Health care bill gets GOP push
Despite little analysis of what their new billwould do, Senate Republicans plan to vote thisweek.
WASHINGTON — Senate Republicans are poised to take an unprecedented leap into the dark as they prepare to vote on legislation that would affect health protections for tens of millions Americans yet has been subject to virtually no analysis or public scrutiny.
The proposal goes far beyond previous bills to repeal the 2010 health care law, often called Obamacare, and would fundamentally restructure the nation’s half-century-old health care safety net.
With a vote expected as soon as Wednesday, according to the White House, and backers still talking about potentially major changes, the legislation will get its first and only congressional hearing Monday. The independent Congressional Budget Office, which lawmakers rely on to assess major legislation, already has said it won’t have time to analyze the bill’s effect on health coverage and insurance premiums.
“This is like legislating blind,” said University of North Carolina political scientist Jonathan Oberlander, who has written on the history of health care legislation.“is really hard to find an example of something where Congress was this reckless.”
On Sunday, several key Republican senators expressed doubts about the bill, which appears to remain at least a vote or two short of what GOP leaders need.
Sen. Susan Collins of Maine said on CNN that “it’s very difficult for me to envision a scenario where I would end up voting for this bill.”
Sen. John McCain of Arizona, previously said he would oppose the bill, and Sen. Lisa Murkowski of Alaska, has said she remains undecided.
Sen. Rand Paul of Kentucky, who has previously said several times that he opposes the bill, kept up his criticism on NBC’s “Meet the Press.”
And Sen. Ted Cruz, speaking in his home state of Texas, said that “right now they don’t have my vote.” Cruz said he did not think Sen. Mike Lee, RUtah, was supporting the bill either.
With 52 Republicans in the Senate and no Democrats supporting the repeal effort, sponsors of the bill, including Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., can afford to lose only two GOP votes.
Faced with the resistance within his own caucus, Cassidy suggested Sunday he plans to introduce a new version Monday.
Graham and Cassidy have insisted their proposal would protect Americans’ access to health care while making coverage more affordable.
“President Trump has said he will not sign a bill that does not protect those with pre-existing conditions,” Cassidy said Sunday on ABC’s “This Week.” “I’m a physician who worked in a public hospital for 25 years caring for those with preexisting conditions.”
But the key language in the bill that Cassidy points to as guaranteeing coverage has never been defined or tested, leading to widespread doubts that it would actually do what he says. Cassidy’s claims have been disputed by independent analyses of his proposal, which have concluded that major funding cuts and loosened insurance regulations in the Graham-Cassidy bill will likely erode coverage for many vulnerable Americans.
Leading patient advocates — including the American Heart Association, the American Diabetes Association, the March of Dimes and the advocacy arm of the American Cancer Society — have issued similar warnings, based on their assessment of theGOP proposal.
Over the weekend, groups representing physicians, hospitals and health insurers issued a joint statement condemning the legislation.
“The bill will cause patients to lose important protections as well as undermine safeguards for those with pre-existing conditions,” the groups said, warning additionally that hundreds of billions of dollars in Medicaid funding cuts mean“millions of patients will lose their coverage and go without muchneeded care .”
Under normal circumstances, Congress takes years to develop complex legislation that involves large sums of money and affects millions of Americans.
The legislation creating Medicare, for example, which was signed by President Lyndon Johnson in 1965, was first introduced eight years earlier and studied and debated extensively.
Similarly, bills creating the Children’s Health Insurance Program, which President Bill Clinton signed in 1997, and the Medicare Part D prescription drug program, which President George W. Bush signed in 2003, underwent years of committee hearings and study.
Even the Affordable Care Act, which President Barack Obama signed on March 23, 2010, after a last-minute scramble by Democratic leaders to get the votes, had been debated and analyzed for more than 15 months.
The Graham-Cassidy proposalwould not only roll back the government programs created by the current law to guarantee Americans’ health coverage, it would restructure the 52-year-old system of federal support for state Medicaid programs that currently cover 70 million people. It would also cut future Medicaid funding that supports coverage for poor children, mothers, seniors and the disabled.
The bill would also give states new authority to remake their health care systems and waive many protections in the current law, including the ban on insurers charging sick people more for coverage.
“For something this big, you need to be deliberative, and you need to think it through,” said Matt Salo, head of the National Association of Medicaid Directors, whose bipartisan board of directors also urged the Senate last week to slow down.
“Maybe this turns out great,” Salo said. “But there are so many core questions that we don’t know the answer to. Voting now is like turning off your headlights and driving into the tunnel.”