U.S. Sen. John McCain’s late-night vote in late July to derail Republican health care reform merited the nation’s thanks. Not only did the Arizona Republican deal a mortal blow to a deficient bill, but he sent a pointed message about hewing to the Senate’s time-tested and time-intensive political processes.
Those include thoughtful hearings, transparency and bipartisanship — not rushed party-line votes on a secretive Senate health plan designed behind closed doors — that yield legislation best serving the public. Unfortunately, in rushing toward a vote on another health bill without a full Congressional Budget Office (CBO) score and adequate deliberation, McCain’s Republican colleagues are disrespecting the cancer-stricken senator’s plea to return to normal order.
“Graham-Cassidy” is the latest Republican plan to repeal and replace the Affordable Care Act — former President Barack Obama’s signature health reform law. Its moniker reflects two early authors: Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana. As the Star Tribune Editorial Board has previously argued, the bill still offers the wrong prescription.
Among our concerns: It includes radical cuts to Medicaid, weakens consumer protections for pre-existing conditions and would reduce the aid consumers can tap to buy private health insurance. In addition, it would redirect federal health care dollars away from states like Minnesota that were early adopters of the ACA. More rural states, generally in the South and West, would get a boost.
The American Medical Association, a leading hospital trade organization, and AARP have raised similar concerns in statements opposing the bill. Nevertheless, the legislation remains on track for a vote on or before Sept. 30 — a critical deadline for passing it without reaching the Senate’s usual 60-vote supermajority. There are only 52 Republican senators, so getting to 60 would require unlikely support from Democrats. The month’s end is when the procedural window to circumvent 60 votes closes.
On Monday, the CBO announced that it would not have time to complete a full analysis of Graham-Cassidy before Sept. 30. The respected nonpartisan agency, which has reviewed previous GOP plans, said it would not be able to provide “point estimates of the effects on the deficit, health insurance coverage or premiums for at least several weeks.”
That ought to set off sirens at the Capitol. CBO analysis remains the gold standard for evaluating legislation. How can members of Congress conscientiously cast a vote without a trusted estimate of how many people would lose coverage or how much premiums might increase? Not knowing these answers before voting is reckless when previous CBO reviews concluded that Republicans reforms would cause millions of Americans to lose health coverage.
A Senate committee with health care jurisdiction has been hard at work on bipartisan, pragmatic ACA fixes, thanks to Tennessee Republican Sen. Lamar Alexander and Sen. Patty Murray, a Washington Democrat. Graham-Cassidy’s out-of-the-blue momentum has derailed these workable solutions and the thoughtful deliberation McCain poignantly called for.
Hearings on ACA reforms from Alexander and Murray have relied on experts. Committee members have asked informed questions, kept grandstanding to a minimum and acknowledged the need to compromise.
This is how you should reform health care, which is now one-sixth of the U.S. economy. The rush to pass Graham-Cassidy is not.