|By Mike Dennison, Independent Record, Helena, Mont.|
|McClatchy-Tribune Information Services|
They've voted several times to repeal it (as recently as last Wednesday), supported lawsuits to undo it, tried many ways to block its implementation and relentlessly bashed Democrats who supported it.
What may get lost in the political shouting match, however, is that Rehberg and Republicans do have health-reform proposals of their own -- and have passed bills on the subject.
"These are all pieces that we as a Republican conference wanted to present (in 2009)," Rehberg said in an interview last week. "But (Democrats') solution was essentially a government solution."
Yet, at the same time,
elements of some of their main proposals -- interstate sales of health insurance, allowing businesses to pool together to buy insurance, use of high-risk pools for the hard-to-insure -- are included in the 2010 Affordable Care Act (ACA), known by its detractors as "Obamacare."
The two most prominent Republican reform proposals are to allow more interstate health-insurance products and pooling of health-insurance customers, and to limit what injured patients and their lawyers can recover in medical-malpractice lawsuits.
Republicans in the House passed a medical liability-limit bill in March -- only to see it stall in the Democratic-controlled
Rehberg and fellow Republicans say allowing businesses to pool across state lines to buy health insurance and sales of interstate products would increase the options and reduce the cost for health insurance.
They've also advanced other ideas, such as letting people take tax deductions for the cost of individually purchased health insurance and encouraging more use of tax-deductible Health Savings Accounts.
When asked why Republicans didn't pass such measures in the mid-2000s, when they controlled
Also, Rehberg says the first step now has to be repealing the ACA: "We have to have a starting point. ... "the 'replace' is putting the puzzle back together."
The GOP House voted in March to pass HR5, which would impose a national limit of
There is wide debate on how much these limits might lower costs.
Rehberg, who voted for HR5, says it's clear the limits would lower costs, and that Democrats and the president have refused to consider them.
"Anything you do to control that cost has to save money," he says. "We already know for a fact that the cost of (malpractice lawsuits) will be passed on to consumers."
However, the ACA does include a provision allowing states to conduct pilot projects on malpractice limits. No projects have been funded by
Current law also allows interstate pooling by similar businesses to buy health coverage, on a small scale. Insurance brokers say it produces some savings, and expanding it would be helpful -- but that health-care costs are what really drive the cost of insurance.
The ACA has other provisions to encourage pooling among businesses and allow interstate insurance sales.
Yet many health insurers and state insurance regulators oppose interstate sales, saying it could mean a new level of federal licensing and regulation over insurance, and less consumer protection.
"We don't think it would be in the best interests of either states or consumers," says
Some Republicans in
Rehberg says insurers and state commissioners have always opposed such laws.
"They want to limit the ability of an individual like myself to go over and buy a better product in
Rehberg also says he'd like to expand the use of subsidized high-risk pools for people who have trouble getting health coverage because of pre-existing health conditions.
The ACA did just that, providing funding to cover several hundred additional high-risk people in
(c)2012 Independent Record (Helena, Mont.)
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