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Republicans Are Keeping Their Health Care Bill Secret Because They Can’t Defend It On the Merits

The Senate GOP is relying on the same opaque process they accused Democrats of using to pass Obamacare.

Tom Williams/CQ Roll Call/NewscomTom Williams/CQ Roll Call/NewscomOne measure of the strength of a piece of legislation is how enthusiastic its backers are about defending it at length in public. This may not always account for the full merit of a bill, but at the very least, it provides a sense of whether or not its own supporters believe it is worthwhile, and are willing and able to make the case for its value.

By this metric, the Senate's health care bill is almost entirely indefensible. Although the bill, an update of the American Health Care Act (AHCA) that passed the House in May, is reportedly almost finished, the handful of Senate Republicans charged with drawing up the legislation have declined to share details with the public, and have repeatedly indicated that they have been ordered to keep quiet about the basic framework.

Senate Republicans are so intent on keeping the contents of the bill secret that they have not even revealed specifics to some of their fellow Republican lawmakers. "I want to know exactly what's in the Senate bill. I don't know yet," Sen. Ron Johnson told Bloomberg News.

Nearly everyone, in other words, is being kept in the dark, and although the legislation will eventually have to be made public, the current plan is to vote on it as quickly as possible after the text is revealed—possibly before the July 4 holiday recess.

The reason for this is that Republicans believe that a combination of speed and secrecy is the only way the bill will pass. They have so little confidence in their bill that they don't want anyone to see it.

The first draft may be finished as soon as tomorrow, but Republicans do not plan to make it available for scrutiny even after it is complete. "We aren't stupid," one anonymous Republican aide told Axios. The aide's defense is that the contents of the bill might change even after it is complete, because GOP lawmakers might continue to discuss it amongst themselves. The general public, notably, will not be part of this discussion. It is a defense that merely highlights the GOP's unwillingness to subject their health care ideas to public debate.

In one sense, this is not surprising. The few rumors that have emerged suggest that the Senate bill will look a lot like the House bill, except perhaps a little more expensive. It will, in other words, keep the essential framework of Obamacare—subsidies for individual market insurance, federal regulations for insurers, and a penalty (assessed by insurers rather than the government) for those who go without coverage—while rolling back the current health law's Medicaid expansion over a longer period of time. That plan was supported by less than 20 percent of the public, which is to say that it was even less popular than Obamacare was when it passed.

The AHCA relies on a framework that, regardless of how it is tweaked, is designed to please approximately no one. Critics of Obamacare can argue, correctly, that it keeps Obamacare's core structure in place, rewriting the health care law rather than repealing it. Supporters of the health law can argue, also correctly, that it dramatically reduces the benefits and coverage associated with Obamacare. And health policy experts on all sides of the aisle can argue, again correctly, that it is fundamentally incoherent as health policy, that it would lock the nation into a poorly designed system that serves no substantive ideological or health policy goal. Its chief virtues appear to be that it allows Republicans to claim they repealed Obamacare, and that it paves the way for an overhaul of the tax code that would cut tax rates.

When Republicans do attempt to discuss the AHCA in terms of health policy, they tend to frame it as a response to the failures of Obamacare. It is an argument that, like the bill itself, does not make much sense.

Republicans like to point out that Obamacare's insurance markets are struggling. It is certainly true that the individual insurance markets set up by the health care law are not faring well. Insurers are dropping out, citing massive losses and fundamental structural flaws in the program. Next year, some 45 counties in the nation could have no participating insurer in the exchanges set up under the health law, according to The New York Times. Many states have seen significant rate hikes under the law, and early reports indicate that further hikes are likely this year.

Republicans even have a partial point when they argue that some of this uncertainty is built into the health care law: One of the reasons for the instability in the exchanges is that it is unclear whether the Trump administration will continue to pay subsidies to health insurers. The Obama administration made those payments, but after House Republicans sued, a federal judge ruled that they were illegal.

Republicans sometimes argue that the health coverage offered through the law is not worth much because it is either unavailable or unaffordable.

But "Obamacare isn't working" isn't an argument that the AHCA would. The House version of the AHCA is structured in a way that would create higher premiums and more instability in the individual health insurance market rather than less.

Under the AHCA, premiums would rise faster, on average, through the end of the decade, according to the Congressional Budget Office, and would continue to rise through the next decade, albeit at a slower rate. Meanwhile, the CBO predicts that 14 million fewer people would have coverage next year. The CBO's predictions are unlikely to be precisely accurate, but they are almost certainly directionally correct, so even if the agency's estimates are off by a significant margin, the result would still be premium hikes and coverage disruption for millions. None of the tweaks that the Senate has reportedly discussed would significantly alter those short-term effects.

Republicans, in other words, want to solve the problems of high premiums, market instability, and coverage access with legislation that is likely to make all of those issues much worse. And they want to pass an Obamacare repeal bill that nonetheless leaves its fundamental individual market structure in place, in a vastly degraded form.

It is no wonder, then, that they have chosen to fast track the bill through the legislative process in secret and, quite possibly, without any hearings.

It's a process that Republicans would surely be crying foul about were Democrats attempting anything like it to pass sweeping health care legislation. We can be sure of this because Republicans complained bitterly about the partisanship, speed, and secrecy they said Democrats relied on to pass Obamacare. That was never as true as Republicans made it out to be: As Dylan Scott notes, that law took a year to pass, and during that time Democrats released a discussion draft and went through a Senate markup that considered more than 500 amendments.

If Republicans thought the AHCA could withstand public scrutiny, they would be making it public and proudly defending it on the merits, taking time to explain their rationale for overhauling the nation's health care system and building public support for a plan they believed in. They are not doing so because they cannot.

In the long term, if the bill ends up becoming law, it is hard to see how this does not backfire as both policy and politics. Republicans are not stupid enough to try to defend the health care bill, but they may be stupid enough to try to pass it.

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  • Citizen X - #6||

    The death spiral is gonna go clockwise instead of counterclockwise.

  • Hugh Akston||

    That means it's better!

  • timbo||

    The only chance a 3rd party has is to get the morons to understand that the two existing parties are the exact same thing.

    Any chance we can convince a Bernie lover of that? Absolutely not.

    The only way to cure a brainwashed leftists is to let them take their socialist/fascists objectives all the way to fruition. Then if they live, they might realize how bad things can get.

  • SchillMcGuffin||

    Actually, I think the Bernie Lovers do understand that, it's just that they're pissed off that the Dem's socialist/totalitarian utopian rhetoric is tainted by too much residual capitalism and respect for the wrong (read "White/Male/Religious/ People-with-more-money-than-me") people's civil liberties. If all the Bernie Lovers had done as they were told, Hillary might well have won (though most of them were probably concentrated in states that she won anyway).

    Breaking the Beltway Oligarchy is only part of the fight, breaking it in the right way is equally important.

  • popeye1951||

    What do Bernie lovers know? http://i.imgur.com/38nMT0L.jpg

  • Diane Reynolds (Paul.)||

    Republicans Are Keeping Their Health Care Bill Secret Because They Can't Defend It On the Merits
    The Senate GOP is relying on the same opaque process they accused Democrats of using to pass Obamacare.

    Funny how command-and-control economies work that way.

  • Citizen X - #6||

    Which party is Stupid and which party is Evil now? I forget.

  • Jerryskids||

    What difference, at this point, does it make? As long as you keep believing there's two different parties that's all that matters.

  • This Machine Chips Fascists||

    @trollfood: I like the donkey cuz he cares about the kidz

    @getnuked: I like the elephant because it shares my fear

  • Chipper Morning, Now #1||

    Yes.

  • Don't look at me.||

    If you like your secret, you can keep your secret.

  • popeye1951||

    Did you complain about Obama's command & control? Remember his line of BS? If you like your doctor you can keep your doctor...

    5 Ways Obamacare Proves That Government-Run Health Care Is a Disaster
    Sen. John Barrasso
    (http://tinyurl.com/y9tkbt5o)

  • This Machine Chips Fascists||

    I know one fuckin' guy who will say this is the greatest healthcare bill ever. Ever! Big league.

  • Fist of Etiquette||

    They also correctly predicted that, once in use, Obamacare was here to stay until its inevitable collapse. There was never any repealing the behemoth once the targeted beneficiaries began using it no matter how bad it got for the rest. Put the onus on GOP legislators and health insurance in the United States never had a chance.

  • Citizen X - #6||

    They're conservatives, which means they'll conserve any piece of enacted legislation, not matter how hard they fought to prevent it from passing in the first place!

  • WakaWaka||

    "The business of Progressives is to go on making mistakes. The business of Conservatives is to prevent mistakes from being corrected"

    - GK Chesterton

  • Citizen X - #6||

    Yes.

  • Griffin3||

    alt-text: "You gotta pass i-- {heh} you gotta {heh} I can't even--"

  • Citizen X - #6||

    ...the dutchie on the left hand side?

  • This Machine Chips Fascists||

    Where's my mum y'all?! Whew!

  • This Machine Chips Fascists||

    GD auto correct

    mmj

  • Chipper Morning, Now #1||

    Guys, does anyone know where this guy's mum is???

  • Chipper Morning, Now #1||

    alternate alt-text: "I've already had my bowl of lettuce today, thanks."

  • WakaWaka||

    "When Republicans do attempt to discuss the AHCA in terms of health policy, they tend to frame it as a response to the failures of Obamacare. It is an argument that, like the bill itself, does not make much sense."

    That statement doesn't make a lick of sense. The bill is suppose to be a replacement for the AHCA and they should discuss the failures of the law that they're replacing?

  • Zeb||

    The AHCA is the proposed replacement for the ACA (a.k.a. "Obamacare").

  • EscherEnigma||

    Generally speaking, it's not enough to argue "that guy is bad". What you need to argue is "I'm better".

  • Rebel Scum||

    What goes around comes around.

  • Enjoy Every Sandwich||

    Okay, have we finally figured it out? The Democrats can't do it. The Republicans can't do it. So how about we let go of the fantasy that the government can manage health care?

  • ThomasD||

    Then what the Hell would Suderman do for a living?

  • loveconstitution1789||

    Every politician ever: Naw, we'll just double down on it!

  • mortiscrum||

    Problem is, it's already broke. As....underwhelming....as the attempts have been to fix/improve healthcare, it's not really possible to walk away.

  • Ken Shultz||

    "The few rumors that have emerged suggest that the Senate bill will look a lot like the House bill, except perhaps a little more expensive. It will, in other words, keep the essential framework of Obamacare—subsidies for individual market insurance, federal regulations for insurers, and a penalty (assessed by insurers rather than the government) for those who go without coverage—while rolling back the current health law's Medicaid expansion over a longer period of time."

    Eliminating the ObamaCare Medicaid expansion is destroying the ObamaCare framework.

    So is eliminating the individual mandate--and if you're equating the individual mandate with the uninsured needing to pay extra to get back on the program after they stop paying their premiums and lose coverage, then you should be ashamed of yourself.

    The penalty for skipping premiums should be a loss over coverage with the insurance companies no longer required to take you back. Suderman, you yourself have written about the problem of people hopping on and off the ObamaCare coverage only when they get sick. Equating the solution to that problem with the individual mandate itself is . . . kinda lame.

    Charging people a fee to game the system is not the same as siccing the IRS on them if they don't buy insurance.

  • Ken Shultz||

    "The few rumors that have emerged suggest that the Senate bill will look a lot like the House bill, except perhaps a little more expensive. It will, in other words, keep the essential framework of Obamacare—subsidies for individual market insurance, federal regulations for insurers, and a penalty (assessed by insurers rather than the government) for those who go without coverage—while rolling back the current health law's Medicaid expansion over a longer period of time."

    Bullet points:

    1) Moving people from Medicaid to subsidies is exactly like giving kids vouchers to leave public schools and go to private schools.

    2) Requiring people who stopped paying their premiums to pay a penalty for skipping on and off coverage is not the same as the individual mandate.

    3) Rolling back Medicaid eligibility is an historic achievement--when's the last time that happened?

  • Len Bias||

    Where' s Tony to explain how the Dems keeping ObamaCare secret was no big deal, but the Repubs keeping TrumpCare secret is the end of democracy?

  • mortiscrum||

    "It's a process that Republicans would surely be crying foul about were Democrats attempting anything like it to pass sweeping health care legislation. We can be sure of this because Republicans complained bitterly about the partisanship, speed, and secrecy they said Democrats relied on to pass Obamacare. That was never as true as Republicans made it out to be: As Dylan Scott notes, that law took a year to pass, and during that time Democrats released a discussion draft and went through a Senate markup that considered more than 500 amendments."

    Got yer answer right here brah. It was in the article.

  • Robbzilla||

    THIS JUST IN: Republicans and Democrats are exactly the same!!! Film at 11.

  • Johnimo||

    This is another worthless article written by the spineless idiots at Reason. We all know it's a bad law and we all know that both Obamacare the Republican replacement bill will solve few, if any, healthcare problems. In article after article the writers at Reason refuse to say what should be done: Get the government entirely out of healthcare! Once again, the writers at Reason fail to state how an entirely private healthcare market could lower medical costs and help us all transition to a healthcare insurance market based on catastrophic insurance.

    Reason, we know the current situation is lousy. Please, begin to describe a free market in healthcare towards which we should all move.

  • Amogin||

    Are these the same peopole who screamed that fast tracking the TPP was unconstituional? Maybe the nation won't pay attention to the bill released over the 4 of July weekend but one can bet that those who lose their insurance or see their premiums rise to new heights will be paying attention when November comes along.

  • Budbug||

    DC isn't going to repeal Obamacare, because it has nothing to do with healthcare and everything to do with controlling people. And that is what DC does. Oh, they may delay Single-payer for a while, but they won't repeal it. Band-aid here, band-aid there....

  • jerryg1018||

    Republicans are keeping their healthcare bill a secret until it's ready for a vote so they won't have to deal with the Democrats tearing it apart piece by piece before it's ready for a vote. The Democrats are going to tear it apart anyway. Voters should be asking the Democrats why they are supporting a healthcare law that is falling apart.

  • swampwiz||

    Of course, what's lost in this discussion is that anything that can pass via reconciliation now can be just as easily repealed by unitary Democratic control in 2021.

  • ||

    There is a better, lower conflict, way out of the healthcare mess:
    http://tinyurl.com/y76yly4n

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