Wednesday, June 21, 2017

Update on the Senate stealth-health bill

The Washington Post reports on The Health 202: Here’s what we know about the Senate health-care bill.

Mitch McConnell is still pushing for a vote before July 4th.

There will likely be legislation for Republicans to view this week. Much of its largest outlines will mimic the House version passed in May. Parts of it will be different. It’s almost certain to result in millions fewer Americans having insurance. It will also enact big savings for Medicaid. Here’s what we know so far – and what we don’t – about the emerging bill:

  1. The bill’s 50-vote pathway to passage is most likely to circumvent Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.), the two senators at each end of their party’s spectrum.
  2. The Senate measure seems poised to enact deeper Medicaid cuts than the House bill.
  3. The Senate legislation is likely to gradually phase down the Affordable Care Act’s higher federal payments for the expanded Medicaid population.
  4. The measure seems ready to repeal or delay some or all of the ACA’s taxes.
  5. The Senate bill is likely to include a more generous version of insurance subsidies, tying them not just to age as in the House bill, but also to income.
  6. The measure will likely exclude language banning federally subsidized health plans from covering abortions.

See the Post’s report for more on each of the above items.

However:

The House Republicans can still shape the final bill

The Obamacare overhaul situation is in the hands of Senate Republicans at the moment. But it’s still important to pay attention to what House Republicans say about it because the House will have to put a stamp of approval on whatever a final bill looks like, if it’s ever going to Trump’s desk.

All signs in the Senate bill point to a longer phaseout for the ACA’s Medicaid expansion. A group of House conservatives is trying to tug the bill in the opposite direction. The Republican Study Committee laid out four demands in a letter it’s planning to send to McConnell later this week. Their asks include:

  1. Clamping down on Medicaid expansion more quickly and in 2020 completely cutting off the extra federal dollars for enrollees.
  2. Allowing states to opt out of the ban against charging more to those with preexisting conditions and essential health benefits.
  3. Repealing all of the ACA taxes.
  4. Defunding Planned Parenthood for one year and banning federally subsidized plans from covering abortions.

You think that is bad news? Check out Greg Sargent’s assessment of the time course of McConnell’s secret-speed push to get a vote before the 4th. Sorry, folks. The GOP’s devious strategy for ramming Trumpcare through is working.

We already knew that Senate Republicans were going to try to ram through their health-care bill by resorting to a scandalously secretive, absurdly compressed process. But now we have the details: According to the Wall Street Journal, the text of the bill will be released this Thursday; the Congressional Budget Office will release a score of the bill next Monday or Tuesday; and the Senate may well vote on it next Thursday.

Unfortunately, there are signs this morning that the Republican strategy is already working precisely as intended.

First, let’s note that the secrecy adopted by Senate Majority Leader Mitch McConnell is explicitly designed to shield the Senate GOP health-care bill from as much debate and public scrutiny as possible. The text of the bill will be available for all of one week before it is likely to be voted upon, after having been drafted in such secrecy that even Republican senators complained that they were being kept in the dark. There have not been, and apparently will not be, any hearings before the vote.

… This compressed schedule is not only designed to limit debate on the bill. As the [Wall Street] Journal reports, the vote is being rushed for the express purpose of getting it done before the July 4 recess, because the failure to do so “could open Republican lawmakers up to pressure from constituents,” some of whom might be “concerned about losing their health coverage.” Thus, the schedule is also explicitly designed to shield lawmakers from public exposure and questioning about the immense human toll the measure they are considering could have — before they vote on it.

Sargent cites a new CBS poll in which about 75% of Americans want the Senate Republicans to open up and make the deliberations on their health bill public. Independents sort out about the same way. But! The same percentages of Americans overall and independents say that they do not know enough about the Republican’s bill to have a good understanding of it.

The juxtaposition of these findings neatly underscores the profound cynicism at the core of the GOP approach. As Brian Beutler has argued, GOP leaders are not merely lying about what is in the bill. They are also lying about the process itself, because copping to what they are actually doing would implicitly admit that their bill — which is very likely to be almost as cruel in its broad strokes as the House bill — cannot survive genuine public debate. This new polling illuminates the point: Republican leaders are willing to endure the public’s disapproval of their efforts to hide the bill from the public (to the degree that they care about that disapproval at all), precisely because those efforts are keeping the public ignorant about what they actually intend to do to our health-care system.

It is possible, of course, that public disapproval of the secrecy of the process and of the bill itself — once we see it — could combine to dissuade a few moderate GOP senators from voting for the bill, perhaps dooming it. But nonetheless, right now, the Republicans’ blanket of secrecy is working. By keeping the public in the dark about Republicans’ true designs, it is having precisely its desired effect.

-=-=-=-=-=–=-=-=-=-=-= UPDATE =-=-=-=–=-=-=-==-=-

From The Guardian’s report on Tuesday afternoon: Republicans say they will release draft of health bill amid pressure over secrecy.

Senate leaders announce plan to reveal draft language on Thursday morning, with a finalized version to be released after budget office analysis

Senate Republican leaders said they would release draft language of their healthcare bill on Thursday amid mounting frustration among lawmakers in both parties over the way the party is assembling their bill – behind closed doors and without a single public hearing scheduled. A vote is expected next week.

The Senate majority leader, Mitch McConnell, confirmed that the draft bill would be made public on Thursday during a press conference with reporters on Tuesday.

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