WASHINGTON — Republican senators are expected to learn the contents of legislation to overhaul health care on Thursday as their party leadership continues to work toward a vote on it before they leave town for the July 4 recess.
Senate Majority Leader Mitch McConnell announced Tuesday that he would release a "discussion draft" of legislation to both his Republican members and the public later this week, and he acknowledged for the first time that a vote would "likely" take place next week.
So far, the public has received little information about the contents of the bill that would revamp nearly 20 percent of the economy and affect millions of Americans except through the few leaks to the press.
Most senators haven't seen the substance of a bill yet either, in large part because they still haven't finalized some of the controversial components needed to bridge divides among Republicans as they search for the 50 votes needed to pass it.
With only GOP support expected, leadership can only lose two votes from their own ranks to pass a bill. Rank-and-file Republicans are feeling increasingly frustrated with the process but have yet to say that it will prevent them from potentially voting against it.
Meanwhile, senate Democrats continue to protest a process that has been conducted with little public oversight and with no public debate.
McConnell is eager to move past health care and move on to other priorities, including tax reform and addressing a must-pass increase of the debt ceiling. And a vote before a week-long recess relieves lawmakers from hearing from constituents who could pressure vulnerable and skittish senators from voting against it.
But Tuesday morning, GOP senators didn't have much information.
Sen. Mike Lee, R-Utah, a member of the original 13-member working group on health care, posted his frustration on Facebook.
"It has become increasingly apparent in the last few days that even though we thought we were going to be in charge of writing a bill within this working group, it’s not being written by us. It’s apparently being written by a small handful of staffers for the Republican leadership in the Senate," Lee said. "So, if you’re frustrated by the lack of transparency in this process, I share your frustration. I share it wholeheartedly."
Sen. Bill Cassidy, R-Louisiana, told reporters Tuesday morning that he had heard "from the rumor mill" that legislative text could be released this week.
And when Sen. Susan Collins, R-Maine, was asked if she knew who was doing the work of writing the bill, it wasn't entirely clear.
"I assume Senator McConnell and his staff are with input from his working group, but I really don’t know," Collins said. She was, however, correct.
Collins, a former insurance commissioner in Maine, has had little input about what a replacement to the Affordable Care Act should look like. She said she "appreciated the opportunity" to brief her colleagues about how the risk pool for people with more expensive health care needs said. If they took her advice? "We'll see," she said.
"For the obvious reason, no one has been shared it, we used to complain like hell when the democrats ran the Affordable Care Act, now we're doing the same thing." Sen. John McCain, R-Arizona, told reporters.
Senate Majority Leader Mitch McConnell wants to move past health care and on to other priorities, including tax reform and addressing a must-pass increase of the debt ceiling. And a vote before a week-long recess relieves lawmakers from hearing from constituents who could pressure vulnerable and skittish senators from voting against it.
Democrats conducted a six-hour “talk-a-thon” on the Senate floor Monday night, highlighting the Republicans’ crafting of the bill without public debate, without public hearings, and without any details of what could be in the legislation. They've also vowed to slow Senate business to a crawl, protesting the GOP health care bill. A trio of Democrats went on a quest for the bill, traveling down the street to the Congressional Budget Office where parts of the legislation are being scored for how much it would cost and impact Americans.
While Democrats even some rank-and-file Republican members have complained about the closed process, GOP leaders are defending it.
“As soon as we get to see the final product, we get it scored by the Congressional Budget Office, then we'll have literally a vote-a-rama where there will be an opportunity to debate in a fulsome and comprehensive sort of way an opportunity to offer dozens, if not hundreds, of amendments to the bill. And we'll vote, we'll vote, that's what we do,” said Sen. John Cornyn, R-Texas, the majority whip, on the Senate floor, referring to a process where nearly an unlimited amount of amendments will be voted on. “There’s nothing happening in secret here.”
Democrats conducted a six-hour “talk-a-thon” on the Senate floor Monday night, highlighting the Republicans’ crafting of the bill without public debate, without public hearings, and without any details of what could be in the legislation. They've also vowed to slow Senate business to a crawl, protesting the GOP health care bill. They forced Senate hearings to adjourn after just two hours Tuesday, a tactic they could do every day.
While Democrats even some rank-and-file Republican members have complained about the closed process, GOP leaders are defending it.
"As all of you know, because I've reported it weekly, for weeks now we've been in intense discussions with all Republican senators both in working groups that all members were free to come to if they chose to, and in the larger lunches that we have on Tuesday, Wednesday and Thursday," McConnell told reporters Tuesday.
The bill's authors, which include the offices of Sens. Mike Enzi, head of the Budget Committee, Lamar Alexander, chair of the Health committee, Orrin Hatch, chair of the Finance Committee, and Majority Leader Mitch McConnell, have been sending components of the bill to the Congressional Budget Office to assess its cost and impact.
By sending the bill in parts, senators can assess the cost of individual parts and make changes as necessary. When they complete writing of the text, it would take far less time — only one to two days — to get an assessment instead of ten to 14 days it would take to score an entire piece of unseen legislation.
Republicans sent a series of options regarding the Medicaid to the CBO on Sunday, according to a Republican Senate aide. The CBO's score will likely help to inform the members on which position to accept, even as Republicans are divided on how to deal with the health insurance program for low-income people.
Senators from states that expanded Medicaid or those with large numbers of people on the federal assistance are working to protect the expansion implemented under Obamacare, including Sens. Collins, Dean Heller of Nevada, Rob Portman of Ohio and Shelly Moore Capito of West Virginia. Those from states facing an opioid epidemic are also concerned about a reduction of funding that helps many Medicaid recipients dealing with deadly addiction.
Sens. Rand Paul of Kentucky, Mike Lee of Utah and Ted Cruz of Texas are among the conservatives who could vote against it if the cost is too high and government is too involved.
It was still unclear Tuesday whether President Trump has seen the healthcare bill, with White House Press Secretary Sean Spicer unsure of whether or not the legislation's text had made its way to the White House or the president. Instead, he assured that Trump was giving feedback to Sen. Mitch McConnell and other senators and remained "very excited about where this thing is headed."
But the president's policy desires for the bill are muddled in doublespeak. Trump hosted a Rose Garden celebration when the healthcare bill passed the House in May only to call it "mean" behind closed doors in a meeting with senators.
"The president clearly wants a bill that has heart," Spicer said, stipulating no specifics about what Trump might want in the legislation and declining to get into private discussions.
