From all indications, you’re not going to have much chance to react to whatever a group of senators is putting together to erase health coverage for many Americans, “replacing” it with something else or nothing at all.
“Senior legislative aides” tell Axios the senators have no plans to release legislative details of their health plan anytime soon because “we aren’t stupid,” according to the news site.
I have covered every major health bill in Congress since 1986. Have NEVER seen anything like this. https://t.co/eWcmIQOsKX
— julie rovner (@jrovner) June 12, 2017
The current plan is to release it to the Congressional Budget Office and then vote on it before the July 4th recess, when you’re probably not going to be paying much attention.
The bill won’t even go through the committee process and get a hearing where people and groups, most of whom are likely to be against it, get a chance to speak publicly before the senators.
Roll Call reports that even some Republican senators don’t know what the Senate leadership is discussing.
If you’ve watched sports stadium debates over the years, you might recognize the technique. Nothing’s ever dead except for people’s interest in opposing it.
In the New York Times today, David Leonhart calls the opposition effort “half hearted,” which seems to be a half-heart more than the process birthing the legislation.
Why haven’t the big lobbying groups done more? I think there are two main answers. First, in past campaigns, groups were largely defending their own financial interests. People fight hard when their own money is at stake. Today’s opposition is at least as much about principle as profit, and lobbying groups haven’t been willing to go all-out for principle.
Second, the groups are wary of attacking the Republican Party, given its current power. “We’re living in a world in which it’s just Republican votes,” one lobbyist told me. Speaking loudly against the bill risks alienating powerful politicians — and risks making the health care groups look partisan.
I get their reluctance. I feel a pang of discomfort every time I describe the radicalism of today’s Republican Party. I also know that the groups are lobbying behind the scenes for changes that would make the bill marginally less bad.
But that’s not nearly enough.
“Even if they did what are they going say?” a Times commenter correctly points out. “The health care bill in the Senate is bad, but we don’t know what’s in it.”
We can guess.
Medicaid cuts. It’s a big part of where the money for tax breaks for wealthier Americans is going to come from.
And it’s something you’re going to need, David Grabowski, the director of health care policy at Harvard Medical School writes in the Times today.
“Medicaid is not ‘somebody else’s’ insurance,” he writes in the op-ed, joined by colleagues at M.I.T. and Brown. “It is insurance for all of our mothers and fathers and, eventually, for ourselves.”
Indeed, Medicaid pays nearly half of nursing home costs for those who need assistance because of medical conditions like Alzheimer’s or stroke. In some states, overall spending on older and disabled adults amounts to as much as three-quarters of Medicaid spending. As a result, there is no way that the program can shrink by 25 percent (as under the A.H.C.A.) or almost 50 percent (as under the Trump budget), without hurting these people.
A large body of research, some of it by us, has shown that cuts to nursing home reimbursement can have devastating effects on vulnerable patients. Many nursing homes would stop admitting Medicaid recipients and those who don’t have enough assets to ensure that they won’t eventually end up on Medicaid. Older and disabled Medicaid beneficiaries can’t pay out of pocket for services and they do not typically have family members able to care for them. The nursing home is a last resort. Where will they go instead?
That’s the sort of question that somebody could ask at a public hearing on Capitol Hill if senators weren’t sure the answer — reality — might interfere with things.