When the House passed its American Health Care Act (AHCA) last month, conventional wisdom said it was doomed in the Senate. Moderate Republican Senators would never go along with the more harmful provisions of the House bill – or so the narrative went. It appears those predictions were off base. If the latest reporting from Capitol Hill is accurate, Majority Leader Mitch McConnell has put the Republican healthcare plan on a fast-track for passage in late June or early July. A 13-member working group has been meeting in secret to craft the Senate version of the AHCA – without committee hearings. Zero open debate. Zero public input. Or as the Washington Post described the process: “sabotage, speed and secrecy.” In order to keep pushback to a minimum, McConnell may not release the details of the bill until about 48 hours before the Senate votes on it. That is insufficient time for Senators – and the public at large – to evaluate legislation that could dramatically affect the lives of tens of millions of Americans.
Another false prediction from a few weeks ago said that the Senate would scrap the House bill and start from scratch. But this week Senator John Cornyn (R-TX) revealed that the Senate bill retains about 80% of what the House passed. Since the House bill was so unequivocally bad for older Americans, hearing that the Senate version is at least 80% as bad is cold comfort. The Senate leadership will try to appease GOP moderates with the same kind of token gestures that saved the AHCA from defeat in the House. It is vitally important that those moderates not cave like their House colleagues did. Too much is at stake for our nation’s seniors and Americans as a whole.
The National Committee has identified 11 moderate GOP Senators who may be persuaded to vote against the Republican health care plan – if they are willing to put their constituents’ well-being above party and political expediency. They are:
Sens. Lisa Murkowski and Dan Sullivan (R-AK)
Sens. John McCain and Jeff Flake (R-AZ)
Sen. Cory Gardner (R-CO)
Sen. Charles Grassley (R-IA)
Sen. Susan Collins (R-ME)
Sen. Dean Heller (R-NV)
Sen. Rob Portman (R-OH)
Sen. Lamar Alexander (R-TN)
Sen. Shelley Moore Capito (R-WV)
In fact, we call on these Senators to become what we call “SeniorHeroes” – real-life superheroes standing up for older Americans while the rest of their party pursues a dubious scheme. From what we know of the Senate bill, there isn’t much in the evolving Senate bill for moderates to applaud. Sen. Lisa Murkowski expressed those doubts publicly on Thursday. Here are some of the key areas where the Senate version will likely fail older Americans:
MEDICAID EXPANSION. Senate Republicans are considering “compromises” that would phase out funding more slowly – but do not appear to be considering any approach that would maintain Medicaid expansion over the long run. (Many of the more moderate Senators represent states which chose to expand Medicaid – and have a lot to lose.)
PER CAPITA CAPS. The Senate reportedly will retain the House-passed bill’s Medicaid per capita caps, which would strain state budgets and possibly force rollbacks in benefits or outright termination of coverage for millions of seniors who depend on Medicaid to pay for long-term care. Although it’s unclear whether the Senate will keep the House bill’s $834 billion in Medicaid cuts, Medicaid still likely will be slashed by hundreds of billions of dollars.
PRE-EXISTING CONDITIONS AND ESSENTIAL HEALTH BENEFITS. The Senate may reject provisions in the House bill that would have allowed insurers to charge higher premiums for individuals with pre-existing conditions, but will likely allow states to waive essential benefits coverage. This would dearly cost older Americans seeking essential benefits, such as hospitalization, ambulance services, and rehabilitation services.
TAX CREDITS. The House bill would drive up seniors’ out-of-pocket costs by replacing Obamacare’s income-based subsidies with tax credits based solely on age. Older Americans could pay up to 800 percent more in net premiums under this plan. The Senate has toyed with making these tax credits more “robust,” but the more it increases these credits, the deeper it must cut Medicaid to match the savings in the House bill.
We do not know whether the Senate will allow insurers to charge older enrollees five times more than younger ones, as the House legislation does. Also uncertain is whether the Senate will repeal the Medicare payroll tax on high income wage earners (as the House did), which would reduce the solvency of Medicare by three years.
It’s a safe bet that, like the House version, the Senate GOP healthcare plan will cost older Americans more, make essential health benefits harder to obtain, and cause millions who desperately need healthcare to lose coverage. GOP moderates will be under intense political pressure to toe the line and support the party’s plan, even though the Republican bill has scant public support in even the reddest of states. In asking GOP moderates to don their capes and become SeniorHeroes, we hope they remember who they were elected to serve. It certainly wasn’t Mitch McConnell.
For more about the GOP’s secret Senate healthcare plan, watch this week’s “Behind the Headlines” on Facebook Live from Capitol Hill.