WASHINGTON—When Republicans take President Barack Obama up on his invitation to hash out their differences over health care this month, they will carry with them a fairly well-developed set of ideas intended to make health insurance more widely available and affordable, by emphasizing tax incentives and state innovations, with no new federal mandates and only a modest expansion of the federal safety net.
It is not clear that Republicans and the White House are willing to negotiate seriously with each other, and Obama has rejected Republican demands that he start from scratch in developing health care legislation. But congressional Republicans have laid out principles and alternatives that provide a road map to what a Republican health care bill would look like if they had the power to decide the outcome.
The different approaches will be on display on Feb. 25, when lawmakers from both parties are scheduled to go to Blair House, across the street from the White House, for a televised clash of health policy ideas.
The Republicans rely more on the market and less on government. They would not require employers to provide insurance. They oppose the Democrats’ call for a big expansion of Medicaid, which Republicans say would burden states with huge long-term liabilities.
While the Congressional Budget Office has not analyzed all the Republican proposals, it is clear that they would not provide coverage to anything like the number of people — more than 30 million — who would gain insurance under the Democrats’ proposals.
But Republicans say they can make incremental progress without the economic costs they contend the Democratic plans pose to the nation. As one way to encourage competition and drive down costs, Republican members of Congress want to make it easier for insurance companies to sell their policies across state lines, an idea included, in a limited form, in the Democratic bills.
Republicans would offer federal money as a reward to states that achieve specified reductions in premiums or in the number of people without insurance.
Republicans would provide federal money to states to establish and expand high-risk pools, for people with chronic illnesses who cannot find private insurance at an affordable price. But they would not cap premiums, so some people could still find insurance too expensive.