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Senate Healthcare Again: The Good, the Bad, and the Discussion Draft…and Again…

Senate Healthcare Again: The Good, the Bad, and the Discussion Draft…and Again…

The Daily Shot, Ricochet, June 23, 2017

After weeks of negotiations behind closed doors, Mitch McConnell unveiled the Senate’s healthcare reform bill, a 142-page discussion draft for the Better Care Reconciliation Act of 2017. It’s similar in many ways to the House bill … but different.

So what’s in it? Let’s find out. The plan includes:

-An end to the individual and employer mandates.

-A repeal of all of the taxes in ObamaCare with the exception of the Cadillac tax. (So when your pinko friends cry about how this new bill contains a capital gains tax cut, yes, it does. But it’s a rollback of the 3.8 percent tax imposed by the ACA.)

-A phase-out of the Medicaid expansion, but more slowly than the House bill, and with deeper cuts.

-Federal subsidies are tied to income, not age (as the House bill does), but it’s harder to qualify for them.

-$2 billion to address the opioid crisis.

-$50 billion in the next four years to stabilize the ObamaCare exchanges.

-Continued payments for the next two years to health insurance companies for subsidies to offset out-of-pocket costs for low-income people.

-Continued coverage for “children” until age 26.

-An end to Planned Parenthood funding for one year.

So yeah, there’s some good stuff, some bad stuff, and probably a bunch of stuff we’ll learn more about in the coming days. The CBO is working on a score for the bill, which should be out next week. That’s when we’ll learn how many people will lose insurance coverage from this bill, which will probably shape the discussion.

On the plus side, Ricochet’s own Avik Roy took to Twitter yesterday afternoon to say, “Finished reading the Senate HC bill. Put simply: If it passes, it’ll be the greatest policy achievement by a GOP Congress in my lifetime.” (Of course that view is far from universal.) But if you want to hear Roy’s wonky views on this new bill, he’ll be on this week’s Ricochet flagship podcast, due out later today.

 

And Again: Yeah, Okay, But Will It Pass?, The Daily Shot, Ricochet, June 23, 2017

So now that we have the bill, is it going to get through the Senate? The Republicans hold 52 seats, and assuming the Democrats all stick together (a safe bet), just three Republican defections can sink it. What are its chances?

First, it’s good that this new bill has a different name because the House bill, the AHCA, is wildly unpopular. A recent NBC News/Wall Street Journal poll shows just 16 percent support the AHCA, versus 48 percent opposed.

Yesterday afternoon the Washington Post counted nine Republican senators who either oppose the bill, or have concerns about it: Susan Collins, Ted Cruz, Dean Heller, Ron Johnson, Mike Lee, Lisa Murkowski, Rand Paul, and Rob Portman. And four of them, Cruz, Johnson, Lee, and Paul released a joint statement opposing the bill as written.

Mitch McConnell may have made a mistake by negotiating the thing behind closed doors. Aside from the whole lack-of-transparency-is-generally-bad thing, Senators have big egos and don’t like being left out out of the loop. Rand Paul was annoyed enough that he announced yesterday a resolution to change Senate rules to give members one day of reading time for every 20 pages of a bill.

So where does this leave us? It’s hard to say. There are lots of scenarios where the bill could fail, but as with the House bill, enormous pressure will be brought to bear to try to pass it. So it’s not DOA, but it might not be a slam dunk either.