For health care, talk to all sides

The Senate version of the replacement bill for the Affordable Care Act is on life support, but by no means is it dead. Majority Leader Mitch McConnell delayed a vote on the bill this week, but anyone who has watched the master politician work knows the legislation is not dead. Not because it improves health care in this country, but because the GOP promised — and promised some more — to repeal the Affordable Care Act, known more colloquially as “Obamacare.” Reportedly, GOP senators have been told to firm up final details by Friday, with a vote coming up after the July Fourth holiday weekend. That leaves time in between for the Congressional Budget Office to figure the impact of the Better Care Reconciliation Act, as the bill is named.

Let’s hope they miss the deadline. Not because the state of health care in the United States is perfect, but because if GOP senators don’t finalize their own repeal bill (the House GOP already passed its own version, the American Health Care Act), there is a glimmer of hope that Democrats might actually get to weigh in. From GOP Sen. Lindsey Graham of South Carolina: “If we don’t reach an agreement by Friday, it’s probably the end of the sole party effort on health care.”

Until now, McConnell’s strategy has been to write the legislation in secret, with only GOP (male) senators working on the bill; there have been no hearings, no amendments and no input from the minority party. That’s a bad way to write a bill.

Sen. Lisa Murkowski, R-Alaska, is a voice of reason right now. She has been reluctant to support her party’s legislation because it defunded Planned Parenthood and cut Medicaid — the low-income insurance program that provides coverage for a quarter of Alaska’s population. Listen to these wise words: “When did we get to the point where we said, ‘No, we’re not going to talk to Democrats about a fix?’ We should be working with our colleagues on the other side of the aisle,” Murkowski told NBC News on Tuesday.

Let’s repeat that: “We should be working with our colleagues on the other side of aisle.” Yes, the Republicans should. Yes, the Democrats should. The temporary defeat for the Senate health care plan — McConnell wanted a vote this week — is just that, temporary. He will wheel and deal, offering perks for different senators and changes to the law for others. He needs 52 votes to pass the legislation, and never count Mitch out. Still, with all Democrats opposed, just three GOP senators need to break ranks — Sen. Susan Collins of Maine is viewed as a solid no, and Sen. Dean Heller of Nevada also seems set on opposition. (Attack ads against Heller paid for by a pro-Trump super PAC have not helped, as well as angering other GOP senators.) McConnell has little wiggle room.

As with the original writing of the replacement bill, it’s unclear what is being revised and how. Conservative senators think the bill still has too many Obamacare regulations and too little free market; more moderate GOP senators worry about the impact of reduced Medicaid spending on their states and the damage those would cause patients, for example, being treated for opioid addictions. There is also sincere concern about cutting programs that serve poor people to pay for tax cuts for the wealthy.

Citizens need to raise their objections over the holiday weekend — their calls, letters, sit-ins, emails and other loud protests delayed the vote. Now is no time to quit.

In the meantime, McConnell will be working to bring on board the nine or so senators who have said they won’t vote for the bill in its current form. He also wants to produce legislation House conservatives will support. Maybe this time, the legislative genius will fall short. Rather than ramming through a bad piece of legislation that damages our most vulnerable citizens, McConnell might be forced to deal with all senators, not just those from his own party. Rather than scoring a political win for the GOP, the citizens of the nation might grab a victory — improved health care for all without kicking 22 million people off of their insurance. We can dream, can’t we?