House vote orders committees to work up reform-replacement legislation

The U.S. House of Representatives voted 253-175 on a resolution that instructs four House committees to work on legislation to replace the Patient Protection and Affordable Care Act, with 14 Democrats supporting the measure.

Included in the resolution was one amendment from Rep. Jim Matheson (D-Utah) to include a permanent fix to the Medicare physician payment formula. The House adopted this amendment, which received support from 428 members, with Rep. John Conyers (D-Mich.) voting against it. Five members—Reps. Jim Costa (D-Calif.), Gabrielle Giffords (D-Ariz.), Donald Payne (D-N.J.), C.A. "Dutch" Ruppersberger (D-Md.) and Don Young (R-Alaska)—did not vote.

In morning debate, House Rules Committee Chairman David Dreier (R-Calif.), who introduced the replacement resolution weeks ago, said the measure is the second part of a two-step process, which began Wednesday night with the 245-189 repeal vote that wiped “the slate clean.” That action now makes way for the more challenging process of crafting solutions that will lower healthcare costs, Dreier said.

Specifically, the resolution directs the House Education and the Workforce, Energy and Commerce, Judiciary and Ways and Means committees to work up legislation that proposes changes to the existing law. It also includes 12 guidelines for the committees, including: providing people with pre-existing medical conditions with access to affordable health coverage; reforming the medical liability system to reduce unnecessary and wasteful healthcare spending; providing states greater flexibility to administer Medicaid programs; prohibiting taxpayer funding of abortions and providing conscience protections for healthcare providers; and expanding incentives to encourage personal responsibility for healthcare coverage and costs, according to resolution.

“This is a process in which we all must contribute,” Dreier said in his remarks on the House floor. “We have good ideas that are coming from both sides of the aisle. These must be shared, analyzed and debated,” he said.

But Rep. Jim McGovern (D-Mass.), who also serves on the House Rules committee, said the resolution is nothing more than a series of talking points, and that House Republicans are focused on re-opening old wounds and fighting old battles. “Instead of real language with real benefit, this resolution is simply empty promises,” McGovern said.

McGovern also said resolution is “absolutely silent” on the doughnut-hole issue, and also that the Affordable Care Act already does many of the things the resolution calls for, such as lowering premiums; ensuring more access to coverage; and preserving a patient's ability to keep an existing health plan.

America's Health Insurance Plans did not comment directly on the repeal legislation, but the group reiterated its view of the Affordable Care Act. “We continue to believe that changes are needed to the healthcare reform law in order to minimize coverage disruptions and cost increases for families and employers," Robert Zirkelbach, press secretary at AHIP, said in an e-mail.

Meanwhile, Families USA released a report citing a “double standard” by Republican House members seeking repeal, saying they plan “to take away many healthcare benefits and rights from America's families—but they intend to retain those same benefits and rights for themselves.”