Factbox: Republicans urge modest healthcare changes

(Reuters) - Republicans have rejected proposals put forward by President Barack Obama and his fellow Democrats for overhauling the U.S. healthcare system while urging that he consider some ideas of their own.

Following are some Republican healthcare proposals.

* Allow insurers to sell policies across state lines. Currently health insurance is regulated by the states, preventing consumers in one state from buying a policy sold in another state. Republicans argue that the current restriction locks people into expensive plans in states with high minimum-coverage requirements. Critics argue the proposal could spark a race to the bottom for coverage and consumer protections. The Democratic healthcare bill passed by the Senate in December included a version of this proposal.

* Create new state high-risk pools or reinsurance programs to provide insured people access to health insurance. Republican backers argue this would give everyone access to insurance coverage. Critics argue that most of the millions of uninsured people are between jobs and would not be able to afford the premiums that -- at least in one proposal put forward by Representative Dave Camp, the top Republican on the House of Representatives Ways and Means Committee -- would be capped at 150 percent of the average premiums within a state.

* Some Republicans, including Senate Finance Committee member Charles Grassley, call for barring insurers from excluding people with pre-existing conditions and argue that the reinsurance program would allow for coverage of those people who wait until they get sick before purchasing insurance. Reinsurance pool premiums would be higher than regular insurance. The Democratic bill bars insurers from excluding people with pre-existing conditions. But their bill would require everyone to purchase insurance to prevent people from waiting until they get sick to get coverage, which would send insurance premiums soaring.

* Senate and House Republicans have offered proposals that would provide incentives to encourage states to enact regulatory reforms that reduce premiums and expand coverage without subsidies or expanding the Medicaid government health insurance program for the poor.

* Allow small businesses to pool together in associations to buy health insurance. Republicans argue this would help them obtain more affordable coverage. The Democratic bill would create insurance pools through new state and national exchanges where individuals and businesses would shop for insurance plans.

* Discourage “junk” lawsuits by changing medical liability laws to limit noneconomic damages. Most proposals set a $250,000 cap. The Congressional Budget Office has said this provision could save the federal government as much as $54 billion over 10 years.

* Crack down on waste, fraud and abuse in Medicaid and in the Medicare government health insurance program for the elderly and disabled. Democratic healthcare legislation also includes measures to reduce fraud and waste in those programs.

* Beef up incentives for employer-sponsored “wellness programs” so that workers who participate could get bigger breaks on insurance premiums. Senator Judd Gregg and other Republicans argue the incentives would encourage people to live healthier lifestyles that can lead to lower healthcare costs. But some healthcare advocates argue the proposal is unfair to people with chronic health conditions.

* Expand tax-preferred health savings accounts to help people save to pay for their health expenses.

Reporting by Donna Smith in Washington; Editing by Will Dunham