WASHINGTON – House Republicans will vote on their health care bill Thursday, after months of stops and starts and some late changes to secure enough votes.
Yet as of Wednesday night, some members reportedly hadn’t even seen the bill. The Congressional Budget Office hadn’t scored the changes to things like the preexisting coverage mandate. And the White House was acknowledging that it was simply too difficult to know what impact the changes would have.
Manu Raju tweeted: A number of House members say they haven’t seen latest version of bill that will remake the health care system and will be voted …
For a Republican Party that accused Democrats of being reckless in overhauling health care seven years ago, it reeks of hypocrisy.
And not only that, it reeks of their own recklessness – a willingness to vote on something of such consequence for the country without knowing what it would cost or what new estimates would say about coverage for things like preexisting conditions.
Even just politically speaking, it’s highly questionable.
“I don’t think we should pass bills that we haven’t read and don’t know what they cost,” now-House Speaker Paul D. Ryan said in 2009, when Democrats were allegedly ramming through their own health-care bill. (As The Post’s Philip Bump notes, the Democrats’ process actually took quite a long time.)
Former speaker John A. Boehner, R-Ohio, was even more adamant in 2010, when he was the leader of the minority Republicans, shouting on the House floor: “Have you read the bill? Have you read the reconciliation bill? Have you read the manager’s amendment? Hell no you haven’t!”
So before the 2010 election, Republicans made a pledge to voters:
We will ensure that bills are debated and discussed in the public square by publishing the text online for at least three days before coming up for a vote in the House of Representatives. No more hiding legislative language from the minority party, opponents and the public. Legislation should be understood by all interested parties before it is voted on.
Republicans may argue that most of their bill has technically been available for review for a long time now, except for the late changes. But it’s clear this bill doesn’t meet that latter part of their promise – that language should “be understood by all interested parties” before it is voted on. And it sure doesn’t meet Ryan’s professed desire to not pass bills before you know what they cost.
Journalists are still uncovering new things about the bill. The Wall Street Journal reported early Thursday that it could get rid of out-of-pocket maximums not for Obamacare recipients but for employer plans – the kind the vast majority of Americans have. The New York Times is now reporting that the bill could cut funding for special education programs. Those are two potentially huge impacts that received basically no attention until the vote was announced.
Skeptical Republicans who have come around to this bill are basically investing their trust – and potentially their political futures – in Ryan and congressional leaders without a thorough vetting of what they are voting on. And it’s a bill that will affect tens of millions of Americans under Obamacare and its Medicaid expansion. It’s a bill that the CBO has said would reduce the number of insured Americans by 24 million come 2026. And the recent changes to Obamacare’s preexisting coverage mandate, which allow states to apply for waivers and insurers to charge those with preexisting conditions more, risk pricing these people out of the market.
The late solution to that problem was to fund these so-called high-risk pools with $8 billion, hoping to reduce the burden on those with preexisting conditions. But experts are highly skeptical that’s enough money. And Rep. Fred Upton, R-Mich., who spearheaded the change, said Wednesday that if more money is needed it will simply be discussed … after the bill is passed.
Indeed, there seems to be a sense that the bill will just be updated later if there wind up being any red flags. After all, the Senate still has to vote on it and is guaranteed to make changes before the House and Senate come together to reconcile the two versions. The final bill will clearly be different than it is now, if there is a final bill. Basically, Republicans are passing this bill so that they can check the box and get to the next step, knowing this won’t be the final product.
But that’s a helluva way to conduct business – especially given the GOP’s righteous indignation over how Democrats proceeded on their own overhaul of the nation’s health care system. And especially given the stakes involved right now.
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