible health savings accounts, proposals to let insurance companies sell policies across state lines. Those are all things that Republicans say will boost competition and lower health care cost. But theyre all quite controversial for a variety of different reasons - we dont really have time to get into here.

SIEGEL: Now, Republicans have been saying all year that there are a lot of things they agree with Democrats on when it comes to health care. How many of those things are actually in this bill?

ROVNER: Well, I think fewer than a lot of people expected. The Republican plan does call for prohibiting insurance companies from imposing annual or lifetime benefit caps. It stops a practice called rescission, where insurers can revoke a policy after an expensive claim is made because a person forgot to put on his or her application that they were treated for some minor condition years ago. People have had policies revoked because they were treated for acne, for instance. And it would let young adults stay on their parents health plan until they are aged 25. The Democrats actually raised that to age 27. But the idea is one that shared.

SIEGEL: What about barring insurers from discriminating against people with preexisting health conditions? They all agree on that or no?

ROVNER: Well, weve been hearing that all year from the Republicans that that is something that they agree on. But, in fact, this bill doesnt do that and theres a pretty good reason for it. It turns out you cant just tell insurance companies they have to start taking people who are sick. Otherwise people will wait until they get sick to buy insurance. You really need to require people to buy insurance while theyre healthy if you want to make insurers sell to everyone. But if you require people to buy insurance, then you have to provide financial help to those who cant afford it.

And as weve seen in the Democratic bills, its those subsidies for people who cant afford it. They cost so much that require the Medicare cuts and the new taxes, that the Republicans so want to avoid.

SIEGEL: So, no subsidies and youre saying also no mandates in this Republican scheme.

ROVNER: Thats exactly right.

SIEGEL: Well, when do we expect to see this bill in its final form out in public?

ROVNER: Well, the House Democratic leaders say they still hope to get a bill up on the floor this week. They have a pretty vague view of this week, it might be Saturday. Republicans want to offer this as an alternative to that bill. So we expect to see this very late this week, probably Friday, Saturday. This week may well stretch into next week.

SIEGEL: Thank you, Julie.

ROVNER: Youre very welcome.

SIEGEL: Thats NPRs Julie Rovner. Transcript provided by NPR, Copyright National Public Radio.