Senate Dems: GOP Health Bill Secretive, in Contrast to Obamacare

The secretive way in which Republicans are drafting the current health care bill bears no resemblance to how Democrats put together Obamacare seven years ago, Senate Democrats argue. 

With only a few weeks remaining before the make-or-break August recess deadline, lawmakers from both sides of the aisle have bemoaned the back-room crafting of  Senate Republicans’ American Health Care Act, a draft of which could come as early as Thursday.

“We’re all frustrated,” said Sen. Joe Manchin, one of the Senate’s more moderate Democrats. “Let us be involved, see if we can work together, see if we can find a process. Let’s have hearings, let’s have openness, let’s have amendment processes,” said Manchin. Although no Republicans supported Obamacare eight years ago, he added, “at least they had input.”

Most Senate Democrats agree with that sentiment. Minority Leader Chuck Schumer called the difference between Republican and Democratic handling of health care “night and day.” Perhaps the primary voice of Democratic resistance, Schumer recently called for a full meeting of the Senate to discuss the bill. Not only was that request denied, but Majority Leader Mitch McConnell has also questioned what, exactly, all the fuss is about.

"Nobody is hiding the ball here," he said on June 13. "You are free to ask anybody anything. But there have been gazillions of hearings on this subject when [Democrats] were in the majority, when we were in the majority. We understand the issue very well and we are now coming up with a solution."

Sen. Rand Paul, one of the 50 Senate Republicans who will need to approve the measure for it to pass with reconciliation, seemed to disagree.

“We might have to get the copy machine out -- we haven’t seen the bill yet,” he said, expressing concern that the House version included “90 percent” of the subsidies found in Obamacare. Democratic Sen. Richard Blumenthal, who has also not yet seen the bill, mentioned that Democrats are “developing options” to slow or stop its progress.

Conservative strategist Ford O’Connell lent credibility to McConnell’s original point, noting the primary Democratic goal was to gum up the works.

“There is no question that Republicans could be more open on this,” he said, “but we also know that, when it comes to something as complicated as health care, nobody can have their negotiations in public because you’re never going to get to a ‘yes.’” O’Connell went on to call the closed-door Democratic process of seven years ago “the same thing” happening today.

A Democratic spokesperson challenged that, calling the current level of secrecy “unprecedented,” with no resemblance to 2009.

“When Democrats passed the Affordable Care Act, the Senate Finance Committee held more than 50 hearings, roundtables, and walkthroughs on health reform. They spent eight days marking up the legislation, [and] there were more than 130 amendments,” the source said. “There is zero comparison between the process that Senate Republicans are going through right now… and the process that Democrats had to go through.”

One difference O’Connell noted between the two scenarios, however, is the majority numbers in both the House and Senate. In 2010, Democratic majorities in the House and Senate were 76 and 18, respectively; in 2017, Republicans control those respective chambers by only 45 and four. The AHCA, which passed by a razor-thin 217-213 House vote on May 4, faces an even slimmer margin of error in the Senate, especially with moderate Republican senators like Susan Collins.

Although Democrats insist they are willing to work with Republicans on a replacement -- instead of a repeal -- of Obamacare, skeptics are not so sure. Especially with potentially contentious Senate elections coming next year, some fear that any sudden moves in regard to health care could spell disaster for re-election bids.

“[Democrats] will get primaried if they vote for health care reform, at least as it is understood right now,” said O’Connell, in his explanation of why there is limited interest in supporting a measure that has President Trump’s approval. “What they’re hoping to do is to run out the clock before the 2018 midterms and fire up their base.”

Running out the clock, though, could prove easier said than done. While Monday night’s talk-a-thon may have been helpful in catching public attention, it cannot be said to have done much else. Especially with the limited debate allowed under the rules of reconciliation, the only other viable option would be halting committee work, which would likely be received as a sign of bad faith and could backfire.

Some Democrats have placed their hopes in Republicans on the fence, expecting a fresh chance to negotiate if this bill fails on the floor.

“Under their leadership, [Republicans are] committed to going the path they’re going right now and not being serious at looking at any sort of compromise until it fails,” Manchin said, reiterating his willingness to repair Obamacare, which has left more than a dozen counties without insurance options in Ohio alone. “If it fails, I think then [Sen.] Lamar [Alexander] and some good, moderate Republicans will sit down with some moderate Democrats and try to find a pathway forward to fix it.” 

While many congressional deadlines related to the GOP health care bill are arbitrary, Labor Day seems a firm date in terms of prioritization. If a bill is not agreed to by that point, tax reform, another top GOP policy issue recently brought to the forefront by House Speaker Paul Ryan, will likely take center stage and consume lawmakers’ attention. Trump, who has marketed himself as an astute businessman and a “jobs president” from the beginning, could push the issue to the head of the line even before that point.

Moreover, insurers must decide by Wednesday whether they will participate in 39 states’ insurance exchanges next year -- in other words, without knowledge of available Medicaid dollars, the rate of Medicaid rollback, or federal support of programs such as cost-sharing subsidies seen under Obamacare.

Despite confidentiality that, as of Friday, had kept even Health and Human Services Secretary Tom Price without details of the AHCA, some GOP senators still stand by the bill and its timeline. Sen. Ted Cruz, who has called for Obamacare’s repeal since its March 2010 passage into law, expressed optimism for the next few weeks. 

“The conversations continue, and we have a host of tools available to lower premiums,” Cruz said. “I believe that should be our central focus -- how to make our premiums more affordable so that more families that are struggling can access health care.”

Looking forward, McConnell confirmed Tuesday that he expects to have a “discussion draft” of the AHCA available Thursday. The bill’s implications, whether there’s room for compromise, and, most importantly, the bill’s specifics remain unclear.

The Democratic source underscored the importance of transparency. “The health care issue for all voters consistently ranks at the top of their concerns. It is among the most personal, if not the most personal, issue that voters assess when they’re making determinations about candidates and campaigns. Health care is the one issue that voters personalize and bring perhaps the highest level of concern to.”