After months of Congressional health-care hesitation, events this week switched into overdrive. If things go Senate Majority Leader Mitch McConnell’s way, a bill McConnell says will repeal and replace Obamacare will land on President Donald’s Trump’s desk for signing before you enjoy next Monday morning’s coffee.
Or, maybe it’ll stall again.
If that’s the case, America will be doomed watch Washington spend the month of July, fussing and fighting.
Who really knows with this thing?
While Washington leaked like a broken faucet over the last several months about almost every other issue of national significance, McConnell managed to keep the Senate health care bill as secret as Trump’s income taxes.
The plan: pass the bill — entitled the "Better Care Reconciliation Act" — on a narrow party-line vote in the hopes that the House will eagerly rubber stamp it.
The goal: celebrate the largest transfer of wealth from the poor and working class to the super rich in American History on July 4th, the nation’s birthday.
The value added: elected officials could return home to either celebrate or mourn.
A proverbial fly, however, has landed in the ointment.
As many as 10 Republican Senators appear reluctant to vote for McConnell Care in its current form. If any more than two actually do vote 'No', McConnell’s effort is doomed.
Half of Washington seems convinced that McConnell has this all under control, with plans to tweak the bill to provide just enough political cover for those dissenters to cast their faithful ‘Yeas’.
The other half thinks McConnell will need to delay the vote for a couple of weeks — and that it will then be very difficult to herd all the GOP cats around any final version.
Whatever happens in D.C., headaches are guaranteed throughout New England:
From the moment McConnell released the new bill, nobody has received more national attention than Maine’s Republican Senator Susan Collins. That makes sense; Collins holds the most moderate voting record among Senate Republicans.
Few of those national reports, however, mention that Collins is seriously considering running for Governor in 2018 — a consideration that makes her health care vote even more complicated.
Voting in favor of McConnell’s bill — certain to be dubbed TrumpCare if it passes — would imperil Collins’s efforts to win that general election. But, if she does run, Collins first must contend with a Republican primary. Earlier this month, the state’s former Health and Human Services Commissioner Mary Mayhew announced her candidacy, seemingly with the support of current Republican Governor Paul LePage. (The excitable LePage takes a dim view of Collins.)
Collins has voiced reservations about the McConnell bill’s cuts to Medicaid, effect on premiums, and defunding of Planned Parenthood. But she has stopped short of declaring that she won’t vote for the bill, saying that she is waiting to see the Congressional Budget Office’s assessment which is expected sometime Monday.
It might just be a coincidence, spurred by the demands of the state fiscal year budget process but it certainly was interesting that Gov. Charlie Baker unveiled his health care coverage reforms this past week.
Baker, a popular Republican facing re-election in the heavily blue state next year, is constantly at pains to distance himself from Trump and the national Republican party. That includes denouncing every form of “repeal and replace” that’s come down the pike this year.
Those moot repudiations only go so far for him. But, when combined with his ongoing serious attempts to improve — and fiscally balance — the state’s coverage picture, the former health care executive strikes quite a contrast to the GOP’s national efforts on the topic.
Of course, those other Republicans will, if successful, pull the rug out from under much of what Baker is trying to do — from creating accountable care organizations under Medicaid, to wringing more money from employers who fail to provide insurance.
Another Republican Governor facing re-election in 2018, Chris Sununu, has taken a different approach from Baker. Sununu, a harsh critic of ObamaCare, has been generally supportive of “repeal-and-replace” efforts — though not actually endorsing any specific version of it.
That includes McConnell’s current version.
Late in the week, Sununu sent a letter to McConnell, co-signed with Republican state legislative leaders, encouraging the effort and offering suggestions. He has also suggested that passing no legislation would be unacceptable.
Still, he hasn’t actually given the bill his blessing.
Meanwhile, the state’s two Democratic Senators, Jeanne Shaheen and Maggie Hassan, embarked on a statewide crusade to whip up opposition to the bill. Among other criticisms, they say the bill would cut into opioid treatment — a huge hot-button issue in New Hampshire.
And into this fray dropped the news late last week that Minuteman Health, which ensures some 27,000 New Hampshire residents, mostly through the ObamaCare-created individual exchanges, plans to leave that market next year.
Sununu immediately blamed that on ObamaCare; New Hampshire Democrats blamed it on Sununu and the Republicans mis-managing the exchanges.
When the U.S. Senate’s health care bill became public on Thursday, the political reverberations were minimal — on the surface.
The state’s all-Democratic delegation in Washington, and its Democratic leaders in state government, were not only in full agreement with one another, they seemed to be competing to see who could denounce the bill in the harshest language.
That includes Senator Sheldon Whitehouse, who is up for re-election in 2018. His only declared Republican challenger, state representative Robert Nardolillo, has been silent about McConnell’s bill, and previously opposed the U.S. House version.
Nor has there been a peep out of Cranston Mayor Allan Fung, a Republican who is considered a potential challenger to Democratic Governor Gina Raimondo.
Yet beneath all that agreement there was an unavoidable tension as the state’s Democratic leaders waited impotently for the potentially huge effect the bill could have on the state.
That tension was apparent Thursday, as the state House of Representatives passed a $9.2 billion budget along straight party lines.
That budget includes a phase-out of the car tax, free tuition at The Community College of Rhode Island, and other costly measures. Democrats voted for that budget Thursday knowing full well that the federal health care bill, revealed that same day, would blow a massive hole in that budget — costing the state upwards of $200 million in the next few years from Medicaid cuts.
Vermont’s Republican governor, Phil Scott, expressed “serious concerns” about the Senate bill, and vowed to work with his state’s U.S. Senators to improve it.
But one of those Senators, Bernie Sanders, wasn’t sounding interested in working to improve the bill at all. Rather, he seemed eager to use the bill to pummel Republicans, and reiterate his call for single-payer health care. It almost seemed like a return to his glory days on the Presidential campaign trail.
Sanders spoke at rallies in Pittsburgh, Pennsylvania; Columbus, Ohio; and Charleston, West Virginia — ostensibly to persuade Republican Senators from those states to vote against the bill. The tone seemed more critical than persuasive, however.
In the few days since the bill was unveiled, Sanders has termed it everything from “an unmitigated disaster” to “barbaric.” He has vowed to re-introduce Medicare-for-all legislation soon.
That fiery rhetoric is certainly popular among the Democratic Party base these days. But some political observers think that a calmer tone out of Connecticut might be emerging as the party’s new national voice.
That would be Senator Chris Murphy. An increasingly prominent national figure, Murphy has quickly emerged in the health care debate — and as a potential Presidential or Vice Presidential candidate.
Not that Murphy pulls any punches about McConnell’s bill. “I’ve never seen a more intellectually, morally bankrupt health care proposal than this one,” he said at a press conference, adding that there is something “truly evil” about it.
But, as Murphy has shown when speaking about gun violence — invoking the Sandy Hook tragedy in his own state — he can use highly charged language while still coming across as reasonable and capable of compromise.
Murphy also paid a personal visit to the Congressional Budget Office, which he persuaded to include some effects of the Republican’s bill beyond the 10-year window that the CBO usually limits its analysis to.
Someone in Washington is thinking long term.