Where Health-Care Legislation Stands

Rep. Greg Walden says a bill will be on the president’s desk before August

Businesses are watching closely as Senate Republicans try to hash out a deal on a GOP version of health-care reform to replace the Affordable Care Act.

Whether they can bridge their divisions, however, remains to be seen.

Rep. Greg Walden of Oregon, who helped shepherd the party’s health-care overhaul bill through the House last month, sat down with Louise Radnofsky, The Wall Street Journal’s White House reporter, to offer his take on where the effort stands. Edited excerpts follow.

MS. RADNOFSKY: Should CFOs assume that the ACA will be law of the land this time next year or will it be the American Health Care Act?

REP. WALDEN: We are working diligently to rescue the individual insurance market from collapse. It was predicted to happen. It’s happening. And it needs reform.

I was also a small-business owner for over 20 years. When it came to purchasing insurance as a small-business owner, which we did for all of our employees, all you could do was throw a dart at the board every year to figure out what the rate increase would be. We had no market power. We had no purchasing power.

The House has passed the American Health Care Act to try to do reforms, to get cost control on the Medicaid system, give states more flexibility to design plans that will work for them and move people into an insurance product they can afford.

We know there’s more work to be done. We believe we gave the Senate some nice headroom and some dollars set aside in there to make other changes. So they’ve got some flexibility. We’ll see where this leads. But I think we’ll get a bill to the president’s desk before August.

MS. RADNOFSKY: Before August you think the Senate will do what it needs to do?


MS. RADNOFSKY: Do you think health insurance should be priced like car insurance, based on a person’s risk? Or should it be priced like a social benefit, where we’re all in this together?

REP. WALDEN: I think health insurance is deeply personal because health care is deeply personal. In the auto-insurance market you for the most part can control your behavior. You can follow the rules of the road. You can not be distracted on your devices or additives in your system. You can make those changes. With health care you just wake up one morning and your doctor says, “I got bad news. You’ve got breast cancer.” So it is a different market in that respect. The question is, how do you get an insurance product that people can afford?

States have experimented with high-risk pools. Maine has an interesting idea that we tried to look at, where they have an invisible high-risk pool that comes in behind and just takes that high cost and socializes it, so your rates never really reflect the fact that you have some bad health issue. I think you can incentivize people to take better care of themselves, too.

MS. RADNOFSKY: Have Americans reached a point where they think health insurance should be more like a social benefit?

REP. WALDEN: Well, I’ve done 17 town halls in my district. And for the people that turned out at those—and they were very energized, shall we say—when I asked how many favor a single-payer, government-run health system, the audience went wild.

You see this alternative playing out in California right now with their estimated $400 billion government-run, no-private-sector insurance concept that would result in a 15% payroll tax among other things. And that’s just an estimate, which is probably rosy.

We have a moment here to try to fix this market. If we don’t, the odds are we’re going to move to a more government-run system. Now, some may embrace that. But we have those systems today, and I would bet every single member of Congress has one or two staff persons like I do that spends all day every day trying to help our veterans get access to the care they’re being denied. So I’m not sure that’s the system we want.

MS. RADNOFSKY: Will the Cadillac tax ever go into effect?

REP. WALDEN: We want to get rid of it. We want to get rid of the tax on medical devices. But if we fail [to pass health-care reform], then, yes, you should presume that all those taxes stay in place.

MS. RADNOFSKY: And if you succeed?

REP. WALDEN: Then they go away. And by the way, by making the reductions we’re doing, we reset the baseline, which if you want tax reform, passage of this is worth a trillion dollars in tax reform.

MS. RADNOFSKY: What about employer-sponsored insurance? Will the tax protection of that continue?


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