Policy

Republican Senators Unaware of Health Care Details

Several have no knowledge of specific policy leadership is considering

Senate Majority Leader Mitch McConnell, R-Ky., has kept details of the health care deliberations close to the vest. (Bill Clark/CQ Roll Call File Photo)

Several Republican senators have no knowledge of the specific policy proposals GOP leadership is weighing for inclusion in the pending legislation to overhaul the U.S. health care system.

The lack of widespread knowledge among members about the exact policy under review calls into question whether Republicans will be able to advance a bill before the Fourth of July recess, the timeline that GOP aides say Senate Majority Leader Mitch McConnell is operating under.

While there have been thrice-weekly meetings on the legislation to repeal and replace the 2010 health care law, those have mostly focused on broad policy. And while complete legislative text has not yet been drafted, leadership has begun initial conversations with the nonpartisan Congressional Budget Office on several proposals.

But GOP senators say they do not know what those are. 

“While I haven’t seen the language, I am hoping that it stays within the confines of what we’ve discussed within the caucus,” Sen. Joni Ernst of Iowa told Roll Call.

That echoes comments from other Republican members, like Sens. Ron Johnson of Wisconsin, Ted Cruz of Texas and Bill Cassidy of Louisiana.

Johnson said he is “curious” what will be in the bill, before telling reporters “it’s not a good process.” Cassidy also said he was “not confident” in the process so far.

“As we go along, we hear more and more details as to what’s being considered and so this week I do expect to hear more details,” he said on Monday.

Cruz said discussions on the legislation remain “a work in progress.”

“The working group has been productive but there’s a great deal of work that remains to be done,” he told Roll Call.

GOP aides say it is atypical that members would be kept in the dark on more in-depth policy details at this stage in the process, but also caution that leadership is aware that once specifics are shared with members they will likely be leaked to the public, something McConnell is keen on avoiding

Republican leadership has also taken ample steps to ensure that individual members are able to share their own ideas and concerns. Sen. Steve Daines of Montana, for example, said his voice is being heard, specifically on proposals impacting rural health care. 

Sen. Roy Blunt of Missouri, vice chairman of the Senate Republican Conference, said if members were paying attention at the weekly meetings on the issue they would have a “pretty solid idea of how it was heading.”

The move to keep specific details under wraps could hinder the GOP’s ambitious timeline. While McConnell is hoping to hold a vote by the end of the month, several aides say that is unlikely given members will need time to review the actual legislative language once it is provided by leadership.

And with the conference still divided on several outstanding policy matters, it remains to be seen how conservative and moderate lawmakers will judge the details of the bill when it is complete. 

Republicans have faced enormous criticism for the route in which the legislation has advanced. In lieu of public hearings, the GOP has opted to negotiate the bill in private at health care working group meetings and Senate policy lunches.

The secrecy surrounding the current process has fired up Democrats, who for seven years faced criticism from Republicans for the way in which they crafted the initial health care overhaul legislation in 2009 -- even though Democrats conducted scores of public hearings and markups of their legislation.

“What Senate Republicans are doing on health care is one of the most outrageous examples of legislative malpractice in decades,” Senate Minority Leader Charles E. Schumer of New York said during remarks on the floor on Monday. “It will backfire. It will do potentially irrevocable damage to their party [and] more importantly to our country. Republicans ought to turn back before it’s too late. They will rue the day they rushed this bill in the dark of night that does so much damage to the American people.”

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