Surprise! GOP health bill never left the House

The News:

The US House of Representatives will send its healthcare overhaul plan passed earlier this month to the Senate in a couple of weeks after it receives a final analysis by congressional reviewers, House Speaker Paul Ryan said on Friday (May 19, 2017).

@SpeakerRyan to wait for @USCBO score before sending #Trumpcare to Senate Click To Tweet

Ryan said in a radio interview that the delay was “out of an abundance of caution” until the Congressional Budget Office (CBO) releases its findings on the legislation’s costs and its impact on health insurance coverage.

The CBO’s analysis, or “score,” is expected late Wednesday (May 24, 2017), taking into account final changes to the bill before it passed the Republican-led House earlier this month.

“We are just basically being overly cautious, but there’s really kind of a non-issue here,” Ryan told the syndicated Hugh Hewitt radio show, according to Reuters. “We’re moving it over to the Senate probably in a couple of weeks.”

Ryan and his team could still redo the bill if necessary after the CBO report is released. That would require at least one more House vote of some sort.

Steve’s Take:

After all the hoopla, nay euphoria, on display back on May 4, 2017 when House Republicans finally passed their 7-year quest to repeal Obamacare, I have to admit I was among the widespread consensus that the bill was going immediately to the Senate for its deliberation and prompt action. That was over two weeks ago.

Indeed, it’s been a tumultuous couple of weeks since May 4, and I won’t waste anyone’s time with a list of the White House’s missteps. But call me delusional; hadn’t Republicans rushed to vote on the health bill so the Senate could get a quick start on it, even before the CBO had finished analyzing a series of last-minute changes?

Those of us in the dark had plenty of company on Capitol Hill.

“Unaware,” said Rep. Jeff Denham of California, with noticeable surprise Thursday, when advised that his party leaders still hadn’t sent the bill over to the Senate. Denham was one of the House Republicans who ended up voting for the measure, after earlier opposing it. “I am on the whip team and we have a lot of conversations, but we have not had that one. So I am going to look into it,” said Denham, a member of the party’s vote-counting team.

Other senior Republicans weren’t aware that leaders had been holding onto the bill.

“I had no idea,” Dennis Ross of Florida, another member of the vote-counting team, said Thursday, adding that the prospect of another vote “does concern me.”

Checking back, GOP leaders never said publicly they were planning to hold on to the bill for two weeks or longer, says Bloomberg.

“Republicans who argue that this was an open and transparent process are misleading the American people,” said Rep. Steny Hoyer of California. “If they have to amend the bill next week after they are informed of its effects, then they will have a very difficult time doing so given the fierce backlash over Trumpcare that we’ve seen in the days since passage.”

Bottom Line:

Is this any way to legislate, especially where the entire nation’s health is at stake?

Speaker Ryan just barely rammed the American Health Care Act through the House of Representatives two weeks ago with a 217-213 count. Now he might need to do it all over again – and chances are it will be more difficult, says Ned Resnikov of ThinkProgress.

If this second vote does need to take place, it will be a direct consequence of the rushed, chaotic manner in which Ryan threw the bill together and got it passed. Originally, the AHCA was supposed to be configured to pass through the Senate by “reconciliation”–a lawmaking maneuver that would allow Senate Republicans to evade any threat of a filibuster and approve the law by a straight majority.

But not just any bill can be approved through reconciliation. And in Ryan’s haste to get AHCA out of the House, he might have fashioned something that doesn’t pass muster.

Experts believe the new CBO score needs to find savings of at least $2 billion in the updated bill in order for it to qualify for reconciliation, Bloomberg reported on Thursday. Before the AHCA was amended to let states opt out of most Obamacare regulations, CBO scored the bill as cutting the deficit by $150 billion, says Jed Graham of IBD. CBO’s score of the final bill is likely to show that Trumpcare would add to the deficit, perhaps substantially.

As IBD explains, Trumpcare’s net savings all come from offering subsidies that are too small to buy the Obamacare-type policies that would be required under the initial bill. Something like 30 million people would leave their roughly $3,000 subsidy on the table, amounting to over $600 billion in unclaimed subsidies between 2020 and 2026.

“With the skimpier subsidies, states are going to be under enormous pressure to apply for these waivers”–even deep blue states like New York and California, Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms, told Kaiser Health News.

The math is pretty simple for states: Either keep Obamacare rules and put any health coverage out of reach for millions, or get rid of the rules and double the total subsidies for individual coverage flowing to state residents.

And of course, Ryan’s sleight-of-hand shenanigans with the AHCA pale in comparison with the predicament of President Donald Trump, who is now embroiled in the biggest political scandal since at least Watergate. Multiple investigations of the president and allegations of obstruction of justice are likely to put a damper on any legislative priority that has its name on it.

And House Republicans in vulnerable districts might feel more inclined to distance themselves from the party line in cases where the bill in question enjoys both Trump’s endorsement and widespread unpopularity.

Steve's Take: @SpeakerRyan must wait for @USCBO score before sending #Trumpcare to Senate Click To Tweet

The other problem facing Ryan is that there are three upcoming special elections in the month or so to replace outgoing Republican House members. In two of those races in particular – in Montana and in Georgia’s sixth district –there’s a real chance the seat could turn Democrat. And even one or two fewer Republican House members could spell doom for Trumpcare.

Next time, Speaker Ryan, just wait for the CBO score and perhaps let us know what’s really going on in your chamber. Well, that is if your President will permit you to.