Politics

Republicans Vent About Lack of Health Care Details

Majority leader is driving the process as member frustration mounts

Senate Majority Leader Mitch McConnell, R-Ky., has kept details of the massive rewrite of the health insurance under lock and key. (Tom Williams/CQ Roll Call)

BY JOE WILLIAMS AND NIELS LESNIEWSKI

Senate Majority Leader Mitch McConnell has taken full control of the chamber’s effort to rewrite the U.S. health insurance system, prompting frustrated Republican members to vent their dissatisfaction over the secretive process.

“I have not seen it yet,” said Texas Sen. Ted Cruz, when asked if he would see language of the draft bill before McConnell’s planned public release Thursday. “You tell me.”

“I haven’t seen [the bill] yet either, even though I’ve been a member of this working group among Senate Republicans assigned to help narrow some of the focus,” Utah Sen. Mike Lee said in a video posted to 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 members of the Republican leadership in the Senate.”

Lee is part of a chorus of GOP lawmakers who have bemoaned the secrecy surrounding the bill and chastised the lack of public discourse on the legislation while doing nothing to attempt to change or alter the course leadership is taking.

“We have not yet seen the totality of the language,” Louisiana Sen. Bill Cassidy told reporters. “I’ve always said I would have preferred a more open process.”

Lawmakers in both chambers had high hopes the Senate would provide the policy sounding board that would help the Republicans complete their seven-year effort to undo the 2010 health care law.

But the messy process that haunted the House has swept across the Capitol as senators from both parties clamor for concrete details on what exact provisions will be included in a bill that makes up nearly one-sixth of the U.S. economy.

A trio of Democratic senators even made an unsolicited, impromptu trip Tuesday to the nonpartisan Congressional Budget Office in a last-ditch attempt to find a draft of the legislation, a spectacle not usually witnessed in a chamber commonly referred to as the World’s Greatest Deliberative Body.

Democratic Sens. Brian Schatz of Hawaii, Chris Murphy of Connecticut and Cory Booker of New Jersey take a selfie before a meeting with CBO Director Keith Hall in Ford Building where they asked for a copy of the Republicans' health care bill. (Tom Williams/CQ Roll Call)
Democratic Sens. Brian Schatz of Hawaii, Chris Murphy of Connecticut and Cory Booker of New Jersey take a selfie before a meeting with CBO Director Keith Hall in Ford Building where they asked for a copy of the Republicans' health care bill. (Tom Williams/CQ Roll Call)

Many of the measures in a discussion draft slated for release on Thursday will likely be based on ideas discussed during the regular GOP health care working group meetings. But Republican lawmakers on Tuesday still largely sidestepped commenting on even broad policy questions and said several major decisions were still under debate.

And while GOP aides and lobbyists say McConnell is hoping to hold a vote on the legislation as soon as next Thursday, June 29, the uncertainty over many key provisions is startling for such a massive legislative initiative that would likely have far-reaching effects on America’s health care system.

The areas senators say are still under discussion include: when to begin to unwind the health care law’s Medicaid expansion, what yearly growth rate to put on the entitlement program, how generous to make the tax credits to help individuals afford insurance, whether to include anti-abortion provisions and what to do with the plethora of taxes included in the law.

“We haven’t seen the final decision by leadership,” said Wisconsin Sen. Ron Johnson, a regular attendee of the health care working group meetings, when asked how so many verdicts could remain outstanding.

With such a short period of time between the release of the discussion draft and when McConnell is hoping to hold a vote on the Senate floor, it also remains to be seen exactly what sort of analysis will be available from the CBO.

Senate Republican Conference Chairman John Thune told reporters the office doesn’t have the full Republican health care bill at this time, but does have access to several of its proposed policy changes.

“I don’t think anybody has seen any final text,” the South Dakota Republican said. “In terms of the policy ideas and options, there has been, I think, an exchange back and forth with CBO about some of the various options to try to get feedback to help shape ultimately the way the bill is written.”

Lobbyists say one option under consideration by leadership is using a preliminary report from the CBO to show the legislation complies with the fast-track budget procedure known as reconciliation that Republicans are using to advance it.

Under that process — which permits passage of a bill with only the support of a simple majority of lawmakers — Republicans must prove it adheres with several long-standing Senate rules, as well as the reconciliation blueprint passed earlier this year as part of a bare-bones fiscal year 2017 budget resolution.

And while the initial analysis from the CBO would not include some changes that would be in the final legislation, lobbyists say Republicans would argue the revisions would only strengthen the bill and improve on the preliminary report.

A nearly identical process played out in the House in May when the chamber passed its own repeal legislation.

Meanwhile, President Donald Trump “has been on the phone” with McConnell and “key senators” as they try to hammer out a health care bill, White House Press Secretary Sean Spicer said at Tuesday’s press briefing at the executive mansion. Trump has been giving McConnell and others his feedback and suggestions, Spicer said, but he did not know if the president or senior aides have seen any draft of actual legislation.

Trump wants a measure that “has heart,” Spicer said when asked about reported comments that the president felt the House-passed version was too “mean.” Spicer did not clearly define what kind of measure would meet the “heart” standard.

McConnell can only afford to lose the support of two Republican senators, in which event Vice President Mike Pence could cast a tie-breaking vote. As the majority of the GOP conference has yet to see the final language, aides and lobbyists say it remains unclear whether the legislation can pass the chamber.

And members say there is still a long way to go before consensus is reached.

“We need to see significant improvements in reducing premiums,” Cruz said. “That remains my No. 1 concern, and I think the top priority of the voters who elected us.”

Cruz said he would favor curtailing or cutting recess periods, including the upcoming July Fourth break, because of much of the Republican agenda has thus far failed to advance.

“That makes members sad, but we have important work to do, and I will say quite a few members have expressed that sentiment at each recess we’ve had,” the Texas Republican told reporters on Tuesday. 

John T. Bennett contributed to this report. 

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