GOP 'Pledge' Includes Vow to Repeal Reform Law

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WASHINGTON -- The "Pledge to America" unveiled by congressional Republicans on Thursday includes a vow to "repeal and replace" the healthcare reform law signed six months ago by President Obama.

The American people "don't want the $500 billion in their taxes and the over 150 boards, bureaucracies, and commissions required to implement this," Rep. Bill Cassidy, MD (R-La.) said at a press conference held by GOP congressional leaders. "What the American people told us they want is that we defund, repeal, and replace" the Affordable Care Act (ACA), which was signed by President Obama on March 23.

Read this story on www.medpagetoday.com.

Republicans included the following healthcare-related items in the 21-page "pledge" document:

Repeal the Affordable Care Act. "Because the new healthcare law kills jobs, raises taxes, and increases the cost of healthcare, we will immediately take action to repeal this law," the document says.

Enact Medical Liability Reform. "Skyrocketing medical liability insurance rates have distorted the practice of medicine, routinely forcing doctors to order costly and often unnecessary tests to protect themselves from lawsuits," the document notes. The authors say they plan to "enact common-sense medical liability reforms to lower costs, rein in junk lawsuits, and curb defensive medicine."

Purchase Health Insurance Across State Lines. The document reads, "Americans residing in a state with expensive health insurance plans are locked into those plans and do not currently have an opportunity to choose a lower cost option that best meets their needs. We will allow individuals to buy healthcare coverage outside of the state in which they live."

Expand Health Savings Accounts. The GOP plan touts health savings accounts (HSAs) as "popular savings accounts that provide cost-effective health insurance to those who might otherwise go uninsured." The Republicans pledge to "improve HSAs by making it easier for patients with high-deductible health plans to use them to obtain access to quality care" but do not offer further specifics. They note that the ACA bars patients from using HSAs to buy over-the-counter medicines.

Ensure Access for Patients With Preexisting Conditions. The Republicans pledge to "expand state high-risk pools, reinsurance programs, and reduce the cost of coverage" as ways of ensuring access. They continued, "We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a preexisting condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick."

Permanently Prohibit Taxpayer Funding of Abortion. The pledge includes permanent enactment into law of the "Hyde amendment," a rule that bans the spending of government funds for abortion and that has to be reauthorized every year. Republicans also want to enact "conscience protections" for healthcare providers, allowing them to opt out of providing abortions or other services that they have a moral objection to.

The document also includes a promise to "strengthen the doctor-patient relationship" but provides no further details.

The Obama administration wasted little time in mounting a response to the pledge.

"The [Republicans'] agenda claims to protect people with preexisting conditions, but it repeals the new law's ban on discriminating against uninsured Americans, including children, who have a preexisting condition," Stephanie Cutter, assistant to the president for special projects, wrote on the White House blog. "It will mean that seniors will pay more for their prescription drugs, and their new free preventive Medicare benefits will be cut.

"And it will mean that millions of Americans will have to give up their new Patient's Bill of Rights protections, from the 21-year-old now getting covered on his or her parents' plan to the woman getting the preventive care she needs to prevent breast cancer and the individual who has lost his right to appeal an insurance company's decision to an independent third party."

On a conference call with reporters and senior citizens, vice-president Joe Biden reminded listeners of the Republicans' last such effort in 1994, called the "Contract With America."

"The last time the Republicans went out there and had a new manifesto for the American people, [then-House Minority Whip Newt Gingrich] talked about letting Medicare 'wither on the vine,'" Biden said. "The healthcare bill we just passed does nothing but strengthen Medicare."

"Folks, we're not going to let them repeal this healthcare bill; we're not going to let them take away your benefits," he added. "You may disagree with us on foreign policy, you may disagree with us on trade, you may disagree with us on a lot of different things, but if you care about Medicare, this is where you should be."

The White House also announced Thursday that seniors who fall into the "doughnut hole" -- that portion of the Medicare drug benefit program during which they have to pay 100 percent of all their prescription costs -- will receive a 50 percent discount on all brand-name drugs beginning in 2011.