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After six years of vague talk about a conservative alternative to the Affordable Care Act, House Republicans on Tuesday finally laid out the replacement for a repealed health law — a package of proposals that they said would slow the growth of health spending and relax federal rules for health insurance. Opponents began the “repeal and replace” mantra almost as soon as the Affordable Care Act was signed in 2010, and while they have voted dozens of times to repeal the health law, the replacement has been elusive. (Pear, 6/22)

The plan, revealed Wednesday, relies on individual tax credits to allow people to buy coverage from private insurers, and includes other largely familiar GOP ideas such as medical liability reform and expanding access to health savings accounts. It proposes putting $25 billion behind high-risk pools for people with pre-existing conditions and for others, and transforming the federal-state Medicaid program for the poor by turning it into state block grants or individual per-capita allotments to hold down spending. (Werner, 6/22)

The 37-page white paper, called “A Better Way,” includes virtually every idea on health care proposed by Republicans going back at least two decades. It would bring back “high risk pools” for people with very high medical expenses, end open-ended funding for the Medicaid program and encourage small businesses to band together to get better bargaining power in “Association Health Plans.” What the plan does not include, however, is any idea of how much it would cost, or how it would be financed. (Rovner, 6/22)

The plan leaves myriad details to be filled in, which Republicans say would occur next year, when the party hopes to install presumed nominee Donald Trump in the White House. But by rolling out a broad plan now, they aim to give voters a chance to weigh an alternative health-care system—and give the party an agenda on which to run—before the November elections. “Our proposal is like a health-care ‘backpack’ that provides every American access to financial support for an insurance plan chosen by the individual and can be taken with them job-to-job, home to start a small business or raise a family, and even into retirement years,” the House GOP wrote in summarizing the thrust of the plan. (Hughes and Radnofsky, 6/22)

Like many previous Republican healthcare proposals -- including those put forward by presumptive GOP presidential nominee Donald Trump -- Ryan’s latest blueprint is missing key details and legislative language that would allow independent analysts such as the Congressional Budget Office to assess its cost and impact. Rather than showcasing the party’s seriousness about policy, Ryan’s plan may reinforce widespread skepticism about the GOP’s interest in tackling complex healthcare policy. (Levey, 6/22)

Ryan has framed the new paper as a starting point — a broad outline that the committees with jurisdiction would have to hammer out next year, if there is a GOP president who would sign off on a congressional repeal of Obamacare. There is some overlap with the vague plan laid out by presumptive Republican nominee Donald Trump on his campaign website. The 37-page plan pledges to reduce consumers’ average health care premiums by double digits and bend the health care cost curve. But it does not lay out detailed answers about what it means to people who get coverage now. (Haberkorn, 6/22)

Philosophically, the Republican health-care plan has more in common with Obamacare than many party members might admit. It implicitly acknowledges that sick people should be able to obtain health insurance and that most Americans need assistance paying insurance premiums, either from their employers or from the government. The plan rejects a return to the U.S. health-care system prior to the Affordable Care Act, in which insurers could refuse coverage or charge sick people prohibitively high premiums and there was no guarantee of financial aid. (Litvan, 6/22)