Congress Must Not Normalize The Secrecy Surrounding Trumpcare

Health care debates and bills need to be transparent.
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Jonathan Ernst / Reuters

Congressional Republicans are establishing a new precedent for how the U.S. Congress handles major legislation that impacts all Americans: Keep it in the shadows, hide it in a back room, and vote on it at the last minute.

This is unacceptable, especially for legislation that directly impacts Americans’ pocketbooks and the economy. As most of us have known for years, health care and health insurance are complex. Health care debates and bills need to be transparent so we can understand how they will affect the health care system and our ability to get care. Many Americans will not see a doctor or receive necessary prescriptions if they cannot afford it.

According to the Centers for Medicare and Medicaid Services, health spending accounts for 17.8 percent of our nation’s gross domestic product. That means that major health care overhaul bills affect more than one-sixth of the U.S. economy. Bills of this weight deserve the full scrutiny of all stakeholders – hospitals, physicians, and most importantly, the American people. We must know if health care reform legislation will impact our ability to access health care. Yet Congressional Republicans are not allowing that to happen. This sets a dangerous precedent.

In 2009 and 2010, Congressional Republicans complained of a lack of transparency during the passage of the Affordable Care Act. Compare that process to their own deliberations on health care reform.

In 2009-10, the House held 79 bipartisan hearings and markups over nearly 100 hours, heard from 181 Democratic and Republican witnesses, considered 239 bipartisan amendments, and accepted 121 amendments (30 from Republicans). In addition, the bill was posted for comment for 30 days before considering amendments, and for 100 days before the bill was considered for a vote.

In the Senate, there were more than 100 hearings, roundtables or walkthroughs, 335 amendments considered (147 Republican amendments were adopted), the bill was posted online for six days before markup, and the Senate spent 25 consecutive days in session on health reform, the second longest session in history.

In addition, the Senate bill that the House voted on was on-line for review for three months and the reconciliation bill was online for 72 hours before the final vote. House Democrats hosted more than 3,000 health care town halls and public events, and logged tens of thousands of e-mails, calls, and letters.

By comparison, in 2017, the House’s Trumpcare debate consisted of zero legislative hearings, no experts to provide insight on the bill’s impact on Americans and our health care, two markups held just 48 hours after the bill was posted online, 60 amendments or motions considered (with none adopted), and final passage before the CBO could review the bill.

The Senate has held zero hearings, roundtables or walkthroughs, and there has been no opportunity to offer amendments. Senators from both parties must wait to see what, if any, ability they will have to influence the legislation through an open committee process.

In 2009, Democratic senators negotiated with Republicans for months in hopes of finding common ground. This year Senate Republican leadership has made no effort to include their Democratic colleagues in negotiations.

The same party that felt left out of the process in the minority in 2009 and 2010 has gone out of their way to hide and obstruct its version of repealing the Affordable Care Act. This process makes for bad policy. It’s reckless. As Sandy Levin said, this is legislative malpractice. And I guarantee you this will not be limited to just your health insurance.

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