If Senate Majority Leader Mitch McConnell has his way, the Senate’s Obamacare repeal-and-replace process will be a disciplined and at-times clandestine whirlwind romance, culminating in a shotgun wedding. The goal: have the landmark legislation ready for President Trump’s signature by the time Congress breaks for the Independence Day holiday.
McConnell on Thursday finally okayed release of a 142-page draft bill, dubbed the Better Care Reconciliation Act (BCRA), following weeks of quietly holding listening sessions with GOP colleagues to gauge their concerns, then drafting the legislation behind closed doors (more on that later) with a small group of mostly Senate staff. With a few distinct differences, it follows the general outline of the House of Representative’s American Health Care Act (AHCA), which passed in May.
The nonpartisan Congressional Budget Office is expected to release its analysis of the Senate bill early next week. While at least seven GOP senators (McConnell can only afford to lose two) so far have expressed significant concerns about the bill, the majority leader appears determined to try to bring his caucus to heel more quickly than House Speaker Paul Ryan was able in his chamber. While differences in Senate and House versions of a bill typically can take weeks to reconcile in conference committee, some pundits on Thursday night suggested Republicans may copy a parliamentary maneuver that Democrats used when passing the Affordable Care Act (ACA) in 2010.
A full conference committee would not be necessary if Ryan and his leadership team – eager to proceed with tax reform and loath to reopen a can of worms – can convince their caucus to accept the Senate version as-is. This assumes that blowback from angry constituents over the next several days won’t cause GOP lawmakers to get cold feet and delay action until well after July 4th.
But the potential for Republicans to act quickly means reporters may not have much time to explain the potential implications of the proposed legislation so voters can weigh in with lawmakers in an informed manner. To assist, here is some of the best early coverage and analysis from AHCJ members and their colleagues:
- Shifting dollars from poor to rich is a key part of the Senate health bill and Graphic: How Senate Republicans plan to dismantle Obamacare (Margot Sanger-Katz at The New York Times)
- The Senate GOP’s backdoor Obamacare rollback (Explanation of Section 1332 waivers by Danny Vinik at Politico)
- How killing Obamacare might save Obamacare, for a while (John Tozzi and Zachary Tracer, Bloomberg News)
- Graphic: Who wins, who loses with Senate health care bill (NPR staff; compares ACA, AHCA and BCRA)
- Senate health care bill: Here’s how it would affect you (USA Today staff)
- Inside McConnell’s plan to repeal Obamacare (Burgess Everett, Politico) and McConnell will be a legislative wizard if health care passes (Paige Winfield Cunningham, The Washington Post)
- Graphic: Where senators stand on the health care bill (The New York Times)
- Obama blasts the ‘fundamental meanness’ of Senate health-care bill (The former president’s Facebook post, annotated with analysis by Washington Post staff)
- What the Republicans’ Senate health-care bill means for America (John Cassidy, Benjamin Wallace-Wells and Adam Davidson at The New Yorker)
- Here’s how Ronald Reagan would fix the GOP’s health-care mess (Washington Post op-ed by Henry Olsen, senior fellow at the Ethics and Public Policy Center)
Process Under Fire
Members of AHCJ’s board and the association’s Right to Know Committee have expressed significant concern about the Senate leadership’s lack of transparency in developing the BCRA.
“The secrecy over the health bill has been extraordinary and has made it hard for the media to do its job,” AHCJ Board President Karl Stark said. “The way it’s being handled will likely have the effect of limiting awareness and understanding of the bill, which is unfortunate. There is a great public need to know more.”
Here’s some analysis of the issue in the weeks leading up to the bill’s June 22 debut:
- Republican secrecy faces mounting criticism as GOP senators work behind closed doors to replace Obamacare (Noam N. Levey and Lisa Mascaro at The Los Angeles Times)
- I’ve covered Obamacare since day one. I’ve never seen lying and obstruction like this (Sarah Kliff at Vox)
- Descent Into Secrecy: Senate health talks speak to steady retreat from transparency (Kaiser Health News’ Julie Rovner, who has covered health care reform since the Clinton Administration)
Since the Trump administration took office, AHCJ’s core topic leaders have looked at how the nation’s health care landscape likely will change now that Republicans have someone in the White House who supports their long-stated objective to repeal the ACA. In a new post, insurance industry core topic leader Joseph Burns talks with a California insurer about how the Senate’s bill may affect low-income seniors, children and other vulnerable populations who rely on Medicaid.
If you don’t already follow them, also monitor the Twitter feeds of Health Policy core topic leader Joanne Kenen (Politico’s Health executive editor) and past AHCJ president Charles Ornstein (ProPublica senior reporter) to see what BCRA coverage they find worthy of a retweet.
Finally, for historical perspective, here’s earlier roundup coverage of this year’s GOP health care reform odyssey compiled by Pia Christensen, AHCJ managing editor/online services: