While attention shifts to James Comey’s much anticipated testimony today, Senate Republicans are still working to deprive 23 million people of health care coverage.
Senate Speaker Mitch McConnell (R-KY) said he is striving to get a vote on the Republican health care bill by July 4, before Congress leaves for August recess. As ludicrous as this deadline seems, the Senate could pull it off — but it will be done without much public scrutiny.
Sen. McConnell implemented Senate “Rule 14” Wednesday to fast-track the GOP House health bill. This rule allows the Senate to skip the committee process (goodbye full senate committee debate) and instead “fast-tracks” the bill by moving it on the senate calendar so it can be brought to a vote.
Republicans need to pass a health care bill immediately. And they need to pass a bill that reconciles the needs of both the House and Senate, by September 30th in order to use reconciliation. Reconciliation is a 1974 act that expedites the senate’s consideration of bills that pertain to the budget. While Washington watches James Comey testify before the Senate Intelligence Committee, Senate Republicans leaders and the health care working group will still be meeting for a working luncheon to continue negotiations.
The Senate’s job is harder because unlike the House, the Senate cannot vote on a bill until the Congressional Budget Office scores it. CBO needs to score the bill to see if it meets budgetary standards of reconciliation. The Senate health bill needs to save $2 billion, which the House bill successfully did. But the Senate bill is also bound by the Byrd Rule, which has its own host of additional surgical rules, like that the bill cannot change Social Security spending or dedicated revenue. The CBO will need time to score the bill, so fast-tracking this Senate health bill makes the most sense for Senate Republicans.
During a Senate Finance Committee hearing on the Health and Human Services 2018 budget request on Thursday, Sen. Claire McCaskill (D-MO) vocalized her frustration with the senate leader invoking rule 14. She asked the chairman, Sen. Orrin Hatch (R-UT), if there is going to be a public hearing on the Senate’s secret health bill. A befuddled Hatch said he did not know. “But we have no idea what’s being proposed,” McCaskill exclaimed.
McCaskill makes a valid point. Georgetown University congressional expert Josh Huder says what’s truly remarkable is the Senate will replicate what the House did: push this bill forward with little transparency.
It’s not transparent, but it’s a good way to get health care legislation passed. The Senate is using reconciliation to get this done, which prevents a Democrat filibuster. “This bill will not get 60 votes anywhere. If you want to the bill to pass, this is the only way to do it,” said Huder.
The Senate GOP have been sorting out major qualms they have with the House GOP health bill like how Medicaid should be structured and funded, should states be able to avoid Obamacare regulations, and how to craft tax credits to replace existing insurance subsidies.
Axios health reporter Caitlin Davis says Senate Republicans have agreed on some points, like that the Medicaid expansion phase out process should be slower and that some Obamacare protections should be kept.
The House bill almost immediately reduces enhanced federal spending for Medicaid expansion in 2020. According to Davis, the Senate is looking for a “a three-year glidepath beginning in 2020,” which will give states more time to adjust to the reduced funding.
Your periodic reminder that a slower Medicaid expansion phaseout wouldn't matter in states that have automatic triggers if fed $ declines.
— Rachana D. Pradhan (@rachanadixit) June 7, 2017
The House bill would also allow states to opt out of some Obamacare regulations by requesting waivers. However, the Senate is looking to preserve one Obamacare protection that prevents insurers from denying care to people with pre-existing conditions. Even so, Senate Republicans are allowing states to opt out of providing essential health benefits to individuals and small group markets. Meaning even though insurers may not be able to deny people with pre-existing conditions, insurance plans may not cover care this community needs.