Healthcare groups are decrying Republican senators for closing their doors to the public, e.g. refusing to hold public hearings or committee markups, as they write legislation repealing and replacing Obamacare, affecting millions of Americans and one-sixth of the American economy.
Compare that with the Senate process in 2009, which the New York Times’s Robert Pear recently documented:
“In June and July 2009, with Democrats in charge, the Senate health committee spent nearly 60 hours over 13 days marking up the bill that became the Affordable Care Act. That September and October, the Senate Finance Committee worked on the legislation for eight days — its longest markup in two decades. It considered more than 130 amendments and held 79 roll-call votes.
The full Senate debated the health care bill for 25 straight days before passing it on Dec. 24, 2009.”
In 2009, the Senate spent 25 days debating the ACA before passing the bill on Christmas Eve, the longest markup in the Senate Finance Committee’s entire history. Senate Republicans haven’t even drafted their bill, and Majority Leader Mitch McConnell has already proposed a timeline where the body votes before their Fourth of July recess — exactly 18 days from now.
Healthcare groups fear the final draft will be released just a couple of days before the vote, a major departure from the traditional lawmaking process, and therefore minimizing the amount of time for feedback or for opposition to build.
“There are lots of discussions happening behind closed doors, but it seems to be fairly well confined to the Senate itself,” said Dick Woodruff, vice president of federal relations for the American Cancer Society Cancer Action Network.
Aides say Senate Majority Leader Mitch McConnell (R-Ky.) is expected to send a draft bill to the Congressional Budget Office early this week, but he is not expected to publicly release the measure.
“There’s nothing but closed-door meetings,” said Steven Michaud, president of the Maine Hospital Association, which opposes the hundreds of billions of dollars in Medicaid cuts that are on track to be in the legislation.
“It’s a disaster for us,” Michaud said, adding that he has been “making it clear to our congressional delegation that Maine would be hammered by those kinds of cuts.”
Groups are worried they will not have enough time to respond to the bill before a vote, which Republicans hope to hold before the July Fourth recess.
“I am writing to express our great concern about reports that legislation to repeal and replace the Affordable Care Act (ACA) and radically change how Medicaid is financed is being hastily drafted and rushed forward outside of regular order for a vote on the floor of the U.S. Senate, potentially before the July 4th recess,” Dr. Jack Ende, president of the American College of Physicians, wrote to Senate leaders last week.
GOP leadership staff say senators will be able to offer an unlimited number of amendments on the floor and that there are regular meetings on the legislation.
“The entire Senate Republican conference continues to work on legislation to rescue the millions of Americans trapped by ObamaCare,” Antonia Ferrier, a spokeswoman for McConnell, said in a statement responding to questions about the Senate process.
“The reality is doing nothing is not an option, and that’s why Republicans have been holding meetings at least three times a week in an effort to provide relief for the American people,” she wrote.
Many healthcare groups have serious substantive concerns about the emerging bill. The House’s measure was opposed by a broad cross-section of healthcare groups, including the American Medical Association and the American Hospital Association.
The roughly $800 billion in Medicaid cuts are of particular concern to them, as is the possibility that millions could lose health insurance coverage.
“We’ve been trying to make sure our senators understand how devastating that would be if the Medicaid cuts went through,” said Greg Vigdor, president of the Arizona Hospital Association.
He said his group has set up at least four meetings between Arizona hospitals and the staffs of Arizona Sens. Jeff Flake (R) and John McCain (R) about the repeal bill.
He argued that Obamacare’s exchanges, and not Medicaid, should be the focus of reforms in the replacement bill, known as the American Health Care Act.
“There’s a real problem with how the exchanges work,” he said.
In contrast, “Medicaid in our state works pretty well.”
Sen. Rob Portman (R-Ohio) and other centrist Republicans have proposed a longer, seven-year phaseout of funds for ObamaCare’s expansion of Medicaid.
One piece of formal outreach that some groups pointed to is a letter from Senate Finance Committee Chairman Orrin Hatch (R-Utah) asking for input from healthcare groups.
Finance Committee spokeswoman Julia Lawless said more than 20,000 comments were submitted and that the panel is “carefully studying and reviewing the recommendations.”
Hatch’s call for input was a “good gesture,” said Woodruff, of the American Cancer Society, adding that groups did respond.
He added: “There hasn’t been any follow-up or anything like that.”