Even among members of the same political party, there are differences of opinion when it comes to hot-button issues, especially regarding healthcare. Republicans have long rallied around the idea of repealing and replacing the Affordable Care Act. But how they intend to accomplish this monumental task remains unclear. Right now, there are two major healthcare plans being presented by Republicans to replace the ACA once Trump takes office: the Empowering Patients First Act, and Paul Ryan’s A Better Way.
Empowering Patients First Act
First introduced in 2009, the Empowering Patients First Act (EPFA) originated with Congressman Tom Price, who developed the legislation and has presented an updated version of the same bill to every session of Congress since then. The EPFA was one of the first plans that Republicans introduced as an alternative to the government-heavy ACA, and it marked the beginning of a long line of healthcare plans introduced by conservatives over the next seven years.
A Better Way
The latest health care proposal from the Republicans has come from Speaker of the House Paul Ryan in conjunction with other conservative members of the House. It’s called A Better Way. Ryan’s plan seeks to implement healthcare policies that will be accessible and affordable for all Americans, and it’s based on a patient-centered approach to healthcare reform. Authors of A Better Way claim that the new proposal consolidates many of the ideas that Republicans have put forth over the years into one unifying health reform plan.
Republican Minds Think Alike
Both plans dispose of the current government mandates in anticipation of repealing and replacing the Affordable Care Act, thus placing the power of Americans’ health back into their own hands. The Empowering Patients First Act and A Better Way share several similarities, including the following:
- Full repeal of the Affordable Care Act, which is the cornerstone of both plans. Price, Ryan and many Republicans agree that government-sponsored healthcare contradicts with patient-centered healthcare, so they intend to fully repeal Obamacare.
- Granting federal tax credits based on age instead of income
- Expanding the use of health savings accounts by changing how they can be funded, which services and items are covered, and what the income limits are
- Reducing malpractice claims and addressing medical liability reform. Both plans place this as a top priority, but they differ in their approach to fixing the problem
- Capping the tax break that companies get for providing health insurance to their workers
- The sale of health insurance across state lines, which both plans claim will spur competition and encourage growth in the private health insurance market
- Preventing federal funds from being used to fund abortion services, and protection for the Hyde Amendment
- Requiring people to maintain continuous coverage in order to be guaranteed the same cost for health insurance. Both Price and Ryan propose making sure that people with pre-existing conditions maintain their coverage; if they don’t, then they can be charged higher premiums. Under the ACA, people with pre-existing conditions can’t be charged more for coverage.
Not Quite the Same
It’s natural that two rightwing conservatives should share similar ideas about healthcare reform, but Ryan and Price differ in some key areas. There are as many differences as there are similarities between the two approaches. Here are some of the discrepancies:
|Empowering Patients First Act||A Better Way|
|The EPFA does not address Medicare in terms of reform or future protections.||A Better Way proposes comprehensive Medicare reforms for Americans who are already enrolled. It also outlines structural reforms that could safeguard the program for future generations.|
|Regarding Medicaid, the EPFA seeks to repeal expansion coverage for able-bodied single people.||Under A Better Way, states would be given more control over their individual Medicaid programs, the goal being to foster innovation and eliminate fraud.|
|The EPFA does not allow young adults to stay on their parents’ health care plans.||Young adults up to age 26 can stay on their parents’ health plans under A Better Way.|
|People with certain pre-existing conditions may not be protected under the EPFA.||A Better Way doesn’t specify certain conditions in its protection clause for people with medical issues.|
|The EPFA does not provide major funding for the National Institutes of Health, which could affect research and development.||A Better Way supports the NIH, along with innovation, research and development for new treatment options.|
If you look at the official documents for each healthcare proposal, it appears that one plan may be more comprehensive than the other. Although there are several very similar components between the Empowering Patients First Act and A Better Way, there are significant differences that will impact millions of Americans should one plan be chosen over another. In reality, Trump and Republicans in Congress are likely to combine both proposals with ideas of their own to create a platform that caters to the majority. No one has reached a consensus in Washington yet even as Trump prepares to take office in less than a week.