When House Republicans pulled a vote on an early version of the American Health Care Act in March, they faced and accepted criticism related to the bill’s policy and its process. As they work to craft their own healthcare legislation, Senate Republicans don’t appear to have learned from their House colleagues’ mistakes.
Reports indicate Senate Majority Leader Mitch McConnell, R-Ky., on Tuesday presented members with a plan for the bill that would allow states to waive essential health benefits, but not “community rating,” which requires that customers be charged the same prices regardless of health risk. A similar approach in the House bill that never made it to the floor for a vote contributed heavily to its unpopularity, turning off conservatives who did not believe it would adequately lower costs.
The Washington Examiner reported on Wednesday:
Further rankling conservatives was that the presentation outlined areas of consensus between conservatives and centrists, but, according to one conservative aide familiar with the meeting, several items that were presented as “consensus” items were ones that conservatives only agreed to on a conditional basis. For instance, conservatives would be okay with more gradually phasing out Obamacare’s Medicaid expansion, but only if the long-term growth of the program is set to a slower rate of inflation. Yet it was presented as if everybody agreed to slow walking the rollback of the Medicaid expansion, even without a concession to conservatives on the long-term growth rate. Furthermore, though it is not resolved, all indications are that the tax credits in the Senate bill are going to become more like Obamacare. Rather than being mostly age-based, they are likely to be more income based and adjusted for region.
Process-wise, Senate leadership is crafting the legislation largely behind closed doors, keeping the public in the dark on specifics until the opportunity for substantive debate elapses. The closed-door approach is one that conservatives criticized House Republicans for in the spring, including Sen. Rand Paul, R-Ky., who orchestrated a “National Treasure”-esque stunt to track down the bill’s whereabouts.
At the time, Paul accused GOP leaders of attempting to put members in a “take it or leave it” scenario when the vote came up. As the Examiner wrote of Tuesday’s meeting, “Senators were told that if they did not act, they’d have to explain to constituents why they aren’t addressing the problems in the individual market, as insurers hike premiums and exit markets.”
How is that any different?
Moving the bill further Left and doing so behind closed doors is not a recipe for Republican success. Senate leadership should know that.
To be fair, Senate Republicans are faced with an even more challenging task than their House colleagues in that they need to write a bill that does not lose the support of more than two members of the majority. That means bringing together members as conservative as Paul and as centrist as Sen. Susan Collins, R-Maine. But taking the same approach that failed to build consensus in the House is not the way to smooth over divisions in the Senate.
Fortunately for Senate leadership, their colleagues in the House left them with a roadmap to failure. To avoid reaching that destination, they should at least know which paths to avoid.
Emily Jashinsky is a commentary writer for the Washington Examiner.
