Sen. Claire McCaskill (D-Mo.) lit into some her Republican colleagues on Thursday for writing legislation that would repeal the Affordable Care Act behind closed doors and without formal hearings in order to rush a floor vote and pass legislation along party lines.
“We have no idea what’s being proposed,” McCaskill said. “There’s a group of guys in a back room somewhere that are making these decisions. … We’re not even gonna have a hearing on a bill that impacts one-sixth of our economy. We’re not gonna have an opportunity to offer a single amendment.”
McCaskill happens to be right. Ripping the guts out of the Affordable Care Act, commonly known as Obamacare, and putting a new coverage system in place would be every bit as consequential as she described. Health care really does account for one-sixth of the U.S. economy.
And if the new health care legislation ends up looking like the American Health Care Act, the Republican bill that the House of Representatives passed in early May, it could easily affect health insurance arrangements for the majority of Americans ― most obviously, by depriving 23 million people of coverage altogether, according to projections by the Congressional Budget Office.
When the House passed its bill, rushing so quickly that it couldn’t even wait for the CBO to issue its final analysis, Republican senators swore that they would do things differently. But the process in the Senate looks more and more familiar. Neither of the two committees with jurisdiction over the bill, the Finance Committee and the Health, Education, Labor and Pensions (HELP) Committee, have held hearings on the legislation’s details ― and, as of now, neither committee is planning to do so.
Instead, according to both printed accounts and lobbyists who have spoken to HuffPost, McConnell and his allies are working quietly to stitch together a majority coalition, or something close to it, in hopes of bringing a bill directly to the floor for a vote. Republicans might keep their word about waiting for an updated CBO score, but, once they have it, they’ll likely keep the debate short.
“McConnell has absorbed the most important political lesson from the GOP’s House effort ― namely, that the American Health Care Act is wildly unpopular. The more the public knows about it, the less it seems to like it.”
Democratic leaders, including the ranking members on the Finance and HELP committees ― Sen. Ron Wyden (D-Ore.) and Sen. Patty Murray (D-Wash.) ― have sent letters calling for a more deliberative process. But they lack the power to enforce their will.
As those two senators know well, and as McCaskill pointed out on Thursday, Democrats went about writing health legislation very differently eight years ago.
Here’s a summary from HuffPost a few months ago detailing the deliberation involved in creating Obamacare:
The process that first produced Obamacare in 2009 and 2010 unfolded a bit differently. It featured its share of backroom deals and at least one big vow that Democrats would break. (“If you like your health care plan, you can keep it.”) But it also featured more than a year of public deliberation, including upwards of 130 hearings across the five committees, according to a tally that Democratic staffers compiled at the time.
Many of these hearings included testimony from both liberal and conservative experts, with opportunities for tough questions by both parties. And that followed a presidential campaign in which the Democratic candidates, including the eventual nominee and future president, coalesced quickly around a model for reform and spent their time litigating their relatively narrow disputes in detail.
In case it’s not self-evident, McConnell’s decision to avoid this kind of process has nothing to do with making good policy. However tedious hearings may seem, they offer a chance for outsiders ― the media, the experts and eventually, the public ― to learn about legislation and develop opinions about it.
And that’s what happened in 2009 and 2010 ― even if lawmakers ended up talking too much about some fake issues (like “death panels”) and not enough about some real ones (like how new regulations would affect existing insurance plans). The process gave everybody a long time to contemplate reform and what it would mean.
But McConnell has absorbed the most important political lesson from the GOP’s House effort ― namely, that the American Health Care Act is wildly unpopular. The more the public knows about it, the less it seems to like it.
It was only after the bill appeared to fail in the House, and attention turned elsewhere, that Republican leaders were able to modify it and put together the votes they needed for passage ― and then stage a vote before opposition could mobilize all over again.
By avoiding public scrutiny for as long as possible, and keeping the final debate brief, McConnell is trying to pull off a similar feat in his chamber.
The question now is whether he’ll get away with it.