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A Bipartisan Healthcare Bill Needs to be Fully Vetted in Public

July 25, 2017: Senate Republican Majority Leader Mitch McConnell has announced that the Senate will hold a procedural vote as early as this afternoon (called a “Motion to Proceed”) to force the Senate to start debating a healthcare bill. Yet there is actually no bill that has been shared with the Senate, forcing Members to agree to move forward on something they haven’t even seen. Lacking the 50 votes needed to proceed, there was breaking news overnight that Senator McCain, having just had brain surgery, would travel back to DC today for this vote. The presence of Senator McCain in the Chamber, presuming that he is voting “yes” on the Motion, will be used as a tactic to sway all Senate Republicans to vote “yes” as well.

ACTION

Call your Senators today (202) 224-3121 and tell them to vote “no” on a Motion to Proceed unless there is a bipartisan bill that has been fully vetted in public, that does not take significant cuts to Medicaid and focuses on fixing the existing healthcare system in a thoughtful way. Simply rushing to “get something done” without a plan and without thought to the real implications for Americans is not the right thing to do.

BACKGROUND

The Motion to Proceed requires a simple majority of the Chamber or 50 votes to succeed. As of yesterday evening, it did not appear that the Republicans had the votes needed with Senator McCain (R-AZ) recovering from emergency surgery and with Senator Susan Collins (R-ME) already indicating that she would not vote for a Motion to Proceed. There was breaking news overnight that Senator McCain, having just had brain surgery, would travel back to DC today for this vote.

The Congressional Budget Office (CBO) issued a new report on July 19, 2017, stated that repealing ACA provisions would leave 27 million people uninsured by 2020, climbing to 32 million by 2026, and raise premiums in the individual market by about 25 percent. A separate CBO report on July 20, 2017, indicated that the updated GOP plan replacing the ACA would result in 22 million fewer insured Americans over a decade and cut the deficit by $420 billion.

OPTIONS BEING CONSIDERED

The President has called for action, no matter what it may be: repeal only or repeal and replace. A few options are on the table:

  • Repeal only bill: The Republican Majority lacks the 50 votes for a repeal only measure, with all Senate Democrats and three Republican Senators Shelley Moore Capito (R-WV) Susan Collins (R-ME) and Lisa Murkowski (R-AK) indicating they would not support a repeal only bill. Senate Minority Leader Chuck Schumer (D-NY) warned that passing a repeal-only bill would be a "disaster," and invited his Republican colleagues to work with Democrats on healthcare.
  • ACA “repeal and replace” bill: The Senate could move to take up the House passed bill in May (H.R. 1628, the American Health Care Act) and immediately replace it with a different underlying bill. It is unclear what would replace it, what amendments would be allowed, voted on and in what order.
  • Modified version of previous Senate bill: The Senate could take up a modified version of the Better Care Reconciliation Act) that phases out the Medicaid expansion, provides various risk pool and transition funding, and replaces the ACA tax credits with a new system of tax credits. Complicating possible consideration was a determination by the Senate Parliamentarian that ten provisions of this legislative draft violate the budget rules and could be struck from the bill. This includes a provision cutting off funding to Planned Parenthood for one year and a provision imposing a six month waiting period to buy insurance if continuous coverage is not maintained. However, Senator Rand Paul has indicated he will not support this legislation. Opposition to the Medicaid changes are growing exponentially and some of the recent discussions around the draft bill involved adding an additional $200 billion in Medicaid funds and perhaps an insurance de-regulatory provision in hopes of gaining additional support.

Debate over repeal and replace will continue, however it is important to note that the approach to block-granting Medicaid is not currently part of “Obamacare” that needs to be “fixed.” It is instead an idea supported by some in the Republican Majority that Senate Republican leadership decided to include in the Senate bill. President Trump is calling on Senate Republicans to move forward, despite the lack of any underlying bill or clarity on strategy. Some are indicating that a vote is needed whether it succeeds or fails simply to get Members on the record.

Again, please call your Senators today (202) 224-3121 and tell them to vote “no” on a Motion to Proceed.

Thank you,

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Mike King
President/CEO