The road to a GOP health care deal – is it really that different?

The road to a GOP health care deal – is it really that different? 

Posted: 9:00 pm Monday, June 19th, 2017

By Jamie Dupree

As Democrats took to the Senate floor on Monday evening to denounce closed door Republican negotiations on a GOP plan to overhaul the Obama health law, both parties traded barbs over how this bill was being put together, with Democrats once more zeroing in on a lack of public hearings, as it still wasn’t clear when the full Senate would vote on the top agenda item for Republicans in 2017.

“If there is not going to be a hearing, then we shouldn’t vote,” said Sen. Dianne Feinstein (D-CA).

In recent days, I’ve heard from partisans on both sides about the current situation in the Senate on health care, as Democrats denounce the GOP process, and Republicans point back to eight years ago to claim that nothing different is happening in 2017.

“Jamie, have you ever seen a bill / legislative process like this shrouded in such secrecy?” asked @wcsanders on Twitter.

Having worked my way through way too much Congressional history, I don’t like to ever say that something has “never” happened before in the House or Senate – because there probably is a legislative example that we have forgotten about from many years ago.

In some ways on this GOP health care bill, we have not seen a process like this before – but in others, we certainly have. Let’s take a look.

1. For the GOP health bill, a lack of Senate hearings. If there is one dramatic difference on the GOP health care bill, it is the absence of public committee hearings on various GOP proposals. Republicans in Congress have complained for the past seven years about how the Obama health law was put together in 2009 and 2010, but the process this time certainly has not had anywhere close to the number of public hearings and committee meetings that were held by Democrats on the Obama health law. Yes, the deck was stacked against the GOP back then because Democrats had 60 votes in the Senate, but that did not push most of the process behind closed doors. This time, instead of committee hearings and votes, the focus is on 13 Senate Republicans who are doing most of the work, which has led Democrats to hammer on the idea that all of the GOP health care work is being done in secret. The former Senate historian says nothing this big has been done so secretly in the Senate since World War I.

2. But let’s be honest, closed door talks in Congress are not new. For all of the finger pointing from Democrats about Republicans meeting in secret on health care, let’s not forget that Congress often operates behind closed doors when forging the final details of major legislation – and health care is no different. “Democratic lawmakers have yet to read the health-care bill,” noted one story in the Washington Post from 2009 that Republicans happily emailed to reporters on Monday night, to make the case that Democrats made some late changes to their health plan without much in the way of any legislative spotlights on the details. It’s a reminder that both parties love to talk about bipartisanship, but it’s not unusual for one side to go it alone and assemble a major tax or health care bill, without the involvement of the other side.

3. So, what is different about these health talks? Like 1994 and 2009, the lead on health care is being taken by the Senate Majority Leader. George Mitchell could not put together a bipartisan plan in 1994, but Harry Reid was able to keep things together in 2009-2010. Now, Mitch McConnell is trying to shepherd a health care bill to the finish line in 2017. In terms of comparing this to Congressional history, maybe what’s missing from this process is that it is not being driven by a specific committee or a powerful chairman in the House and/or Senate. So for now, there are no high stakes committee meetings where the hallways are jammed with lobbyists and reporters; instead, this GOP effort in the Senate is focused on 13 Senators of one party, meeting in the Capitol, trying to forge that agreement.

4. It’s important to remember some 2009 lessons. As we wait to see how Senate Republicans might alter the House-passed health care bill, we should go back to how Democrats made late changes with their own health plan in December of 2009. A few days before approving that bill on Christmas Eve, Senate Democrats added in a 383 page amendment, which included the “Cornhusker Kickback” and other provisions. A few months later in March, House Democrats would add in 153 pages of legislative text just a few days before the final vote. The truth is, both parties excel at dropping large amounts of legislative text on lawmakers at the last minute, and asking for a vote a few days later on a major bill that most lawmakers have not read. Last minute deals were made in 2009-2010, and may be part of the deal in 2017 as well, no matter how much Democrats complain.

5. Are we really near a final Senate vote? It depends on who you talk to, but there are some Republicans who are still forecasting a final vote in the Senate by the end of next week, before lawmakers go home for a July Fourth break. One rule that won’t be changed for health care is the need for a cost estimate by the Congressional Budget Office, which is mandatory before a Senate vote (but not in the House). Just like for Democrats back in 2009 and 2010, the Holy Grail is not a date certain for a vote, but when you can get a majority of votes. Republicans need 50 Senators plus the Vice President to provide the margin of victory on their health care package – which we are still waiting to read.

6. One other likely difference – a much shorter floor debate. Back in 2009, Democrats started the final push on a Senate health care bill on the Monday after Thanksgiving, and didn’t stop until approval of the bill at sunrise on Christmas Eve. That was almost four weeks of time on the Senate floor, as Democrats massaged the details of the measure (and came up with changes like the Cornhusker Kickback). This time, the total debate could be no more than 20 hours of debate – the amount set forward under special expedited rules for “budget reconciliation,” which does not allow for a Senate filibuster. Democrats were more than happy to remind the GOP of that extended 2009 debate, as we wait to see if there will be final action over the next ten days on a GOP health care bill – or if this spills into July.

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