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Senate Republicans stumble in their haste to jam through Obamacare repeal

Compared to the current debate, the fight to pass Obamacare was strikingly deliberate and transparent.

President Donald Trump, center, speaks during a meeting with House and Senate Leadership in the Roosevelt Room of the White House in Washington, Tuesday, June 6, 2017. CREDIT: AP Photo/Pablo Martinez Monsivais
President Donald Trump, center, speaks during a meeting with House and Senate Leadership in the Roosevelt Room of the White House in Washington, Tuesday, June 6, 2017. CREDIT: AP Photo/Pablo Martinez Monsivais

A week before former President Barack Obama left for Russia to meet with President Vladimir Putin at his Moscow residency, on July 7, 2009, he held a town hall on health care. The president spoke to — and took questions from — a studio and online audience for an hour and fifteen minutes at a community college in Virginia.

“What we have been working on is the creation of something called the Health Insurance Exchange,” said Obama. He went on to explain, in broad strokes, the so-called Obamacare exchanges. Granted, he gave a generous description of the marketplace — he was after all trying to sell it. And the town hall would later be criticized for being tightly controlled.

But that town hall would be the third time President Obama took questions from the public about health care, because, as he put it, “this is a big, complicated process.”

The White House homepage for the Obama administration on July 6, 2009 vs. Trump administration on July 6, 2017, CREDIT: Politico/Dan Diamond
The White House homepage for the Obama administration on July 6, 2009 vs. Trump administration on July 6, 2017, CREDIT: Politico/Dan Diamond

Fast forward eight years: President Donald Trump is meeting Putin and lawmakers are still trying to push health care reform. What has changed is that today’s health care overhaul approach is shrouded in secrecy; instead of being invited into the process, the public needs to stage sit-ins and flood senators’ town halls during the July recess to get answers.

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The last publicly available version of the Senate Republicans’ health care bill — the Better Care Reconciliation Act (BCRA) — is already out of date. At a June town hall, Senator Bill Cassidy (R-LA) told ThinkProgress and a group of reporters that he has not seen the final bill, and could neither support nor explain its revisions.

What the public does know about, they do not like. The Senate bill is among the most unpopular bills in three decades, and Trump seems to understand that. His Special Assistant for Legislative Affairs has told conservative groups that the president will only sign a repeal-only bill, according to Politico. Without the support of the President and full Republican party —which is bleeding more defectors by the minute — Senate Majority leader Senator Mitch McConnell (R-KY) signaled doubts Thursday about passing the Senate bill.

On its face, BCRA is problematic: If passed, it would cost 22 million people their health insurance over the next decade, according to a Congressional Budget Office analysis.

And surely Sen. McConnell and the working group, composed of all white, cis, straight men, underestimated how difficult it is write and rewrite the American health care system, much less advocate for their changes afterward.

“Nobody knew health care could be so complicated,” said Mr. Trump in February during a meeting at the White House.

Some knew.

Angela Lorio knew. Her son John Paul spent the first 164 days of his life in the hospital, having been born premature at 27 weeks. He has respiratory problems that would require the now-four-year old to indefinitely live in a nursing home. Angela had to navigate the Louisiana Medicaid Home and Community-based Waiver Program so John Paul could be raised at home, with the all the medical supplies he needs.

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Jonathan Miller knew. He has cystic fibrosis, a medical disease that causes his lungs to fill with choking fluid. He could tell you a rough estimate of how much his prescriptions would cost him if he lacked health insurance for a month: over $10,000.

Due to severe health complications, Angela and Jonathan have been forced to closely monitor health care policy — and by extension the Senate bill. Journalist Stephen Brill said in his book ‘America’s Bitter Pill’ that “people care more about their health than they care about health care policies or politics.” Not that the latter isn’t important. It’s just that health care is as personal as it is complicated.

The fact that health insurance can be complex is not new information, especially for politicians and the public at large. Before the Affordable Care Act (ACA) was passed, the Senate health committee spent 13 days marking up the bill. The Senate finance committee worked on the legislation for eight days, its longest markup in two decades, according to the New York Times. And the full Senate debated the bill for 25 straight days before passing it in December 2009.

Even with the relative transparency of the ACA process, health care confusion was still inevitable. This became evident in 2010 when people, many of whom had never had insurance before, enrolled in the marketplace set up under the Affordable Care Act. People were expected to grasp basic insurance terms, but the Kaiser Family Foundation soon noted what it called a “perilous gap in health insurance literacy.”

As recent as February 2017, the New York Times reported that one-third of Americans still don’t understand that Obamacare and the Affordable Care Act is the same thing. There is still public confusion over both the contents of current law and the bill that could repeal it. But the president and Republicans in Congress in charge of health care reform this time are around aren’t looking to dispel the misinformation. In some cases, they’re deliberately adding to it.