Dem-GOP Split on Health Care Goes Beyond Public Option

If you were to listen to most coverage of the health-care debate, you would be excused for thinking that the public option is the only significant difference between the parties.

It's not.

Republicans and Democrats are at loggerheads on a far broader set of issues.

The distance between the parties' leaders on health care was made clear on Tuesday when the No. 2 Republican in the Senate held a conference call with reporters.

Asked by ABC News about a package of insurance market reforms that have been endorsed not only by President Obama but also by the insurance industry, Sen. Jon Kyl came out against all three proposals.

VIDEO: The president sends mixed messages on a public option in his reform bill.

In particular, the Arizona Republican signaled that he opposes requiring insurance companies nationwide to provide coverage without regard to pre-existing conditions; requiring them to charge everyone the same rate regardless of health status; and requiring all Americans to carry health insurance.

"One of the concerns I have about the approach of the Democrats ... is an assumption that there has to be a national mandate on all insurers to do various things," Kyl told ABC News when asked for his position the three issues.

"Those are techniques that states can, and some have, used in the past with fairly disastrous consequences," he said.

Although the public option has dominated coverage of the health-care debate, Kyl's comments underscored that the rift between GOP leaders and Democrats runs much deeper.

VIDEO: Opting for Health Care Co-ops

"The more you look into [the views of congressional Republicans], the more you are going to find significant opposition up and down the board to most ideas on the table when it comes to comprehensive health-care reform," Jim Manley, the senior communications adviser to Senate Majority Leader Harry Reid, D-Nev., told ABC News. "Republicans are betting that the president will fail."

Kyl said he opposed guaranteed issue -- requiring insurers to provide coverage without regard to pre-existing conditions -- and community rating -- requiring them to charge the same rate regardless of health status -- because of concerns about cost.

"There's no question that it does raise costs," Kyl said. "And the objective here is to reduce costs."

Video of Rep.

Obama Supports Mandating Individuals to Have Health Insurance

Two years ago, the insurance industry commissioned a study of states that have pursued guaranteed issue and community rating.

The study, which was conducted by Milliman, Inc., found that these policies "have the potential to cause individuals to wait until they have health problems to buy insurance. This could cause premiums to increase for all policyholders, increasing the likelihood that lower-risk individuals leave the market, which could lead to further rate increases. If this continues, the pool or market could essentially collapse or shrink to include only the high risk population."

The insurance industry has since concluded, however, that these problems can be overcome by requiring all Americans to purchase insurance.

"If we can get everyone in the health-care system, we can do guaranteed issue, which means no denials on the basis of preexisting condition, and no rating by health status or gender," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans (A.H.I.P.), the insurance industry's trade group.

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