GOP offers health care repeal without alternative

WASHINGTON -- House Republicans generally avoided talk of replacement measures Tuesday as they mobilized for an election-season vote to repeal the health care law that stands as President Barack Obama's signature domestic accomplishment.

Instead, they lambasted the 2-year-old law as a threat to the nation's economic recovery and predicted some Democrats would join them in repudiating it.

"This is nothing short of economic malpractice," said Rep. Nan Hayworth of New York, citing tax increases, government mandates and other items in the law. "We can and we must do better."

She did not elaborate, nor did any of the members of the leadership in their remarks to reporters after the meeting.

Republican officials said the general reluctance to sketch any sort of alternative resulted from a desire to focus public attention on the health care law itself. It generally fares poorly in public polling, both nationally and in surveys of independent voters.

In addition, they said that while many Republicans ran on a slogan of "repeal and replace" in 2010, the rank and file is far from united around any precise alternative.

Republicans in both houses have suggested numerous measures in recent years to remake parts of the sprawling health care system. The last time the party offered a full-fledged legislative alternative was in 2009, meaning that none of the dozens of first-termers elected in 2010 were involved in its drafting.

That measure called for capping medical malpractice judgments, allowing insurance companies to sell policies across state lines and permitting small businesses to pool together to purchase coverage for their employees.

It also would have provided funds to the states to help maintain high-risk insurance pools for people with pre-existing conditions, for whom insurance is otherwise either unavailable or prohibitively expensive.

Taken together, Republicans said at the time their alternative would have reduced federal health care costs as well as the deficit. It also shunned the government mandates at the heart of the law that eventually passed.

The Congressional Budget Office estimated the GOP alternative of three years ago would have contributed to a reduction in premiums, particularly for individual policies and those covering small groups.

At the same time, the CBO estimated it would have left the percentage of legal residents without coverage unchanged at the end of a decade, a contrast to the reductions envisioned in the Democratic legislation then taking shape.

Nor would it have required insurance companies to cover pre-existing conditions or make other changes included in the law that passed.

In the run-up to today's vote, Democrats sought political advantage in the lack of a Republican alternative.

"What the Republicans are really doing this week is to try to repeal health care reform and protections against insurance company abuses," said Rep. Sander Levin of Michigan, the senior Democrat on the House Ways and Means Committee.

He said repeal of the legislation would eliminate an existing guarantee on coverage for those with pre-existing medical conditions, raise out-of-pocket costs for seniors with high prescription drug expenses, reinstate annual and lifetime benefit caps and jettison a requirement allowing children up to age 26 to remain on their parents' coverage.

But given the evident unpopularity of the current law, Republicans have appeared eager to avoid any association with any part of it -- or even the monthslong process that produced it.

"We will not push through a 2,700-page bill the American people can't afford and don't want," Sen. John Barrasso of Wyoming said in the weekly Republican address a few days after the Supreme Court had upheld the constitutionality of the law.

"Unlike President Obama, we will not cut deals behind closed doors to protect special interest groups, or include political carve-outs for some states at the expense of others. ... Republicans in Congress are committed to a step-by-step approach that's focused on lowering the cost of care."

In his remarks, Barrasso advocated several of the provisions contained in the alternative Republican alternative from 2009.

Despite the political maneuvering, the outcome of the vote Wednesday is scarcely in doubt.

All Republicans are expected to support the repeal legislation. McCarthy did not offer an estimate of the number of Democrats who would vote with the Republicans.

The measure faces certain death in the Senate, where Democrats hold a majority, and Obama recently declared the law is "here to stay" following a ruling by the Supreme Court that it is constitutional.

Even so, Senate Republican leader Mitch McConnell of Kentucky said during the day he hopes for a vote on the House bill later this year.

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Associated Press writers Alan Fram and Andrew Taylor contributed to this report.