House GOP has no alternative to health care law - Boston Globe

WASHINGTON — Three years after campaigning on a vow to ‘‘repeal and replace’’ President Obama’s health care law, 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 reelection add up to uncertainty on 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 Representative Greg Walden of Oregon, who heads the party’s campaign committee. He added that what is important is ‘‘trying to delay Obamacare.’’

Michigan congressman Fred Upton, who leads a committee with jurisdiction on 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.’’

In an interview on CBS’s “Face the Nation’’ on Sunday, House Speaker John Boehner said Congress ‘‘ought to be judged on how many laws we repeal,’’ not by how many new laws it creates.

The Ohio Republican was responding to a general question about how little Congress is doing these days. He says the United States has ‘‘more laws than the administration could ever enforce.’’

Boehner said that view may be unpopular but he and his allies in Congress are fighting for what they believe in. ‘‘Sometimes the American people don’t like this mess,’’ he said.

Divisions were evident earlier this year, when a bill to make it easier for high-risk individuals to buy 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 admit that without changes, they likely could not 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 did not 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 vowed ‘‘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 preexisting conditions gain access to the coverage they need.’’

But Representative Paul Broun of Georgia, a Republican, 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.

Other Republicans are at work on different bills, in the House Energy and Commerce Committee headed by Upton, and elsewhere.

Representative Steven Scalise of Louisiana, who leads the Republican Study Conference, said the organization is working on legislation to reduce health care costs ‘‘without the mandates and the taxes’’ in the current law. Like others involved in the issue, he had no timetable and few specifics.

At the same time, the other half of the 2010 pledge to ‘‘repeal and replace’’ is getting a workout. The House voted last week to delay two requirements, the 38th and 39th time they have gone on record in favor of repealing, reducing, or otherwise neutering a system that bears Obama’s name.

In the case of one of the rules, a requirement for businesses to provide insurance to their workers, the administration announced a one-year delay earlier this month.

Democrats and even some Republicans say the intense focus on repealing the health law is wide of the mark.

‘‘Every voter knows what Republicans are against. They don’t know what they’re for’’ on health care, said Representative Steve Israel of New York, who heads House Democrats’ campaign committee.