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Senate Republicans made a big deal of releasing a revision to their draft "Better Care Act" or Trumpcare on Monday, a revision that might have been intended to make the coverage estimates in their Congressional Budget Office score a little better because it requires people have had continuous coverage for a year prior to getting a new plan. That provision, however, might not comply with the Senate reconciliation rules. So it could be stripped out after the CBO score is released but before a final vote.
But that's not the only chicanery McConnell could engage in. It's possible, maybe even probable, that the final vote will be on a secret bill that hasn't been scored by the CBO or seen by most senators.
Along with piecemeal amendments that the full Senate might adopt, McConnell could introduce a full substitute amendment up to the very end of debate that could replace what was the subject of debate with a substantially new piece of legislation. The result could be a literal “bait-and-switch:” debate over one proposal, followed by a vote on a significantly different one.
That means senators and the public might have virtually no time to see the actual text that the Senate will vote on—and that could become law if the House then passes it without further amendment. Moreover, McConnell could force a vote on this new substitute proposal without a CBO analysis of its impact on health coverage and cost of health insurance. That would enable senators who vote for the final bill to claim that it covers more people or increases costs less than CBO’s earlier analysis indicated, with no evidence to back up that point.
In such an environment, senators could portray small, last-minute changes as major “concessions” even though they do little to undo the bill’s overall damage. Undecided senators have expressed concern over issues like the time provided to phase out the ACA’s Medicaid expansion, the need for additional funds to respond to the opioid epidemic, and the depth of Medicaid cuts. Senators could portray changes in these areas as major wins that have secured their votes, even if they have little impact on the bill as a whole.
All we need is three Republican senators to block Trumpcare. If you have a GOP senator, we need you to call their office at (202) 224-3121. Demand that they put their constituents above their party. After the call, tell us how the call went.
That's a lot like how the House bill happened, if you remember. At the last minute, House Speaker Paul Ryan swooped in with the "Upton amendment," with $8 billion funding for high-risk pools, a laughably insufficient amount of funding. Ryan added it to the bill and rushed it to the floor before the CBO could rescore the bill. It could very well happen again.
One of the big questions is whether McConnell would even share that with his full conference. He sure as hell isn't going to let Democrats—or the public—see it before they vote. If there's nothing else in this process that should be making Republican senators, particularly those supposed "institutionalists" who go on and on about how they hold the Senate so near and dear—finally rebel against their leadership and the entire broken and subverted process McConnell has used for this legislation.