Republicans Are Destroying The Senate To Pass A Healthcare Bill They Haven’t Read
Drama and good governance are two concepts that do not belong together. While the American people, or some of them anyway, may have decided that politics is the new pop-culture and electing a reality-TV star to run our country was a good idea, it is beyond irresponsible to tackle people’s healthcare in such a fashion. Senate Republicans have made gargantuan efforts to create the illusion of distance between themselves and President Trump, but his slapdash and corner-cutting style (shocking that any of his buildings are still standing given this) infuses all the procedures and tactics the GOP is using to pass their Affordable Care Act Repeal Bill.
The Shadow Of A Maverick
Senator John McCain (R-AZ) returned home for surgery last week targeted at a blood clot in his brain. His doctors confirmed that this clot was the result of a rather aggressive form of brain cancer sparking an outpouring of well-wishes and sympathy from across the country and the political spectrum. Rather than recovering, Senator McCain is rushed back to Washington today hoping to alter the math and help Senate Republicans plunder healthcare from tens of millions of people.
In returning to Washington despite significant health issues, Sen. McCain continues a proud tradition of service to country present in both his past and ours. Clair Engle was one such Senator and keeper of this proud tradition. Senator Engle also underwent brain surgery and while unable to speak was one of the votes that helped pass the Civil Rights Act of 1964. Although he could not stand, Sen. Engle stood up and was counted for what he believed in and perhaps Sen. McCain sees himself similarly.
Greeted with applause as he entered the Senate chamber, Senator McCain cast the deciding vote to begin debate on the healthcare bill. McCain followed up his vote with a speech extorting the Senate to return to the glory days of political decency when legislation was actually passed and every issue was debated until compromises could be found. Apparently, the irony of such statements cannot penetrate the thick walls of the US Senate.
Follow The Bill
Round and round the Senate healthcare bill has gone with amendments and revisions (all produced in secret) proposed one after another. There was something strangely familiar about the entire process that took me a while to put my finger on but any resident of NYC will instantly recognize:
“Find the bill, which one are you voting on?” shouts the huckster attempting to fleece the crowd out of their political capital. Mitch McConnell (R-KY) is attempting to pass something, anything, so the Republicans can declare victory and go home. On Tuesday Senator McConnell made a last push to get his party to move forward on the Motion to Proceed assisted by Senator McCain’s early return and McConnell’s fellow senator from Kentucky, Rand Paul’s, signal that he is willing to move forward as long as the Senate at least votes on a clean repeal of the ACA.
The Motion To Proceed Is Passed. What Next?
The shuffle begins with the Motion to Proceed, which passed Tuesday afternoon. Basically, the Senate votes to begin discussion of the healthcare bill, technically they are voting the bill passed by the House months ago, but with the stated intention of marking it up and passing a final bill that will likely bear scant resemblance to the original bill. In a vicious twist of irony, Republicans are voting to repeal a bill that bears many similarities to one proposed by their own leadership back in the 90's.
There will be 20 hours of debate and time to propose amendments which will be voted on to add to the bill. Something to keep an eye on is how Democrats choose to participate in this section of the process and what amendments they offer up. It is extremely unlikely that the debate will yield anything final as McConnell will have a chance to pass a final amendment that basically serves as a new bill. Senator Wyden (D-OR) agrees.
Mitch McConnell will swoop in with a mystery bill at the end. It will be a mystery to your GOP senator, too.
Expect to see votes on several versions of the healthcare bill, importantly one on the total repeal of the ACA. Such a “clean repeal” vote was the carrot offered to Rand Paul (R-KY) and other far-right Senators to gain their support for the bill. While “clean repeal” will be voted on, do not expect that version of the healthcare law to go anywhere just yet, as kicking 32 million Americans off of their health insurance does not seem to sit well with voters and has a hard time gathering 60 votes.
The “Skinny” Repeal
A conceivable, and very very new, option to pass is what has been dubbed “skinny” repeal. The emphasis here is on the repeal of the individual mandate, employer mandate, and medical device tax. The first two being items Republicans claim their constituents worry greatly about while the last one has been a sticking point for sections of the healthcare industry, and benefits certain Republican officials as well (Tom Price comes to mind).
Such a repeal of the ACA would likely keep the Medicaid expansion, pre-existing condition coverage, some subsidies, and maybe even some of the ACA’s taxes. Sounds sort of humane right?
According to the Congressional Budget Office repeal of the individual mandate, the part of the ACA that requires healthy people to purchase insurance would result in about 15 million more uninsured Americans in 2026. These healthy people subsidize those with more serious conditions, as with all insurance, and permitting them to leave the individual insurance market will significantly raise premiums. Similar outcomes would happen with the removal of the employer mandate.
Unless the Senate votes to pass the House’s healthcare bill (AHCA) from May, both versions of the bill will have to undergo reconciliation. Representatives from both houses, and parties will meet behind closed doors to come to some sort of agreement on the bill. There are no requirements the bills that come out of reconciliation resemble in any way those that went in. Still, these laws have to return to both chambers to be voted on again, the passage of ACA repeal is far from over with significant legislative and procedural hurdles still to overcome.
Keep your eyes on the bills folks, this legislative session is far from over and short windows between announcing and taking votes make publicly pressuring your elected officials difficult. Senator McConnell may eventually get what he wants, a bill to declare a “win” for the Republican party to take home to primary voters. Ultimately, however, the damage done to the norms of the Senate by the unprecedented Republican obstruction from 2008 to the present, Democratic maneuvering to pass the bill initially, and the current Senate going nuclear on rules, not much will be left when the smoke clears. Among all the other norms being disregarded by the current administration, however, what are a few more archaic rules to stand in the way of Republican righteousness.