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Several Republican senators on Monday proposed a partial replacement for the Affordable Care Act that would allow states to continue operating under the law if they choose, a proposal meant to appeal to critics and supporters of former President Barack Obama’s signature health law. (Pear, 1/23)

The plan by Sens. Bill Cassidy of Louisiana and Susan Collins of Maine would retreat from years of GOP cries to repeal Obama's law and replace it with a still undefined Republican alternative. It comes as GOP lawmakers face pressure from President Donald Trump to quickly void and replace the health law and as Republicans continue hunting for a proposal that would unite them. "It has been a Republican principle that power is best held by individuals and states, not the federal government," Cassidy told reporters. (1/23)

The bill relies on Obamacare’s taxes to offer states a new option that replaces mandates to buy insurance with automatic enrollment in new plans with more choices. Cassidy said that option could lower premiums and cover far more people. (Dennis, 1/23)

The legislation attempts to insulate Republicans in Congress from some of the difficult choices associated with overhauling the entire health care law. The proposal wouldn't fully repeal the law and would push many of the toughest decisions about coverage to the states. Its backers, including Sens. Shelley Moore Capito of West Virginia and Johnny Isakson of Georgia, are some of the Senate's more moderate Republicans. (Mershon, 1/23)

The Senate’s top Democrat, Charles Schumer of New York, blasted the GOP plan as unworkable and an “empty façade” that would create chaos in the marketplace. “Millions of Americans would be kicked off their plans, out-of-pocket costs and deductibles for consumers would skyrocket, employer-based coverage for working families would be disrupted, and protections for people with pre-existing conditions, such as cancer, would be gutted,” Schumer said. “It is nearly impossible to keep the benefits of the Affordable Care Act without keeping the whole thing.” (Shesgreen, 1/23)

But Ms. Collins and Mr. Cassidy argued that theirs is the only approach with a chance of attracting support not only from Republicans but from the handful of Democrats needed to enact a complete ACA replacement. “At some point in this process, we’re going to need a bill that would get 60 votes, OK?” Mr. Cassidy said. “Now, if you can say to a blue-state senator who’s really invested in supporting Obamacare, ‘You can keep Obamacare, but why force it upon us?’, we think that helps us get to 60.” (Radnofsky and Hughes, 1/23)

“We give states the option,” Cassidy said at press conference Monday. “California and New York — you love Obamacare, you can keep it.” (Terhune and Bartolone, 1/24)

The proposal is one of many GOP-written alternatives expected to be released in coming weeks as the party scrambles to avoid criticism for repealing the ACA without a viable replacement. Many of the proposals include similar elements, such as shifting the burden of administering insurance coverage to states through block-grant-style funding, and an emphasis on individual health savings accounts. The true test of any of these plans will be how they are received by President Trump, who has said he wants to see insurance for everyone. (Snell, 1/23)

In California, where health advocates after President Donald Trump’s election continued to aggressively push enrollment in Medi-Cal and Covered California, and state officials have vowed not to let years of enrollment efforts go to waste, there were questions about the details. Legislative language was only released late Monday. “For me, the absolute most important aspect of anything proposed at the federal level is the federal dollar and what’s going to be coming – is it less, or the same, or more?” said California state Sen. Ed Hernandez, D-Azusa, chairman of the California Senate Health Committee. “If they truly want to allow states to continue on within the (Affordable Care Act), then give us the same amount of money we’ve been receiving, and don’t block grant us, and we can make it work.” (Clark, Caiola, Lowry and Chang, 1/23)

Both Cassidy, a doctor, and Collins, a centrist, have been adamant that a replacement plan needs to quickly follow any vote to repeal ObamaCare. They have pushed back on Republican leaders’ idea of passing repeal first and replacing later. (Sullivan, 1/23)