Shortly after 10 p.m., the Senate Republican leadership introduced the “Health Care Freedom Act.” As advertised, the bill would eliminate the individual mandate, a key underpinning of the exchanges that allow insurance to be made affordable to people too affluent for Medicaid who can’t get it through work. But the changes would not end there. States could have more leeway to weaken consumer protections. Health-savings accounts, a tax shelter used by affluent people, would grow. Planned Parenthood would lose federal funding, as would the Centers for Disease Control, whose public health budget would be cut 14 percent.
More detailed analysis is difficult given the time constraints. That is, of course, the point. Since their unexpected election victory forced them to actually write and pass replacements for Obamacare, the Republican proposals have been a series of public-opinion disasters on a scale unseen in the annals of polling. The party’s response to the public’s disgust has been to conceal its intentions, and the Senate vote is the ultimate expression of that furtive impulse. Mitch McConnell’s sincere belief is that his plan can only pass if experts and authorities — the Congressional Budget Office, insurance actuaries, think tanks — cannot inform his members of its likely effects.
A handful of recalcitrant Republican senators called the preliminary outlines of this bill a “disaster,” and insisted they would vote for it only if the House promised not to pass it into law. Even this absurd condition was not met. House Speaker Paul Ryan released a statement indicating that he would like to go to conference and write a different bill, but pointedly refusing to rule out passing the Senate bill unaltered. Attempts to further clarify his position simply underscored Ryan’s outright refusal to commit himself to the simple and clear promise not to pass the law.
Republican aides say it is a coin flip whether the House will pass the Senate bill. There really is no cover for senators who vote for this, no room to insist they have been fooled if it passes into law unaltered. Their cooperation in the charade has been given willingly.
The public, on the other hand, has ample grounds for complaint. The Senate is engaged in a mockery of legislating. The Senate vote is a scandal, a crime against the public good.