The GOP’s big health care secret.

What Senate Republicans Learned From the House: Don’t Let Anyone See the AHCA

What Senate Republicans Learned From the House: Don’t Let Anyone See the AHCA

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June 12 2017 4:44 PM

The Senate’s Big Secret

Why Mitch McConnell and his fellow GOP senators don’t want anyone to see their health care bill.

Senate Majority Leader Mitch McConnell
Senate Majority Leader Mitch McConnell speaks to the media after attending the Senate Republican policy luncheon on Tuesday in Washington.

Mark Wilson/Getty Images

At some point this week, the Senate GOP is expected to finish drafting a health care bill. The bill will then be schlepped to the Congressional Budget Office for analysis. Once that analysis is complete, and assuming it comports with Senate reconciliation rules, Senate Majority Leader Mitch McConnell will bring the bill to the floor for debate, bypassing the committee process. Republicans hope to pass their health care bill by the Fourth of July recess to clear the way for the rest of their busy agenda. Their last scheduled day before that recess is June 30, 18 calendar days from now.

Jim Newell Jim Newell

Jim Newell is a Slate staff writer.

Yes, the dates are all lined up. The only part of this wildly rushed, secretive process that Senate Republicans don’t have penciled in on the calendar is when the bill will be shown to the public.

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It’s hard to believe that any process could be more closed-off than the House’s path to passing the American Health Care Act. The Senate process, though, has made the drafting of the House bill look like that of a publicly edited wiki. The original version of the House bill was also written privately between leaders and key figures on the relevant committees. But once it was released, it was released. Energy and Commerce Committee Chairman Greg Walden and Ways and Means Committee Chairman Kevin Brady revealed their portions of the bill on the night of Monday, March 6, and Speaker Paul Ryan immediately began a media tour touting the bill’s perceived virtues. The two committees marked up and passed their respective texts later that week.

It was only after the bill was released to the public that the real debate began. The conservative Freedom Caucus made it known early on that it could not support the bill. It met several times a week, and after each meeting, Chairman Mark Meadows briefed reporters on where they stood, and what they wanted. The Tuesday Group moderates were less organized, but it was not difficult to get, say, co-chairman Rep. Charlie Dent to explain his position on any given day.

The first House effort to pass the bill was withdrawn on March 24, 18 days after the first draft was made public. The effort was revived shortly thereafter, several amendments were accepted to bring moderate and conservative factions on board. The bill passed on May 4, 59 days after the first draft was released for all to see.

I do not mean to make it sound like the House process was conducted with the full public consideration and input that the product merited. The final version was passed before the CBO could take into account important last-minute amendments, most notably the MacArthur amendment, which gave states the option of waiving out of certain protections for people with pre-existing conditions. (Once the CBO score did come out, several weeks after the bill passed, it proved that the MacArthur amendment would have profoundly negative consequences for those with pre-existing conditions.) The bill was debated for just a few hours before the vote. Though the legislation went through committees, those committees held no meaningful hearings to collect public input before the bill was written.

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The House bill took several months to complete, from drafting to passage, and even that was a rush job. Among those blasting the House process was the Republican senior senator from South Carolina, Lindsey Graham.

The lesson that McConnell and other Senate GOP leaders took from the House process, though, was not that Ryan rushed the bill without any effort to obtain public buy-in. It was, apparently, that by making the bill public so “early” in the process, they exposed themselves, giving opponents—either activists or industry groups—time to mobilize. The problem with the House bill, if we’re judging by the way the Senate has conducted its process, was that the public got to see it at all.

Let me tell you what it is like trying to report on the progress of the Senate effort to reform one-sixth of the American economy. The Senate working group meets for lunch several times a week when in session. Each time, reporters stake out the location of the lunch. Eventually Sen. Ted Cruz, who first convened the working group, comes out and tells reporters, “We continue to have productive discussions, our goal is to lower premiums,” in response to 80 or 90 different questions. Senate Majority Whip John Cornyn offers optimism devoid of content.

Wyoming Sen. John Barrasso walks extremely fast and, if he has nowhere to move, will tell reporters that Obamacare is a failed law and they need to fix it. West Virginia Sen. Shelley Moore Capito, if she’s attending the meeting, will come out looking sad because she knows that she ultimately will have to vote to end to the Medicaid expansion. Same with Ohio Sen. Rob Portman and Nevada Sen. Dean Heller. As far as I can tell, the only way to get Utah Sen. Mike Lee—a critical conservative vote—to answer any spontaneous question about anything is to corner him on the floor of the Republican National Convention, and those opportunities come but once every four years. Sen. Susan Collins tells reporters that she can’t talk because she has a Senate Intelligence Committee meeting. I asked Graham’s office how he felt about the Senate process on Monday afternoon and am still awaiting a response.

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Obviously, there haven’t been any hearings, and there won’t be.

It’s not just that Republicans don’t want to litigate the bill through the press. They’re also not planning to allow for a lengthy public comment period once they’ve completed the draft.

Axios reported Monday that Senate Republicans, even as they expect to finish drafting the bill soon, “have no plans to publicly release the bill, according to two senior Senate GOP aides.”

“We aren’t stupid,” one of the aides told Axios.

Indeed, Mitch McConnell is not stupid enough to show the public what sort of health insurance system the Senate Republican caucus has planned for them or to let this hang in the wind. The public doesn’t even know how close the Senate is to completing this, and releasing a bill might complicate that. If they were so stupid as to let the public in on their progress, people might begin to jam Senate switchboards, just like they did with the House. There might be protests, or condemnatory letters from the American Medical Association or the American Hospital Association. The bill might dominate the news, and there might be a robust debate over it. How stupid would that be?

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