Whatever happened to that health care bill?

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.

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.

No, better to keep you distracted by Shakespeare, Russia, Twitter misspellings, and now, apparently, Cuba.

  • This is government in the dark, stealthy and sneaky; covered in the stink of illegitimacy conferred by gerrymandering, fake news, Russian interference, and big money.

    • Rob

      Gods bless our Kronyist Kleptocratic Kakistocracy.

    • JamieHX

      It’s not GOVERNMENT “in the dark, stealthy and sneaky…” It’s the Republican Party operating in its usual diabolical manner.

  • jon

    “we aren’t stupid,”

    Eh… they might be stupid.

    Both Pew and gallup reported the majority of americans support the ACA as of earlier this year.
    And the GOP wants to take that away…

    Seems like pissing off a majority of the country in 2017, before the 2018 mid terms, which will put the representatives in office that control the 2020 redistricting is pretty stupid.

    • Mike

      Your comment makes a lot of sense, except for the fact that the Democratic Party is expert at snatching defeat from the jaws of victory. They are their own worst enemy, and I try never to underestimate their ability to underwhelm.

      • jon

        When you look at your opponent and see that they are terrible, and you look at the scoreboard and see that you tie about half the time… maybe it’s time to consider being less terrible instead of going out of your way to be more terrible.

  • wjc

    I know they promised to repeal Obamacare, but why would the GOP want to replace it with something that seems to be wildly unpopular with the public? Something about cutting off your nose…

    • RBHolb

      Because the promise was to repeal “Obamacare.” The whole point is to undo any and every part of President Obama’s legacy.

  • AL287

    The American public expects smoke and mirrors from the House but not from the U.S. Senate.

    That being said, far too many Americans have the attitude “I’ve got mine. I could care less about you.” This is how we got into this whole sorry mess to start with.

    It seems the French, who have an historical reputation for rolling over when the going gets tough (Insert WW II) have surprised everyone by rejecting the growing wave of self-absorption and have come to the middle instead of going to the extremes.

    Of course the Republicans want to keep their constituents in the dark, mainly to prevent the damage that will be inevitable at the voting booth in the midterm elections if they don’t start moving some sort of legislation regarding healthcare, tax reform and infrastructure funding.

    The only thing their idiot-in-chief knows how to negotiate is a better deal for himself.

    Party before country will be the United States undoing and the American electorate have only themselves to blame. They wanted a savior and they got a demagogue instead.

    The British are self destructing.

    We’re next.

    • Ickster

      (Slight derail – can we abandon the canard about the French giving up all the time?)

      • AL287

        if the shoe fits…

    • Jack

      I thought we were first.

  • Al

    Thanks for reminding us that Medicaid covers so much of long-term care, nursing homes, end-of-life costs. Millennials can’t afford to care for aging parents in their homes like some might have pre-Medicaid. Something’s gotta give.

    • AL287

      Anytime budget cuts loom on the horizon, the elderly, the very young, the mentally ill and the medically fragile/disabled get hit—really hard.

      You are absolutely right that the Millennials can’t afford to care for their aging Baby Boomer parents.

      As a Boomer and a registered nurse, I’ve worked in the LTC industry for most of the last 25 years. We don’t value age and wisdom in the United States. We’re obsessed with youth and beauty and staying that way for as long as possible.

      The real truth of the matter is that death comes to all of us and our bodies wear out and for some of us those changes include devastating changes to the brain and cognition.

      Before the advent of modern medical technology and life-prolonging medication, most people didn’t live long enough to suffer the slings and arrows of dementia and Alzheimer’s. We were so focused on extending the lifespan we never saw the tidal wave coming.

      • I have no intention of bankrupting my children. Perhaps we should be talking end-of-life methods in conjunction with the health are debate.

        • Kassie

          Are you suggesting Death Panels?

          • No, I’m suggesting people have the right to end their life when they see fit. That’s different from other people telling you. Which, under present law, actually, is the system we have now.

          • 212944

            Unfortunately, such talk does not help next quarters profit numbers.

            As long as there are assets available for care costs, there will be for-profit care facilities whose backers keep a keen eye on such talk.

            Follow the money. Always.

        • jon

          Right to die legislation should definitely be part of the discussion…
          But it won’t be. Because the GOP opposes it in their platform (which I suppose means about as much as their support for PR statehood in their platform).

        • Rob

          Yes. Please do some more posts on the topic. If we’re truly the consumer society we claim to be, having choices as to how and when to end your own life only makes sense. And I say that in all seriousness.

        • AL287

          I agree with you 100% but unfortunately, the majority of the American public has issues with euthanasia, equating it with suicide and you well know the discussions we have had on that issue on this blog.

          I’ve already filed my advance directive and had the discussion with my son and his wife. He knows exactly what I want at the end of my life.

          My best friend of 55 years is my deputy and I have had the discussion with her as well.

          My Catholic family down South know nothing about it. I only wish my mother would have had one. She would not have suffered the way she did at the end of her life if she had.

          We don’t need a federal law. Some of the 50 states have already legalized it and that is where it should be decided.

          The SCOTUS will never allow a federal law allowing euthanasia to pass. It’s not happening. You can count on that. We’ll be lucky if Roe v. Wade isn’t overturned.

          No one should pass judgment on anyone who decides to opt for euthanasia. It’s no one’s business but their own.

        • asiljoy

          The problem I have with that discussion in this political climate (war on those who are different from rich white dudes) is that it becomes a pretty short slippery slope for the masters of twisting facts for the question to change from ‘ who has the right to die?’ to ‘who deserves to live?’.

  • Kassie

    If Medicaid is cut drastically, I have a couple co-workers who will likely end up in nursing homes. They use the program Minnesota has called Medical Assistance for Employed People with Disabilities. They are only able to continue to work and live in their own homes because they receive nursing care through the program that isn’t covered by normal employer sponsored insurance. These are people who are software developers, policy makers and attorneys contributing to society, owning homes, and having families. Cutting Medicaid could take all of that away from them and away from all of us. It is shameful to even consider.

  • Chris

    After all of the republican bleating about Obama ramming the ACA down our throats, the republicans will pass a bill created in back room deals with no hearings and ram it down our throats. Difference is the ACA tried to get more people covered. The Trump/republican bill will take away coverage. They have no shame in doing what it takes to pay for tax cuts for the rich.

    • jon

      They must have some shame…
      If they had none they wouldn’t be doing it in back rooms…

      Unless of course that is just to avoid the backlash that hit the representatives when they went home to hold town halls…

      • Chris

        So now the GOP senate is banning on camera interviews in the senate hallways. No shame. Gotta keep the secret bill secret until they have the votes. Wouldn’t want the public to know what’s in it and give senators a chance to hear the the public strongly opposes cutting health care for millions while funding a tax cut for the rich.

  • kevins

    Mr. McConnell is clever, but has no moral center, and has in the past been willing to be as unpatriotic as any other self-serving party first pol. Although I should not be, I am continually surprised by voters that vote against their own interests and to their detriment.

  • lindblomeagles

    Are we REALLY surprised by Republican secrecy? Be honest with yourselves. When was the last time Trump, the Republican Senate, or the Republican House TOLD YOU the truth this year?

    • lindblomeagles

      1) Ban constitutional. LIE
      2) Obama Care bad. LIE.
      3) Ryan Care Good. LIE.
      4) Trump will change. LIE.
      Seriously. When has anybody from the GOP in Washington D.C. told us, the public, the truth this year?