Senate Majority Leader Mitch McConnell has finally pulled back the curtain on his much-awaited and mystery-shrouded plan to repeal and replace much of the Affordable Care Act, and now that people — including some who were supposedly involved in its crafting — are seeing the proposal, the bill is being met with a wide range of reactions and lots of questions about whether the GOP will have the votes to pass it.
Those Opposed
• Democratic Leadership
It’s not surprising that Democratic party leaders quickly came out against the awkwardly titled Better Care Reconciliation Act, as no Democrats (and many Republicans) were involved in the 13-member working group that put together the draft proposal.
Sen. Chuck Schumer of New York said this morning that “This is a bill designed to strip away healthcare benefits from Americans who need it most in order to give a tax breaks to the folks who need it least.”
Schumer criticized the bill, which delays the end of Medicare expansion but would ultimately result in massive cuts to the program’s budget in the long-term.
“Medicaid is not just an insurance program for Americans struggling in poverty,” said the senator. “Medicaid is increasingly a middle-class program. Medicaid is how many Americans are able to access opioid abuse treatment. Medicaid foots the bill for two-thirds of all Americans living in nursing homes, and Medicaid provides the cushion — particularly in rural areas — so hospitals can survive and give top-notch healthcare to all of us.”
House Minority Leader Nancy Pelosi called the draft “just as heartless and cruel” as the version that barely passed through the her chamber earlier this spring.
“The Senate draft proves Trumpcare fundamentally means higher health costs, tens of millions of hard-working Americans losing health coverage, gutting key protections, a crushing age tax, and stealing from Medicare,” says Pelosi. “In fact, Senate Republicans made the devastation to working families and seniors with long-term care needs on Medicaid even more severe – destroying jobs across America.”
• Hardline Conservatives
Even though Sen. Ted Cruz and other hardline conservatives were part of the small closed-door working group, they were not pleased with what McConnell released today.
“It does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs,” said Cruz, along with Senators Rand Paul, Mike Lee, and Ron Johnson, all of whom have said they are currently “not ready” to sign this bill as it doesn’t go far enough in repealing the changes put in place by the Affordable Care Act.
The GOP can only afford to have two members vote against the bill. However, any changes made to the proposal to please this group of four could cause moderate Republicans to go from being on the bubble to voting “no.” (More on them in a minute.)
• Consumer Advocates
Consumer advocacy groups are coming out in opposition to Senate bill, concerned that it will result in millions of additional Americans going without healthcare.
Betsy Imholz, Special Projects Director for our colleagues at Consumers Union, says this latest repeal legislation is “equally misguided and harsh as the House bill.”
“The consequences of the Senate’s legislation are just as dangerous,” explains Imholz, “Millions of Americans could lose coverage, consumers would likely pay more out-of-pocket for care and higher premiums for plans that cover less, and Medicaid would be cut off at the knees.”
McConnell has promised that this bill will prohibit insurers from denying coverage or raising premiums on people with preexisting conditions, but Imholz notes that it gives states the ability to waive Essential Health Benefits requirements, and “could leave all privately insured Americans at the mercy of annual and lifetime caps — putting meaningful coverage out of reach for many Americans, especially those with chronic and preexisting conditions.”
Non-Committal
•Moderate Republicans
While the group of four hardline conservative senators have effectively said they won’t vote for this bill as it is, a number of more moderate GOP lawmakers are being cautious about what they say right now.
Sen. Lisa Murkowski of Alaska, who has previously taken issues with legislative efforts to defund Planned Parenthood and block subsidies to insurers that cover abortion procedures — and who has been critical of McConnell’s secretive tactics in drafting the proposal — released a statement on Twitter explaining that now that the proposal is finally available to her she will do her “due diligence and thoroughly review it.”
I will be working closely with the state over the next several days to analyze the text and crunch the numbers,” wrote Murkowski without giving any indication of where she’s leaning.
Sen. Susan Collins of Maine has not issued a written statement of her own regarding the proposal but told reporters earlier today that she is “very concerned” about the effect of the proposed cuts to Medicaid and how they would ultimately affect rural Americans. Her office later released a statement on the senator’s behalf, saying that Collins is “particularly interested in examining the forthcoming CBO analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes in the Medicaid program.”
In a statement released this afternoon, Sen. Rob Portman of Ohio said that while there “some promising changes to reduce premiums in the individual insurance market” in the Senate proposal, “I continue to have real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic… If the final legislation is good for Ohio, I will support it. If not, I will oppose it.”
• President Trump
Even though many have dubbed the repeal-and-replace effort “TrumpCare,” the President is not showing the enthusiasm he previously demonstrated for the healthcare reform legislation.
That’s not to say that he’s said anything negative about it, but the message coming from the White House is far from fireworks and champagne.
“The president is pleased to see the process moving forward swiftly in Congress, and he looks forward to seeing a finalized bill on his desk,” said White House spokeswoman Sarah Huckabee Sanders this afternoon. “I don’t think we’re as focused on the timeline as we are on the final product.”
“He wants to bring the stakeholders to the table, have those conversations and we’ll get back to you,” added Sanders.
Speaking for himself later in the day, the President would only that “Obamacare is dead, and we’re putting a plan out today that is going to be negotiated.”
Vice-President Mike Pence was slightly more upbeat about the Senate bill, saying this afternoon that “The President and I are determined before this summer is out to keep our promise to the American people to repeal and replace Obamacare and give the American people the kind of world-class health care that they deserve.”
All In
• HHS Secretary Tom Price
While Price’s boss isn’t yet pulling out the t-shirt cannon to celebrate today’s proposal, Tom Price, Health and Human Services Secretary and the architect of previous efforts to repeal the ACA, was laudatory about the bill.
“The Senate’s proposal is built on patient-centered reforms that put the American people in charge of their healthcare decisions, not government, protecting patients, bringing down the cost of coverage, and expanding choices,” said Price in a statement. “The Trump Administration is committed to the health of all Americans.”
• Sen. Orrin Hatch
The Utah Republican and Chairman of the Senate Finance Committee, who has been lambasted by critics for defending McConnell’s lack of transparency on this bill, appears to be happy with what the working group came up with.
“Today, after years of discussions and hearings, Senate Republicans are putting forth solutions to rescue the American people from this devastating law,” said Hatch in a statement released by the Finance Committee. “The discussion draft released today is an important step in our effort to replace Obamacare with patient-centered reforms that address costs, provide more choices, and ultimately put Americans – not Washington – back in charge of their health care.”
Speaking to reporters earlier in the day, Hatch acknowledged that many of his colleagues had concerns or questions about the bill but chalked most of them up to “misunderstandings.”
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