I want to work w/ my GOP & Dem colleagues to fix the flaws in ACA. CBO analysis shows Senate bill won’t do it. I will vote no on mtp. 1/3
— Sen. Susan Collins (@SenatorCollins) June 26, 2017
New York Times with the bad news for Senate Majority Leader Mitch McConnell, Sen. Cory Gardner, and maybe you:
The Senate bill to repeal the Affordable Care Act would increase the number of people without health insurance by 22 million by 2026, a figure that is only slightly lower than the 23 million more uninsured that the House version would create, the nonpartisan Congressional Budget Office said Monday.
Next year, 15 million more people would be uninsured compared with current law, the budget office said.
The legislation would decrease federal deficits by a total of $321 billion over a decade, the budget office said.
The release of the budget office’s analysis comes as a number of reluctant Republican senators weigh whether to support the health bill, which the majority leader, Mitch McConnell of Kentucky, wants approved before a planned recess for the Fourth of July…
Before the budget office released its report on Monday, the American Medical Association officially announced its opposition to the bill, and the National Governors Association urged the Senate to slow down.
Now, the budget office’s findings will give fodder to Democrats who were already assailing the bill as cruel. It could give pause to some Republican senators who have been mulling whether to support the bill — or it could give them an additional reason to come out against the bill altogether.
And for all that, as the Washington Post reports, the reality might be even worse:
For the Senate bill, the CBO’s estimates of insurance coverage and federal spending are influenced by the fact that its forecast covers a 10-year window and the legislation’s most profound changes for the nation’s health-care system are tilted toward the latter part of that period.
The bill would, for instance, leave in place the ACA’s expansion of Medicaid through 2020. After that, it would begin a three-year phaseout of the federal money that under the ACA has paid almost the entire cost of adding 11 million Americans to the program’s rolls in 31 states…
Over the weekend, the senior Democrat on the Senate subcommittee that oversees the CBO said in a tweet that he had asked the budget office to estimate the Senate bill’s effect on insurance coverage over a longer time horizon. “GOP is hiding the worst Medicaid cuts in years 11, 12, 13 and hoping CBO stays quiet,” wrote Sen. Chris Murphy (D-Conn.) [Pols emphasis]
Regardless of any clever accounting that might have been attempted to reduce the visibility of the pain, it’s clear now that the Senate’s Obamacare repeal legislation is no more defensible than the House’s bill. With only a small fraction more Americans protected, there’s little worry now about Republicans forcing us to debate between the House’s “worse” measure and the Senate’s “bad” one–they’re both really bad. That means the comparisons will be to existing law, meaning the status quo under the Affordable Care Act. The possibility that Senate Republicans might have gained leverage with a bill substantially less harmful than the House’s was one of the few real opportunities to break out of the present stalemate, but that is not what happened.
What we have now is legislation that almost certainly cannot pass the Senate. In his interview last week with Denver7 in which he admitted not being as involved in the drafting as we were led to believe, Sen. Cory Gardner laid out several conditions that the then-forthcoming bill would have to meet to gain his support: that the legislation reduce the cost of insurance, create “stability in the insurance markets,” and make Medicaid “sustainable.” It’s very difficult to argue that reducing the number of insured patients by tens of millions will bring “stability” to the market. As for making Medicaid “sustainable?” Unless that represents an abandonment of Gardner’s previous stated desire to protect Medicaid expansion patients, this bill won’t meet that test either.
The CBO’s estimate is bad enough that it could well doom this legislation before a vote even takes place, much like the CBO’s estimate of the first House bill forced Speaker Paul Ryan to pull that bill without a vote. At this point, the most politically face-saving outcome for Gardner would be for the bill to be pulled, which would leave Gardner in a position to say whatever he wants to say.
Otherwise, Gardner must take a vote that either damages GOP Senators he must defend next year as head of the National Republican Senatorial Committee, or damages Gardner personally. Either way, today’s news just underscores the folly of this whole effort. Ending the GOP’s seven-year campaign to destroy the Affordable Care Act would have negative long-term consequences for Gardner, since he has invested disproportionate political capital into vilifying the law.
But at this point, keeping his promise could be Gardner’s worst choice.