In contrast to the very public spectacle in the House as Republicans took up healthcare, a much more muted approach has been taken in the Senate. Last week, the Senate non-partisan parliamentarian advised that the American Health Care Act (AHCA), passed by the House, met the budget reconciliation rules. That means this legislation could avoid much of the process normally required for bills being considered – and now the backroom dealing has begun in earnest.
The Senate will be starting over with their own version of the bill and the “repeal” will be significantly watered down. For one, it is expected that many of the ACA taxes will remain in effect, at least on an interim basis, so that changes can be funded. As a result of the fallout from the House bill and public uproar over the now 23 million Americans expected by the Congressional Budget Office (CBO) to be vulnerable to losing coverage, some Senators are concerned with protecting these Americans – particularly those affected by the rollback of Medicaid expansion. There will be many other changes to the House version, but it is important to consider that under Senate rules, any bill they pass will have to save at least the $119 billion over a decade saved under the House version, and it will require scoring by the CBO as well.
Striking a balance between the Senate and the House will not be easy. The conservative House Freedom Caucus will want a bill much closer to repeal, but polling has shown that realistically Americans favor the ACA over the radical repeal introduced by the AHCA. Despite this increase in approval rating, it’s ironic that Centers for Medicare and Medicaid Services reported this week that nearly 2 million of the 12.2 million Americans that acquired coverage during the latest enrollment have now fallen off the insured ranks.
The interest in reality TV is waning in America – we have our own version playing out every day.