WASHINGTON (AP) — Three years after campaigning on a vow to "repeal and replace" the Patient Protection and Affordable Care Act (PPACA), House Republicans have yet to advance an alternative for the system they have voted more than three dozen times to abolish in whole or in part.
Officially, the effort is "in progress" — and has been since Jan. 19, 2011, according to GOP.gov, a leadership-run website.
But internal divisions, disagreement about political tactics and Obama's 2012 re-election add up to uncertainty over whether Republicans will vote on a plan of their own before the 2014 elections, or if not by then, perhaps before the president leaves office, more than six years after the original promise.
Sixteen months before those elections, some Republicans cite no need to offer an alternative. "I don't think it's a matter of what we put on the floor right now," said Rep. Greg Walden of Oregon, who heads the party's campaign committee. He added that what is important is "trying to delay Obamacare."
Rep. Fred Upton of Michigan, who leads a committee with jurisdiction over health care, said, "If we are successful in ultimately repealing this legislation, then yes, we will have a replacement bill ready to come back with."
Divisions were evident earlier this year, when legislation to make it easier for high-risk individuals to purchase coverage died without a vote. It was sidetracked after conservatives, many of them elected with tea party support, objected to any attempt to improve the current law rather than scuttle it.
With the rank and file growing more conservative, some Republicans acknowledge that without changes, they likely couldn't pass the alternative measure they backed when Democrats won approval for Obama's bill in 2010.
Among other provisions, it encouraged employers to sign up their workers for health insurance automatically, so that employees would have to "opt out" of coverage if they didn't want it, and provided federal money for state-run high-risk pools for individuals and for reinsurance in the small group market.
The current state of intentions contrasts sharply with the Pledge to America, the manifesto that Republicans campaigned on in 2010 when they took power away from the Democrats. That included a plan to "repeal and replace" what it termed a government takeover of health care.
It promised "common-sense solutions focused on lowering costs and protecting American jobs," including steps to overhaul medical malpractice laws and permit the sale of insurance across state lines. Republicans said they would "empower small businesses with greater purchasing power and create new incentives to save for future health care needs." They promised to "protect the doctor-patient relationship, and ensure that those with pre-existing conditions gain access to the coverage they need."
But Rep. Paul Broun, R-Ga., said, "We never did see a repeal and replace bill last time," referring to the 2011-2012 two-year term that followed the Republican landslide. "I hope we can this time, and I'll keep fighting for it."
Broun, running for the Senate from Georgia in 2014 as a conservatives' conservative, has drafted legislation of his own that relies on a series of tax breaks and regulatory changes such as permitting insurance companies to sell coverage across state lines to expand access to health care.
