Friday, June 16, 2017

Some Republican senators, including Rand Paul, don't like Mitch McConnell's strategy of drafting health bill in secret

Kentucky Health News

Senate Majority Leader Mitch McConnell continues to catch heat from Democrats, and dissatisfaction from some Republicans, about Senate Republicans' secret drafting of a repeal-and-replace-Obamacare bill that he wants passed by June 30.

At the congressional baseball game, McConnell and Schumer
gave their first joint interviews, as did House Speaker Paul Ryan
and House Minority Leader Nancy Pelosi. (AP photo by Alex Brandon)
Senate Democratic Leader Chuck Schumer of New York told the Kentuckian in a letter that they should convene a meeting of all 100 senators "on the topic of health care," which "affects every single American and one-sixth of our economy. We believe we all owe it to our constituents to pursue any bipartisan potential legislation because it profoundly impacts so many American lives."

Schumer told reporters, “They’re ashamed of the bill. If they liked the bill, they’d have brass bands marching down the middle of small-town America saying what a great bill it is. But they know it isn’t.”

McConnell spokesman David Popp "argued that the letter suggests Democrats are now open to the 'repeal' component of the 'repeal and replace' health care effort," CNN reports. "He alluded to Schumer's comments earlier this year in which he said Democrats will work with Republicans on repairing Obamacare as long as Republicans back off of the 'repeal' part of it."

Popp noted that Schumer's letter said Democrats would like to "discuss how to make health care more affordable and accessible." Popp said that was an admission that Obamacare is neither. "That admission is another positive step from a party that, until now, has been wedded to the unsustainable status quo and its consequences for families across the country," he told CNN, urging Democrats to "propose ideas."

Meanwhile, seven governors — four Democrats and three Republicans — wrote McConnell and Schumer, asking that senators in both parties be allowed to help draft the bill. McConnell has said he wouldn't involve Democrats in drafting because "They're not interested in doing anything that we're interested in doing," and hearings aren't needed because the issues are well known.

Republican grumbles

The lack of "a formal, open drafting session . . . has created an air of distrust and concern — on and off Capitol Hill, with Democrats but also with Republicans," report Thomas Kaplan and Robert Pear of The New York Times. "The secrecy surrounding the Senate measure to repeal and replace the Affordable Care Act is remarkable — at least for a health-care measure this consequential."

Sean Sullivan and Kelsey Snell of The Washington Post report, "Rank-and-file Republican senators are increasingly frustrated that McConnell and a small group of GOP aides are crafting a bill behind closed doors."

They quote Sen. Bob Corker, R-Tenn.: “I’ve said from day one, and I’ll say it again. The process is better if you do it in public, and that people get buy-in along the way and understand what’s going on. Obviously, that’s not the route that is being taken.”

The Times reports, "Mr. McConnell said there had been 'gazillions of hearings on this subject' over the years — a less-than-precise tabulation that offered little comfort to Democrats who want hearings held now, in this particular year, on the contents of this particular bill."

Corker is not the only Republican who wants to know more, and sooner. McConnell's Kentucky colleague, Rand Paul, asked reporters if they had a copy of the bill, and if so, whether he could have one. Paul is considered one of the Republicans least likely to support the bill, since he said the House version didn't go far enough. “My preference would be a more open process in committees, with hearings and people on both sides,” he told the Times.

Among Republican senators, "Few seem to have a clear, coherent picture of what will be in the legislation," the Times reports, quoting Ron Johnson of Wisconsin: “I come from a manufacturing background. I’ve solved a lot of problems. It starts with information. Seems like around here, the last step is getting information, which doesn’t seem to be necessarily the most effective process.”

Republican rationale

The Post reports, "Senate leaders argued that they are keeping a tight grip on emerging bill language a secret because they are writing several different policy options for each section of the bill. They worry that sharing any one piece out of context could give a distorted impression of what the final bill will include."

The Times says, "It is not unusual for lawmakers to draft major legislation in private, but they usually refine, debate and amend it in open committee sessions. The House bill to repeal the Affordable Care Act did not receive a hearing where outside experts could have testified, but lawmakers dissected its contents and were able to propose changes at three stages: in the Ways and Means, Energy and Commerce, and Budget Committees. Senate Republican leaders evidently think their back-room approach gives them the best chance to devise a health care bill that can squeak through the Senate, given their narrow majority and the policy differences in their conference."

Fifty-two senators are Republicans, allowing defection by only two to let a bill pass with the tie-breaking vote of Vice President Mike Pence. McConnell plans to bring the bill to a vote by June 30, the last day before a week-long recess, the Post reports. If it passes, a House-Senate conference committee would be named to work out the differences.

"The largest, most enduring clash within the Senate is over the future of Medicaid," the Post notes. "Republican senators are at odds over how much and how quickly to pare back federal spending on the program, which expanded under Obamacare and added millions of Americans to the rolls of the federally insured." It added 470,000 Kentuckians.

Does McConnell really want to pass a bill?

Jennifer Rubin, a conservative columnist for the Post, wonders whether McConnell really wants to pass a bill: "There are two possibilities here: First, McConnell has some magic formula for getting the votes of all but one senator (if Paul is indeed a “no” vote ) in a conference that includes far-right ideological twins Sens. Ted Cruz (R-Tex.) and Mike Lee (R-Utah) and moderates such as Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska), who among other things object to rolling back Medicaid or blocking Planned Parenthood funding. If such a formula exists, McConnell would have to think he can garner support in lightning speed, hold off uniform Democratic objections and ignore concerns from outside groups (doctors, hospitals, insurers). I suppose anything is possible, but such a process would be unique in Senate history.

"The other possibility is that McConnell knows this is impossible. He has set an entirely artificial deadline that cannot be met precisely because he knows health-care reform won’t happen. He wants to wipe the slate clean and move on to other issues such as tax reform and the budget — before those issues become untenable. He is experienced enough to know that this administration and the dysfunctional House are entirely capable of careening toward a government shutdown in the fall. Therefore, the sooner Congress can turn to these items, the better."

The Times notes, "While much of the Affordable Care Act was written in the open, some important provisions were hashed out in private, just before the Senate vote, by Senator Harry Reid, the Nevada Democrat who was then the majority leader. Republicans complained bitterly at the time, and Democrats threw those complaints back at them this week. 'This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors, without input from anyone, in an effort to jam it past not only the Senate but the American people,' Mr. McConnell said in December 2009, using words that could be spoken by any Democrat today."

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