‘Obamacare’ replacement bill not likely to settle debate

The nation's passionate debate about the role of government in providing health care for citizens and paying the costs is unlikely to be settled by the legislation newly revealed by House Republicans.

With Republicans now controlling the White House and both chambers of Congress, the bill would drive government policy down routes long advocated by conservatives. The course correction would take at least two years to get rolling, and probably longer to show definitive results. If it falls short, it would give rise to a fresh set of health care grievances.

The Republican legislation would limit future federal funding for Medicaid, which covers low-income people, about 1 in 5 Americans. And it would loosen rules that former President Barack Obama's law imposed for health plans directly purchased by individuals, while also scaling back insurance subsidies.

Republicans say their solutions would make Medicaid more cost-efficient without punishing the poor and disabled, while spurring private insurers to offer attractive products for the estimated 20 million consumers in the market for individual policies.

But Democrats say the bill would make many people uninsured, shifting costs to states and hospital systems that act as providers of last resort. Individual policy holders might be able to find low-premium plans, only to be exposed to higher deductibles and copayments.

There are no easy answers, said Dan Mendelson, CEO of the consulting firm Avalere Health. "Health care is expensive and it becomes more expensive every year," he said. "Under the GOP plan, it will be more expensive every year just like it was under the Democratic plan."

Nonetheless, he called the Republican proposal a feasible alternative.

Over the next few days, stakeholders will be dissecting the GOP proposal, which may become the second major shift on health care policy in less than a decade. Democratic and Republican governors, hospital executives, physician groups, insurers, drug makers and consumer groups will have their say. The bill will be measured against expansive promises that President Donald Trump made during the campaign.