An unhealthy secrecy shrouds the Senate's bill to replace Obamacare
Jun 19, 2017 | 3:00 AM
Health insurers across the country are making plans to raise Obamacare premiums or exit marketplaces amid exasperation with the Trump administration’s management. (May 18, 2017) (Sign up for our free video newsletter here)
For all the pumps of hand sanitizer that have cropped up everywhere in recent years to help prevent the spread of germs and illness, an even more plentiful disinfectant is going unused despite a looming public health threat.
"Sunlight is said to be the best of disinfectants," Justice Louis Brandeis once wrote, adding some years later: "If the broad light of day could be let in upon men's actions, it would purify them as the sun disinfects."
But for more than a month, a group of 13 Republican Senators has been meeting behind closed doors and in total secrecy, writing their version of an Obamacare replacement after receiving the House's hastily-passed and wildly unpopular repeal bill last month. For all the far-reaching ramifications of this legislation — on how and under what circumstances and at what cost people will get health care — what is even in the bill at this point has yet to see Brandeis' broad light of day.
Yet Senate leadership wants to vote on this mystery bill before the Fourth of July recess. Less than two weeks from now.
Their plan is to hold no hearings before the vote and take no input on the bill from experts, advocates or the public. There will be no committee hearings, no opportunity for amendments. Nothing, despite the fact that the only thing currently on the table, the American Health Care Act to repeal Obamacare that was passed May 4, has an approval rating below 20 percent.
The House bill's process to passage was hardly a model of government-in-sunshine. The original bill crashed to a humiliating defeat in March — House Speaker Paul Ryan pulled the AHCA ahead of a scheduled vote when it was clear it wouldn't pass — but representatives ultimately revived and tinkered with it. By May 3, an amended bill had taken shape and was rushed to a vote less than 24 hours later, before the bipartisan Congressional Budget Office could analyze it. It passed, narrowly: 217-213.
At the time, a number of senators airily noted that's not how they operate, and any vote on their bill would come after a CBO review. "Y'all, I'm still waiting to see if it's a boy or a girl," Sen. Lindsey Graham of South Carolina said of the fast-delivered House legislation. "Any bill that has been posted less than 24 hours, going to be debated three or four hours, not scored? Needs to be viewed with suspicion."
But now, the Senate is birthing its own bill under a veritable cone of silence and a compressed schedule as well. Even aides of the 13 Senators in the working group appear to be in the dark about a bill expected to come to the floor within weeks. NBC News reported that it asked one such aide about the bill's text and was told, dryly, "Why would they show us any legislation?"
Senators haven't said when they'll release the bill publicly, so it's unknowable how many days — hours? — after that they will vote on it. CBO scoring is expected to take about two weeks, so the window seems quite narrow, given the coming July 4 recess.
Despite the GOP's complaints at the time that Democrats were rushing the Affordable Care Act to a vote, the path from bill to law was a lengthy process of multiple committee hearings and debates, including 25 straight days on the Senate floor proceeding its passage. And it is myth that no one knew what was in the bill, despite the hay Republicans made of then then-House Speaker Nancy Pelosi infamously saying that "we have to pass the bill so that you can find out what's in it." That was taken out of context; she meant that after its passage, the public would be able to appreciate its value, away from the contentious legislative process.
So why would today's Senate Republicans do exactly what they complained (without basis) that the Democrats did in 2009-2010? What is in their bill that they want to hide, at least for now? Could it be that it's not much better than what the House came up with, and which the major medical associations and patient advocacy groups opposed? After seven years of characterizing Obamacare as an utter disaster, shouldn't it have been easy to come up with something even marginally better? That they would proudly wave from the dome of the Capitol to the cheers of the masses who have waited so long to be rescued from the Affordable Care Act?