Republicans plan alternate health care law

— Less than two months before the Supreme Court begins hearing arguments in the landmark health care overhaul case, Republicans are formulating a new law to replace the Affordable Care Act.

In the first coordinated attack since their failed effort to repeal Obama's signature health plan, Republicans announced last week that they will be ready with new health care legislation regardless of whether the court strikes down the law.

"We'll have a window of opportunity with everyone looking to explain the Affordable Care Act," said Rep. Joe Pitts, R-Pa., who chairs the Energy and Commerce Health Subcommittee. "It's not fully implemented yet. We'll use this opportunity, this window, to discuss the full ramifications of the ACA and what we would replace it with."

More than 120,000 South Florida seniors have free access to such preventive services as mammograms, colonoscopies and wellness visits through the Affordable Care Act, said Rep. Debbie Wasserman Schultz, D-Weston .

"The Republicans had the power to present sweeping health care reform for 12 years and didn't act," she said. "Now that we have a law that is benefiting millions across the country, they want to repeal it and go with their own plan, which doesn't yet exist."

While details of the Republicans' plan are not yet known, Pitts said they want to do away with one of the more popular aspects of the law: prohibiting insurance companies from refusing coverage for Americans with pre-existing conditions.

The sickest Americans would not be left uninsured under the Republican plan, but states through a high-risk pool - rather than insurance companies - would bear the burden of insuring them. With state budgets already under strain, it's unclear whether that provision will get the support of local elected officials, regardless of party.

During a campaign swing Thursday through Florida, first lady Michelle Obama seized on the idea of letting insurance companies off the hook.

"Now, there are folks out there actually talking about repealing that reform," she said in Sarasota. "We have to ask ourselves: Are we going to stand by and let that happen? Are we going back to the days when insurance companies could deny our children coverage because of a pre-existing condition, like cancer or diabetes or asthma?"

Republicans also want to open the insurance market across state lines, so that Americans who live in Florida can buy insurance in Georgia if the coverage and price are better.

Their biggest concern with the law is the requirement that virtually every American buy health insurance or face a penalty. That's the part of the law opponents believe is most susceptible to legal challenge.

If the court strikes down only that part of the law, it could have disastrous implications, its proponents said. If healthy as well as sick Americans are not required to buy coverage, the price of insurance could rise for everyone with a plan.

Without such a mechanism, taxpayers and employers are charged a "hidden tax," the cost of treating uninsured Americans in the emergency room, said Rep. Ted Deutch, D-Boca Raton.

"If Republicans have a secret plan to cover 32 million uninsured Americans, improve Medicare benefits for our seniors, lower premiums and reduce the deficit without some sort of enforcement mechanism, they would have introduced it by now," he said. "The fact is, they have never introduced such a plan because it doesn't exist."

But the individual mandate is just part of what critics oppose in the law .

They say the government is overstepping its authority and that Americans should have the right to choose whether to buy health insurance, just as they can decide whether to buy a car.

Florida is leading 25 other states in a challenge to the law's expansion of Medicaid, growing coverage that includes 50 million Americans, including 1 of 4 children and 7 million people with disabilities. States argue the additional costs will harm them.

Many conservatives instead want to see fewer people - not more - eligible for the program, said Nina Owcharenko, director of the Center for Health Policy Studies at the Heritage Foundation.

Healthy but poor women and children should be removed from Medicaid, Owcharenko said, and instead given a voucher they can use to buy insurance on the open market.

Such a move could improve coverage, she said. She argues that in some communities, families have to travel a great distance to find a doctor who will accept Medicaid.

"They shouldn't be put in a second tier because they're poor," Owcharenko said.

Heritage is also encouraging Republicans to correct what they view as an unfair tax advantage for people who get their coverage through their employer, Owcharenko said. People who buy insurance through work can pay with pre-tax dollars, but those who must get their insurance on the open market have to pay with after-tax dollars, she said.

Proponents of the federal health

care overhaul say it has created more competition in the Medicare market, resulting in better plans and lower premiums for seniors. Starting in 2011, the Affordable Care Act required pharmaceutical companies to offer a 50 percent break on brand-name drugs for seniors in the Medicare coverage gap.

Democrats also say that 2.5 million young people now have health insurance through a provision that allows adult children to stay on their parents' health insurance until age 26.

The Supreme Court will hear oral arguments in March and is expected to announce a ruling in June.

Before the Affordable Care Act, the health care system was broken, many Republicans concede.

"The status quo was crying for change," Owcharenko said. "The problem is the change we got, from a conservative perspective, is not the change that we wanted."

The Associated Press and The Washington Post contributed to this story.