With President Obama still in office, Republicans know repealing the Affordable Care Act is impossible. Instead, Sen. Orrin Hatch (R-Utah) suggested a piecemeal approach to alter the health care law during a speech Tuesday to the U.S. Chamber of Commerce where he outlined the Senate Committee on Finance’s 2015 agenda.

“We’re going to continue to strike away at it, piece by piece if we have to,” said Hatch, the committee’s chairman. In addition to legislation Hatch introduced last week to repeal the medical device tax, Hatch said he also plans to re-introduce a bill to repeal the employer mandate. Both are “anti-job provisions,” he said.

Defining full-time employees as those who work 30 hours a week is another part of the ACA that negatively affects jobs and the economy, Hatch said. On Jan. 8, the House passed a bill amending the definition to 40 hours a week, and it’s also on Hatch’s to-do list. 

“I plan on having the Finance Committee work through these bills so that we can send them all to the president’s desk and have him try to explain to the American people why he’s right and they’re wrong,” he said.

Also see: Brokers, employers welcome ‘common sense’ fix to ACA work week definition

The first order of business will be the Hire More Heroes Act, a bill the House passed that allows employers to exempt veterans who are already receiving health insurance from the employer mandate. “This will be the first bill we markup in the Finance Committee.”

Changing the ACA isn’t enough, Hatch said, “We need to work toward positive solutions of our own.” Like the Patient Choice, Affordability, Responsibility and Empowerment (CARE) Act, which Hatch and Sens. Richard Burr (R-N.C.) and Tom Coburn (R-Okla.) proposed last year as a replacement to the ACA. “Our plan addresses the shortcomings of Obamacare head-on, expanding patient choice, curbing rising health costs and injecting market forces into our health care system,” he said.

Republicans must agree on an alternative to the ACA, Hatch said, should the Supreme Court invalidate the rule that says consumers who sign up for insurance on the public marketplace can receive premium tax credits in states that haven’t established their own exchange.

Hatch wouldn’t speculate on the outcome of King v. Burwell — arguments will be heard in March and a decision is expected by June — but Congress should be ready if the subsidies rule is overturned. “We’ll need to act to mitigate the additional damage Obamacare will inflict on the health care system,” he said.

Also see: Six states urge Supreme Court to uphold ACA subsidy challenge

Hatch listed a couple “must-pass items,” one of those being the Children’s Health Insurance Program, which expires in September. “I am optimistic that we can work on a bipartisan, bicameral basis to extend CHIP in a responsible way,” he said.

On March 1, Medicare’s Sustainable Growth Rate is set to expire. The formula is “broken,” Hatch said, and his goal is to “address the SGR challenge once and for all.” 

Along with Medicare, Medicaid and Social Security also need to bolstered, Hatch said. “We’re facing an unprecedented fiscal crisis in the coming years if we don’t act to shore up our unsustainable entitlement programs.

“With these programs, we’re talking about tens of trillions … in unfunded liabilities,” Hatch added. “Our nation’s permanent fiscal health, not to mention our economy and the future of the safety net, stands in the balance. Everyone talks about entitlement reform, but few are willing to do anything about it.  But, we cannot continue to kick the proverbial can down the road on this issue.”

Pension reform is another priority Hatch said, citing the Secure Annuities for Employee Retirement Act. He also discussed the debt limit, oversight of the administration and the Tax Code. The latter is Hatch’s top priority. “Tax reform is long overdue,” he said.

Hatch listed seven principles for tax reform:

1)      Growth in the economy

2)      Fairness

3)      Simplicity

4)      Permanence

5)      Competitiveness

6)      Savings and investment

7)      Revenue neutrality

At the beginning and end of Hatch’s speech, he called his agenda “ambitious,” saying that “we have to be ambitious if we’re going to do anything worthwhile.”  

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