This is a busy week for healthcare reform efforts in the U.S. Senate. On Tuesday, the Senate voted (with Vice President Pence breaking the tie) "yes" on the Motion to Proceed to a debate on healthcare legislation. That evening, senators voted on a new edition of the Better Care Reconciliation Act, which included Ohio Senator Rob Portman's amendment to include $100 billion to help lower costs for consumers, but would still have meant huge cuts to Medicaid. The vote failed 43-57.
Yesterday, there were two more important votes: one on a measure that would have repealed ACA taxes and Medicaid expansion and subsidies after two years. It failed 45-55. Earlier the Congressional Budget Office (CBO) found that measure would have resulted in a loss of coverage for 32 million Americans. The other measure would have required the legislation to return to committee with instructions not to include Medicaid cuts. This vote failed along party lines: 52-48.
Now, there is a lot of talk now about the Senate passing a “skinny” repeal bill at the end of the current floor debate — which could come as early as sometime today. Rumor has it that the skinny bill would leave Medicaid out since it has been hard to appease all sides of the Republican caucus, especially the expansion versus the non-expansion states. So we don’t know exactly what will be in the “skinny” repeal bill (current rumors are that it will repeal the individual mandate, the employer mandate, and the medical device tax) but it is clearly designed to avoid the current infighting on Medicaid and just pass something to get to conference with the House. Republican Senators who are worried about losing their state’s expansion may see this as a viable path to yes.
Leaving aside the damage that this approach would cause through destabilization of the individual insurance market that would send premiums soaring, should Senator Portman and his fellow Senators who have worried about the massive Medicaid cuts feel better? Nope. Yesterday, Majority Whip Senator Cornyn of Texas confirmed that Medicaid cuts would be back on the table if the bill makes it to conference. And that process will be even more secretive.
But, here's the good news. While this has been a long and challenging process, we have been successful so far in protecting coverage for at-risk kids and families. The Senate is struggling so much to get votes because your stories, phone calls, letters, emails, op-eds, visits, etc. are resonating. So, keep up the pressure on Sens. Portman and Brown and tell them to vote "no" on the "skinny" repeal and any other measures that would result in families losing coverage, healthcare workers losing jobs, rural communities losing hospitals, and the American people losing their ability to engage in an open, public debate over a bill that will so intimately change their lives.