Despite the failure of the latest Trumpcare bill on Monday, Senate Republican leadership is moving forward with plans to have a health care debate on the floor next week. It remains completely unclear, however, whether senators will consider a revised version of Trumpcare, a repeal-and-delay process, a more straightforward Obamacare repeal bill, or something else.
On Thursday, the second-ranking Senate Republican — John Cornyn (TX) — was asked by a reporter from The Hill if “some people want to know the plan before the vote.” He responded by saying that sort of deliberative process isn’t “a luxury” Republicans can afford — meaning he thinks senators will have to vote on a motion to proceed with floor debate before having an inkling of what bill they will be debating.
Here's transcript of my question to Cornyn where he said "luxury we don't have" pic.twitter.com/pfcvEzna1U
— Peter Sullivan (@PeterSullivan4) July 20, 2017
On Twitter, Cornyn later indicated his primary concern is coming up with a health care plan that is acceptable to at least 50 of the 52 Republican senators.
Hard to predict final bill after open amendment process. We do know that it will have to be acceptable to at least 50 Senators to pass https://t.co/mynUTHZdWB
— JohnCornyn (@JohnCornyn) July 20, 2017
Cornyn might want people to believe there’s a health care crisis, but the nonpartisan Congressional Budget Office doesn’t buy it. In March, the CBO concluded that Obamacare exchanges are likely to “be stable in most areas.”
“The subsidies to purchase coverage combined with the penalties paid by uninsured people stemming from the individual mandate are anticipated to cause sufficient demand for insurance by people with low health care expenditures for the market to be stable,” the CBO wrote, debunking notions that Obamacare is in a “death spiral.” (The Trump administration is doing everything it can to sabotage it, however.)
Republicans are nevertheless rushing to pass health care legislation. On Thursday, Sen. John Thune (R-SD) said that if a motion to proceed succeeds and a floor discussion about health care begins, the approach Republicans take will ultimately be up to Senate Majority Leader Mitch McConnell (R-KY).
Thune: If Senate can get onto health care debate it will be a "judgement call" by McConnell whether they substitute repeal or repeal/replace
— Mary Ellen McIntire (@MelMcIntire) July 20, 2017
Summing up the comments a number of Senate Republicans made to reporters on Thursday, Kristina Peterson of the Wall Street Journal said they’re confident that at some point before voting, they’ll learn details about legislation that impacts one-sixth of the American economy and affects the well-being of tens of millions of people.
GOP senators say they are confident they will know what they're voting on at *some* point before they actually vote.
— Kristina L. Peterson (@kristinapet) July 20, 2017
Julie Rovner of Kaiser Health News thinks the approach Senate Republicans are taking is intentionally aimed at bewildering the public.
I think Senate R's are trying to confuse the media by dumping every possible health bill out in public. And to some extent, it's working
— julie rovner (@jrovner) July 20, 2017
From a political standpoint, Senate Republicans have good reason to release as little information as possible until the last possible minute. The Trumpcare bill passed by the House and the various versions considered by the Senate have remained unpopular — both in their own right and in comparison to existing law — since the framework of the House version first came together in March. And there’s good reason for that: Every Trumpcare version the CBO has scored would strip coverage from more than 20 million people, take away protections for people with preexisting conditions, and gouge seniors.
At least one key Senate Republican has concerns. Dean Heller (NV) came out in opposition to Trumpcare last month, citing concerns about how the bill’s rollback of Obamacare’s Medicaid expansion would impact the more than 276,000 Nevadans who have received coverage thanks to it. During remarks to reporters following a Republican health care luncheon at the White House on Wednesday, President Trump threatened to end Heller’s tenure in the Senate if he doesn’t vote in favor of Trumpcare. (Heller is up for reelection next year.)
During an interview with Axios that took place after a Senate Republican health care meeting on Wednesday evening, Heller said he couldn’t answer questions about whether his thoughts about Trumpcare have changed because “things are changing so quickly.”
“I want to have all the information that I can have and continue to gather this information to the point that I can actually make a decision,” he added. “I’m not at the point I can make a decision.”
But President Trump doesn’t share Heller’s concerns about learning the specifics. In a statement released Thursday, Trump — who has publicly endorsed three distinct and incompatible health care plans this week and indicated during a New York Times interview conducted Wednesday that he may not even know how insurance works — said he has “pen in hand” and is ready to sign anything.
“We must repeal and replace this disaster,” Trump said. “The Senate should not leave for summer recess until it has passed a plan to give our people great healthcare.”
During an MSNBC interview later Thursday, Sen. Bill Cassidy (R-LA) defended the president, and said he doesn’t think it’s a big deal if Trump doesn’t grasp the details of health care policy.
“I don’t think it’s important to him to understand the policy intricacies of this bill,” he said. “What’s important for him is to understand the principle. His principle is that there should be a replace, associated with repeal.”
The form that replacement will take remains anyone’s guess, but based on the previous iterations of Trumpcare considered by Senate Republicans, it’s safe to concluded that it will strip coverage from tens of millions.