WASHINGTON — At the prodding of business organizations, House Republicans quietly secured a change in President Barack Obama's health law to expand coverage choices, a striking, one-of-a-kind departure from dozens of high-decibel attempts to repeal or dismember it.
Democrats describe the change involving small-business coverage options as a straightforward improvement of the type they are eager to make, and Obama signed it into law. Republicans are loath to agree, given the strong sentiment among the rank and file that the only fix the law deserves is a burial.
"Maybe you say it helps (Obamacare), but it really helps the small businessman," said Rep. Phil Roe, R-Tenn., one of several physician-lawmakers among Republicans and an advocate of repeal.
No member of the House GOP leadership has publicly hailed the fix, which was tucked, at Republicans' request, into legislation preventing a cut in payments to doctors who treat Medicare patients. The bill was approved last month.
It is unclear how many members of the House knew of the fix because the legislation was passed by a highly unusual voice vote without debate.
Several lobbyists and Republican aides who monitored the issue said the provision reflects a calculation that no matter how hard the party tries, the earliest the law can be repealed is after Obama leaves office in 2017. In the meantime, according to this line of thinking, small-business owners need all the flexibility they can get to comply with it.
The provision was relatively minor. It eliminated a cap on deductibles for small group policies offered inside the law's health care exchanges as well as outside; the cap was set at $2,000 for individuals and $4,000 for families.
Republicans said they sought it so small businesses can offer high-deductible plans that could be purchased by individuals who also have health savings accounts. These tax-preferred accounts are a longtime favorite of many Republicans, who say they give consumers greater control over their own health care.
The health law contains no deductible caps for individual plans or those offered by large employers, and the Department of Health and Human Services already had waived them for small businesses through 2015. The legislation means they will never go into effect.