Republican Senator Susan Collins criticizes secretive process of Senate health care replacement bill

Sen. Susan Collins (R-Maine) tweeted Monday evening that she will vote no on a motion to proceed the Senate health-care bill, the Better Care Reconciliation Act.

Collins made the announcement a few hours after the Congressional Budget Office released its preliminary analysis of the Senate Republicans' health-care proposal, which estimates that in 10 years, if the plan passes, 22 million more people would be uninsured than if the Affordable Care Act remained the law. "I want to work with my GOP and Dem colleagues to fix the flaws in ACA," she tweeted. "CBO analysis shows Senate bill won't do it. I will vote no on mtp," meaning motion to proceed.

"CBO says 22 million people lose insurance," she continued. "Medicaid cuts hurt most vulnerable Americans; access to health care in rural areas threatened. Senate bill doesn't fix ACA problems for rural Maine. Our hospitals are already struggling. 1 in 5 Mainers are on Medicaid." Senate Majority Leader Mitch McConnell (R-Ky.), who wants a vote on the BCRA this week, cannot afford to lose more than two votes, and now six GOP senators have shared their displeasure with the bill.

WASHINGTON — The Senate bill to repeal the Affordable Care Act was edging toward collapse on Monday after the nonpartisan Congressional Budget Office said it would increase the number of people without health insurance by 22 million by 2026.

Two Republicans, Senators Susan Collins of Maine and Rand Paul of Kentucky, said Monday that they would vote against even debating the health care bill, joining Senator Dean Heller of Nevada, who made the same pledge on Friday. Senator Ron Johnson of Wisconsin hinted he, too, would probably oppose taking up the bill on an expected procedural vote as early as Tuesday, meaning a collapse could be imminent.

“It’s worse to pass a bad bill than pass no bill,” Mr. Paul told reporters.

Ms. Collins wrote on Twitter on Monday evening that she wanted to work with her colleagues from both parties to fix flaws in the Affordable Care Act, but that the budget office’s report showed that the “Senate bill won’t do it.

The report left Senator Mitch McConnell of Kentucky, the majority leader, with the unenviable choices of changing senators’ stated positions, withdrawing the bill from consideration while he renegotiates or letting it go down to defeat — a remarkable conclusion to the Republicans’ seven-year push to repeal President Barack Obama’s signature domestic achievement.

But the budget office put Republicans in an untenable position. It found that next year, 15 million more people would be uninsured compared with current law. Premiums and out-of-pocket expenses could shoot skyward for some low-income people and for people nearing retirement, it said.

The legislation would decrease federal deficits by a total of $321 billion over a decade, the budget office said.

Mr. McConnell, who is the chief author of the bill, wanted the Senate to approve it before a planned recess for the Fourth of July, but that looks increasingly doubtful. Misgivings in the Republican conference extend beyond just a few of the most moderate and conservative members, and Mr. McConnell can lose only two Republicans.

The loss of Ms. Collins could bring along Senators Lisa Murkowski of Alaska and Shelley Moore Capito of West Virginia, whose rural states would face effects similar to those in Maine.

“If you were on the fence, you were looking at this as a political vote, this C.B.O. score didn’t help you,” said Senator Lindsey Graham, Republican of South Carolina. “So I think it’s going to be harder to get to 50, not easier.”

He added, “I don’t know if you delayed it for six weeks if anything changes.”

Under the bill, the budget office said, subsidies to help people buy health insurance would be “substantially smaller than under current law.” And deductibles would, in many cases, be higher. Starting in 2020, the budget office said, premiums and deductibles for a midlevel silver plan would be so onerous for a person with modest income that “few low-income people would purchase any plan.”

Moreover, the report said, premiums for older people would be much higher under the Senate bill than under current law. As an example, it said, for a typical 64-year-old with an annual income of $26,500, the net premium in 2026 for a midlevel silver plan — after subsidies — would average $6,500, compared with $1,700 under the Affordable Care Act. And the insurance would cover less of the consumer’s medical costs.

Likewise, the report said, for a 64-year-old with an annual income of $56,800, the premium in 2026 would average $20,500 a year, or three times the amount expected under the Affordable Care Act.

but this murderous bullshit is not the way.

Senate Democrats are warning supporters that the fight to repeal and replace ObamaCare isn't over, even after Republicans delayed a vote on their bill until next month.

"Over the next couple of weeks, we know that Leader [Mitch] McConnell will try to use a slush fund to buy off Republicans, cut back-room deals, to try and get this thing done," Senate Minority Leader Charles Schumer

He added that Democrats aren't "resting on any laurels, nor, do we feel any sense yet of accomplishment, other than we are making progress."

Schumer's remarks were echoed across his 48-member caucus, with Democratic members unanimously opposed to the GOP bill.
They warned that while they scored a win with Senate Republicans delaying their healthcare legislation until after the July 4 recess, they don't believe the GOP move to repeal ObamaCare is dead yet.

"Just like the House of Representatives did after their initial failure, I take Majority Leader McConnell at his word that he will bring the bill back to the floor," said Sen. Kirsten Gillibrand

(D-N.D.), a red-state Democrat up for reelection in 2018, added that the "Senate delaying vote on health care bill is good, but fight is far from over. Must [continue] fight to protect access to quality, affordable care."

Top Senate Republicans pledged on Tuesday that they would return to its healthcare legislation next month, after they worked out significant differences remaining within the caucus.

Democrats don't have the ability to block the healthcare bill, but they have been under a wave of pressure to grind the Senate to a halt in retaliation for Republicans crafting their legislation behind closed-doors.

Democrats stepped up their attacks this week, staging an hours-long protest from the Senate floor and holding an impromptu "sit in" outside of the Capitol on Monday night.

Progressive groups are expected to hold events and protests around the Capitol this week. Protestors yelled "shame on you" and "kill the bill" at Republican senators as they returned to the Senate on Tuesday evening from a meeting at the White House.

Republicans have a narrow path for clearing healthcare legislation through the Senate. They have 52 seats, and need at least 50 votes as well as Vice President Mike Pence to break a tie.

If after the recess, they manage to pass their bill, won't it have to go the house? Will house republicans sign on to it just to get a bill passed you think?

President Trump reversed course on health care on Friday, saying the Senate should just repeal Obamacare and replace it later on — if they can’t do both at simultaneously.

“If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” he wrote in an early morning tweet.

The president has previously said Obamacare should be repealed and replaced at the same time.

Friday is the deadline for working out changes to the Senate’s healthcare bill, which already saw its vote delayed this week because the measure hasn’t gained enough support among GOPers.

Sen. Ben Sasse (R-Nebraska), who pitched the same idea earlier this week, tweeted his support of Trump’s suggestion.

“Sounds great, Pres. @realDonaldTrump We are agreed. We need to break the logjam,” Sasse (R-Nebraska) wrote.

I just wish they would concentrate more on fixing Obamacare and less on depriving millions of health care while giving tax cuts to the rich. But if wishes were horses...

Republican Sen. Bob Corker, R-Tenn., on Wednesday told reporters a tax break for high earners in the Republican healthcare bill was a mistake, The Hill reported.

The tax cuts include a repeal of a 3.8 percent investment tax and a 0.9 percent Medicare payroll tax, both of which apply to individuals earning $200,000 or more a year and couples earning more than $250,000. Repealing that tax, according to the Congressional Budget Office, could cost the federal government $172 billion over the course of 10 years.

Corker says the cuts come at the expense of low-income individuals who would be provided less federal money and have plans that cover less with higher deductibles and copays.

After weeks of withering criticism over their plan to take health insurance from 22 million to finance tax cuts for rich people, some Senate Republicans have been kicking around an idea: Maybe don't give tax cuts to rich people.

Sens. Susan Collins of Maine, Mike Rounds of South Dakota, and Bob Corker of Tennessee have proposed the idea of retaining at least the 3.8% surtax on high earners' investment income — though the same political and policy logic would seem to also apply to another Obamacare tax, the 0.9% surtax on high earners' labor income.

A lot of commentators, including me, have been saying for months that the main objective of the Republican health bill is to cut taxes on the rich. The whole reason Republican leaders decided healthcare had to go before tax reform was that they wanted to repeal high-income taxes imposed in Obamacare before setting a revenue baseline for tax reform.

They wanted to get this tax cut for the rich out of the way so they could have as much room as possible to cut taxes on the rich again in a few months.

Obviously, if they don't repeal the high-income taxes, they won't have done that. They could repeal the taxes later as part of tax reform, but then they'd have to find a way to pay for that (other than throwing people off Medicaid), or they'd have to grow the deficit, in which case the tax cuts couldn't be permanent.

That's why I expect this idea won't go anywhere. Republicans are very eager to repeal these taxes on rich people, and "these taxes were part of Obamacare and we are repealing Obamacare," while not much of an argument, is better than any argument they'll have later for repealing them on a standalone basis.

But these apostates in the Republican Senate conference do have a point: If the point of this bill is supposed to be to fix the health-insurance system, or to reduce government expenditure on healthcare, or to give consumers more "freedom" to manage their healthcare, what does any of that have to do with cutting taxes on the rich?

Trump White House: millions more uninsured is ‘not losing, it’s choosing’
Candidate Trump vowed everyone would have coverage under his secret Obamacare replacement.

A top White House official said Sunday “we’re getting close” to having the votes needed to repeal and replace the Affordable Care Act, more commonly known as Obamacare.

During an interview on Fox News Sunday, President Trump’s director of legislative affairs Marc Short said a vote could take place soon after the July 4 recess.

“We are at the point of scoring two separate bills throughout the course of this recess this week,” Short said. “So, we hope that we come back the week after recess, we’ll have a vote.”

He added that if Republicans find that the “replacement part too difficult for the pulpits to come together” that they should still move ahead with repealing Obamacare and come up with a replacement later. Both approaches contradict what President Donald Trump said on the campaign trail when he vowed “insurance for everybody” and White House counselor Kellyanne Conway’s promise that no one would lose coverage.

Short also suggested that the nonpartisan Congressional Budget Office’s credibility “should be certainly questioned” regarding its projection that 22 million people would be left uninsured within the decade because of the GOP bill, echoing what the White House previously claimed.

“They reported what CBO says but the CBO credibility should be certainly — should be questioned at this point,” Short said. “Seven million of those people are people that don’t exist. They’re people that is based upon a baseline that CBO put out in 2014, even though the actual number is way down here.”

“There’s another 7 million people they say will choose to leave the market that they say are losing insurance. That’s not losing, that’s choosing,” he added.

Trump’s administration has disputed the CBO projections, claiming a partisan bias towards Democrats. But Republican and Democratic experts have soundly rejected any bias, with the Washington Post pointing out that it is particularly difficult to forecast what could happen in individual states. For example, the CBO scoring for Obamcare was off in part because the Supreme Court made it optional for states to expand Medicaid under Obamacare. As a result, fewer people received coverage after some Republican officials chose not to expand Medicaid in their states.

But Short is also wrong that people choose, rather than lose their plans. There is no guarantee that repealing Obamacare would later include a replacement plan. Under a 2016 GOP draft of just repealing Obamacare without a replacement plan, it was estimated that roughly 19 million people could lose Medicaid. In the current Senate repeal-and-replace version of the health care bill, upwards of 15 million people could lose Medicaid coverage.