By Lise Millay Stevens
The GOP has released yet another health care bill, and it hasn’t stoked the enthusiasm of two tough Republicans holdouts in the Senate any likelier to cast a ‘yes’ vote. Senators Rand Paul (R-Ky.) and Susan Collins (R-Maine) have swiftly come out against the bill and will oppose moving it to a vote next week.
With Democrats in unilateral opposition to any GOP health bill, there no room for any other defectors; Senate Majority Leader Mitch McConnell cannot lose more than two votes if the bill is to pass. Other senators critical of the previous version of the Better Care Reconciliation Act have not commented to date, but chances are that many of them won’t be voting for this version either.
The latest bill contains the controversial Cruz-Lee Amendment, an addition that is widely touted as a disaster for the sickest, most vulnerable Americans. The amendment allows insurance companies to sell cheaper plans that do not cover the 10 essential services mandated by the Obama administration’s Affordable Care Act, which has provided millions of Americans with health coverage. The amendment authored by Senators Ted Cruz (R-Texas) and Mike Lee (R-Utah) allows insurance companies to offer cheaper plans that do not cover the ACA’s 10 essential benefits, as long as the companies sell other plans that do cover those benefits.
According to a report from the Kaiser Family Foundation released on Tuesday, the Cruz-Lee Amendment would cause premiums to skyrocket for approximately 1.5 million Americans who have pre-existing conditions. In addition, according to the report, it would render many of the sickest Americans ineligible for the subsidies they receive under President Obama’s Affordable Care Act. In other word, the same populations would be targeted as were in previous versions of the BCRA—older, sicker and poorer Americans.
The Congressional Budget Office has not yet scored the just-released legislation, but the
changes are not likely to improve CBO’s scathing assessment of the BCRA; in May, a CBO report stated, “The Senate bill would increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law, slightly fewer than the increase in the
number of uninsured estimated for the House-passed legislation.” The report added, “By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.”
The new bill does not roll back the huge tax cuts to the wealthiest Americans, or the deep cuts to Medicaid that are needed to provide shift money in lower taxes for the rich. The bill does provide $45 billion to combat the country’s opioid epidemic, but in states at the apex of the drug scourge such as Ohio and West Virginia, the additional funding is not apt to quell fears of residents of those states losing their Medicaid coverage—which provides funding for 60 percent of the people in this country who receive mental health and substance use treatment. Cutting that coverage will guarantee that the opioid epidemic will continue to rage out of control.
Despite the anxious and angry constituents, a deeply divided GOP and negative feedback from leading health care organizations, Mitch McConnell has insisted that the Better Care Reconciliation Act, the “repeal and replace Obamacare debacle,” can be passed before the Senate’s summer recess in August. And he is doing everything possible to guarantee it; like a stern school master, McConnell has threatened to delay summer vacation for his party’s unruly and recalcitrant senators until a bill is passed.
But that may not be enough. What Senator wants to go home on vacation to angry voters, critical local media outlets and, one would hope, a conscience shattered with guilt? There is no other possible outcome given the cynical and cruel legislation that is being pushed closer to a vote next week. The 2018 election looms large for those who would vote in favor.