WASHINGTON -- House Republican leaders are adopting an agreed-upon conservative approach to fixing the nation's health care system, in part to draw an election-year contrast with President Barack Obama's Affordable Care Act.
The plan includes an expansion of high-risk insurance pools, promotion of health savings accounts and inducements for small businesses to purchase coverage together.
The tenets of the plan -- which could expand to include the ability to purchase insurance across state lines, guaranteed renewability of policies and changes to medical-malpractice regulations -- are ideas that various conservatives have for a long time backed as part of broader bills.
But this is the first time this year that House leaders will put their full force behind a single set of principles from those bills and present it as their vision.
This month, House leaders will begin to share a memo with members outlining the plan, with suggestions on how Republicans should present it to constituents.
"We've got to get to where you can compare the two perspectives, Republican and Democrat," House Majority Whip Kevin McCarthy, R-Calif., said in an interview. "We've got all of these bills out there, so we're going to take this core of policies and grow from there."
Republicans have campaigned heavily on their opposition to the health care law in this year's congressional elections, betting that anger with the law will propel them to gain seats to add to their House majority and take control of the Senate. Those efforts accelerated last week, after Republican David Jolly's upset victory in a special House election in Florida in which the campaigns focused on the law.
In meetings last week with Speaker John Boehner, R-Ohio, House leadership allies cast Florida as a good portent for November. But they also cautioned that Republicans needed to offer a clearer alternative. "It's going to be all about giving people a choice," said Rep. Andy Harris, R-Md., an anesthesiologist.
Democrats dismissed the GOP approach as a purely political gesture ahead of this year's midterm elections, saying the focus on long-held conservative ideas was more of an attempt to rally Republicans than to find bipartisan solutions. "If they had fixes, I'd certainly consider it," said Sen. Tim Kaine, D-Va. "But if they are trying to scrap it all, going back to the bad old days, it's not going to go anywhere."
A CNN-ORC International survey released last week showed support for the Affordable Care Act ticking up slightly, with 39 percent of Americans saying they support the health care law, up from 35 percent in December. Fifty-seven percent of those polled oppose the law, down from 62 percent in December.
The Republicans' plan is hardly intended as a full replacement of the federal health care law -- and that is by design. They would prefer to see a shift away from the federal government and toward the states, with an emphasis on getting more consumers on private plans.
As they finalize their alternative, House Republicans are continuing their years-long effort to take a legislative hammer to the law, passing a bill Friday that would delay the individual mandate and repeal Medicare's sustainable-growth rate.
For the most part, House Democrats are not taking the bait. Outside the House floor Thursday, Rep. Ron Barber, D-Ariz., facing a difficult re-election race, said he would like to "make some amendments and adjustments" to the health care law, but added that "the bill is the law and not going anywhere."
At a news conference Thursday, House Minority Leader Nancy Pelosi, D-Calif., said Democrats would not run away from the law and shrugged off talk that the recent Florida race could be a harbinger of looming Democratic losses in the House and Senate. "I'm very proud of our House Democrats and how they have not only embraced the Affordable Care Act, because they helped create it, but how proud they are of it," she said. "I think the Republicans are wasting their time using that as their electoral issue, and they will find that out."
A complete health care overhaul remains the GOP's overarching goal. But party leaders are open to adopting conservative versions of elements from the law. Regarding people with preexisting conditions, for instance, they point to the high-risk insurance pools, which would be managed and subsidized by states. On allowing children to stay on their parents' health plans until age 26, they said Republicans may back that policy.