The Senate will be voting on health care on Tuesday, but no one knows what that vote will look like, including the president.
Standing in front of people he called “Obamacare victims,” President Donald Trump gave yet another plea against the Affordable Care Act (ACA) on Monday. He called on the Senate to act now and replace current health care law with the Better Care Act Reconciliation (BCRA).
“The question for every senator, Democrat or Republican, is whether they will side with Obamacare’s architect, which have been so destructive to our country, or with its forgotten victims,” said Trump. “Any senator who votes against starting debate is telling America that you are fine with the Obamacare nightmare which is what it is.”
But Trump’s pitch for the BCRA was riddled with falsehoods, making it unclear if the president even knew what he was advocating for. The few moments the president engaged on specific policy changes, he completely mischaracterized the effects of BCRA.
Here are some misleading provisions he highlighted:
The pitch: BCRA repeals the individual and employer mandate.
The reality: BCRA repeals the health insurance mandate, and replaces it with a six month lock out if patients do not maintain continuous coverage. The Senate parliamentarian, the Senate’s rule gatekeeper, has said the provision does not meet Senate rules. Meaning BCRA cannot stabilize the individual market and pass using reconciliation, a budgetary process that allows bills to pass with a simply majority.
The pitch: BCRA lowers marketplace insurance premiums.
The reality: Premiums don’t necessarily go down for everyone. Premium tax credits are less generous for older and low-to-moderate-income Americans. Even though premiums go down for some, namely younger patients, out-of-pocket costs (i.e. deductibles and copays) will spike.
The pitch: BCRA provides coverage for people with preexisting conditions.
The reality: BCRA, like the ACA, does not allow insurance companies to deny people with preexisting conditions. However, insurance companies can sell plans that provide inadequate coverage for people with preexisting conditions. Meaning, a cancer patient cannot be denied coverage but insurance companies can certainly not pay for treatments the patient requires.
A pig-in-a-poke bill
Trump is demanding the Senate move on something. Before Trump took the podium, Health and Human Services Secretary Tom Price demanded the Senate bring a bill for Trump to sign. Monday’s pitch just so happened to be one for BCRA — although Trump doesn’t seem to understand it very well.
This week the Senate could vote on the bill to repeal-and-replace (by voting for BCRA), or the Senate could move on a straight repeal (the Obama Repeal Reconciliation Act).
The first tell will likely be on Tuesday, when Majority Leader Mitch McConnell seeks a full Senate vote to open up debate on the House-passed bill (the American Health Care Act). This is called the “motion to proceed.”
Senate Republicans are desperate for votes to even start debate. They are trying to get ailing Senator John McCain (R-AZ) to return for the vote.