South Carolina Republicans offer different ideas on fixing Obamacare

January 5, 2017

WASHINGTON — On the second day of the 115th Congress, Republicans on Capitol Hill kicked off efforts to repeal and replace Obamacare.

But the task of reaching consensus on a final product remains highly elusive.

“I think Republicans are pretty uniform in the fact that Obamacare was a bad idea when it was passed and it needs to go away,” said U.S. Rep. Tom Rice, R-S.C.

“It’s going to be hard to find agreement on how exactly we’re going to replace it,” he added, “but with a president with a bully pulpit willing to push for this, we got a real chance.”

“I think there will be an emphasis on ‘repeal,’ but what do you replace it with?” U.S. Rep. Mark Sanford, R-S.C., queried. “And that’s a more complex political consideration, given not everybody’s gonna like what you might replace it with.”

For years, legislative blueprints have been floated as alternatives to the Affordable Care Act of 2010. But as long as President Barack Obama was in the White House, chances of enactment were zero.

Now that President-elect Donald Trump is poised to take the reins later this month, the GOP has to move beyond the more symbolic gambits and produce something that will really work.

Rice, who sits on the House Committee on Ways and Means with some jurisdiction over health care legislation, said encouraging health savings accounts and reforming medical malpractice laws were among two concrete areas he wants to address.

U.S. Rep. Jeff Duncan, R-S.C., who is making a play to join the U.S. House Committee on Energy and Commerce — another committee of jurisdiction — mentioned changing the law to allow associations, such as professional associations covering realtors or other groups, to offer health insurance.

“When Trump says people with preexisting illnesses are not going to be denied coverage, that’s a good thing. But that does require us to come up with available coverage for everybody because if you can get coverage after you’re sick, why would you buy it before you get sick?” said U.S. Sen. Lindsey Graham, R-S.C.

None of these ideas are necessarily in conflict with each other. Still, the potpourri of suggestions in the South Carolina congressional delegation alone hints at just how hard it will be to move a final bill from committee to floor, let alone from Capitol Hill to the White House.

These lawmakers are also dealing with high stakes back at home, where tens of thousands of South Carolinians rely on the Affordable Care Act for health insurance. A federal report shows more than 147,000 people in this state had signed up for coverage through Dec. 19. Open enrollment is scheduled to run through January, and 212,000 people in South Carolina have already signed up for Obamacare plans for 2017.

“In the future, the average person in South Carolina will not be able to afford what is already so difficult to afford,” said U.S. Sen. Tim Scott, R-S.C., who will get two opportunities to weigh in on an Affordable Care Act replacement bill as a member of the Senate Committees on Finance and Health, Education, Labor and Pensions.

“There’s no benefit to having a health insurance card if there’s no hospital that you can go to,” Scott continued. “We’ve had a couple hospitals close in South Carolina. I believe it’s because of the health care law, though I don’t pretend to be an expert at everything.”

In fact, several rural hospitals did close in the state in 2016, a trend attributable to the migration of people to more urban areas of the Palmetto State. To the extent the hospital closures left a gap in some people’s coverage, they might have been able to get help through Medicaid, but Gov. Nikki Haley has resisted expanding the program since 2012.

Meanwhile, there is now only one insurance provider left in the South Carolina that will offer policies through the Obamacare marketplace. Rice said his 28-year-old son, who is purchasing insurance through the exchanges, is paying more than $300 a month.

Republicans want to put forward an alternative quickly, even if implementation can’t take place until much further down the calendar, to avoid disruptions in people’s health insurance coverage.

Democrats who have been eye-rolling GOP efforts to roll back the health law are now facing the reality they could see it totally gutted. Those fears mounted more on Wednesday as President Obama came to Capitol Hill to encourage lawmakers to keep up the fight.

U.S. Rep. Jim Clyburn, South Carolina’s lone Democrat in Congress and the Assistant House Minority Leader, predicted Republicans will ultimately decide a “reform” of the existing law is a better tact than a full “repeal,” and approach Democrats to work on a bipartisan bill.

“They won’t change their tune by the time they come to the table,” said Clyburn, “but they’ll change by the time they leave.”

Lauren Sausser contributed to this report from Charleston.