Partisan Divides Harden as Senate Republicans Run Down the Clock on Still-Secret Bill to Gut Obamacare and End Coverage for Millions


As the Republican-led Senate barreled toward a high-stakes vote on upending health insurance marketplaces and repealing taxes on the medical device industry, the schisms between Republicans and Democrats only grew more pointed on the third day of debate. The final vote on an anticipated but still-unseen final bill is expected to come after midnight Friday morning or later in the day, where it appears that Republican Majority Leader Mitch McConnell will present a last-minute amendment that repeals the Affordable Care Act’s requirement that individuals buy health insurance and that all but the smallest businesses offer it to employees.

During Thursday's lengthy day of speeches, the contours of McConnell’s plan seeped out, prompting the health insurance industry and many medical associations to issue statements opposing the prospect of fewer Americans being covered by insurance, which they said would lead to higher costs across the health care industry.

Meanwhile, as the hours passed on the Senate floor, the speeches by Democrats and Republicans were increasingly like ships in the night—mostly passing each other except for an attempt by Republicans to troll Sen. Bernie Sanders, I-VT, and his push for a Medicaid-for-all system. After Sanders spoke and berated Republicans, Sen. Steve Daines, a Montana Republican, introduced an amendment that was a copy of a single-payer House bill introduced by Rep. John Conyers, D-MI. Then, like all Republican senators, he voted against it. Most Democrats voted no. As Sanders left the floor, the microphones were still live and Republicans were heard laughing and mocking him.

By 7pm, Republicans started making speeches that supported eliminating the individual and business coverage mandates, which appeared to signal the path to be taken by McConnell—who still hadn’t produced his amendment. All of the entreaties by Democrats, and some Republicans like Arizona Sen. John McCain, to resurrect the traditional Senate way of doing business—legislating in the open and holding hearings, debating amendments, etc.—seemed to be for naught.

While it is still unclear whether McConnell has the 50 votes he needs—with Vice President Mike Pence being the tie-breaker—the House GOP leadership told their members to plan to stay in town over the weekend for fast action on whatever might emerge from the Senate.

With that backdrop, here are four excerpts from speeches by senators. First is Sanders, berating Republicans for their legislation. That is followed by Sen. Patty Murray, D-WA, the ranking Democrat on the committee with jurisdiction over health care. Then comes Sen. Roy Blunt, R-MO, who began the parade of Republicans railing against the ACA’s coverage mandates with disingenuous arguments. He's followed by Sen. James Lankford, R-OK, who also offered disingenuous arguments—in his case, claiming to stand up for the poor people in his state who are uninsured even though that red state’s leaders rejected Obamacare’s expansion of Medicaid, which would have helped them.

These varied remarks set the stage for Friday’s final vote and showdown.

Vermont's Bernie Sanders, Independent

“I say to my colleagues in the Senate, maybe, just maybe, we want to stand up for working people and the middle class, rather than for the owners of the insurance companies and the pharmaceutical industry…

“While the American people are getting ripped off by the drug companies, the five largest drug companies in America in 2015 made over $50 billion in profits. Five companies, $50 billion in profits, and yet one-fifth of the American people cannot afford to buy the prescriptions they need. How outrageous is that! And my Republican colleagues are telling us that they are dealing with health care reform without mentioning one word about the high cost of prescription drugs. Give me a break. You’re dealing with many things, but you’re not dealing with health care reform.

“Some of my Republican colleagues have been spending the last few days using words like freedom, choice and opportunity, to try to convince the American people about their abysmal health care legislation. This is the same language that right-wing ideologues like the billionaire Koch brothers use when they try to discredit government programs and move to privatize them. What the Koch brothers mean by freedom is their own freedom to profit off the misery of ordinary Americans who rely on a wide variety of government programs that make life bearable and in some cases even possible.

“I want to say a word about freedom… We are talking about the freedom to stay alive, the freedom to be able to go to the doctor when you are sick, the freedom not to go bankrupt if you end up in the hospital with a serious disease. So when my Republican friends talk about freedom of choice… we say that the children of this country that have serious illnesses have the freedom to stay alive even if their parents do not have a lot of money, that older people who are now in nursing homes should have the freedom to get dignified care in a nursing home, even if they have Alzheimer's and even if they don’t have a lot of money. Health care is not another commodity… Health care is whether we stay alive or we don’t, whether we ease our suffering or whether we don’t. And I believe—unlike, unfortunately, too many of my Republican [colleagues]—that the right to get health care when you need it is something that every American should be able to get. Right here in the Senate, we have good health insurance.”

Washington’s Patty Murray, Democrat

“It appears that the Republican leader has a last-ditch plan waiting in the wings. As soon as they have an official score from the CBO [Congress Budget Office], which could be hours from now, in the dead of night, Sen. McConnell will bring forward legislation that Democrats, patients and families, and even many Senate Republicans have not seen and try to pass it before anyone can so much as blink.

“We have heard rumors about what could be in this bill. And based on what we know, Democrats took it upon ourselves to do the best we could to figure out what its impact will be. The CBO scored our best guess about what the Republicans are talking about doing and here is what they found. Sixteen million people will lose their health care coverage in the next 10 years under this bill. Premiums will increase by 20 percent every single year for the next 10 years… all while special interests in the health industry are going to get a massive tax break.

“Now, Republicans can play games with the language as they negotiate now in secret somewhere to get it, quote, better than this, but no matter what they do here. If they jam it through they will be held accountable for the millions of people who lose their health care and the millions and millions more who will see their premiums go up… I hoped when my Senate Republican colleagues began this process, they were not planning to pass a bill in the dark of night to deny millions of people health care and hand special interests billions in tax breaks. But right now, that’s the path they are careening down.”

Missouri’s Roy Blunt, Republican

“Remember former President Clinton’s observation on this? What a crazy system. The cost keeps going up and the coverage keeps going down. So we have forced people to be in a system, that according to President Clinton, the cost keeps going up, the coverage keeps going down, and if you don’t participate in it, you pay a penalty… We have to move in a different direction here. Eliminating these mandates helps do that.

“You know, there’s some Congressional Budget Office numbers out there that estimate what’s about to happen. It’s certainly totally misestimated the current law. I believe under the current law there would be 25 million people roughly, some big number on the [government managed health insurance-buying] exchange today. There are 10 million… So CBO is notoriously wild with their projections. They projected 15 million people would drop out of the individual market if one of the many versions of this bill—these amendments would pass. There’s only 10 million people in the individual market. How do 15 million people drop out if there are only 10 million people there? They said that 7 million people who get Medicaid and pay nothing for it wouldn’t take that if the government didn’t force them to…

“Now the current system just isn’t working. Now the other mandate, the employer mandate, telling employers what they had to do… The government requiring you to do something that you don’t want to do and thinking there’s a constitutional right to do that just doesn’t work. In fact, with the employer mandate [there’s been] all kinds of unintended consequences. People with 50 employees didn’t want to get more than 50 employees. The 30-hour workweek became a problem. In fact, Sen. Collins, the senator from Maine [who voted no on having this debate—one of two Republicans to do so] has said from almost day one, why do we want to enshrine a 30-hour workweek [which is less than what’s required for employees to offer insurance]? Let’s have a 40-hour workweek. People are reluctant to hire full-time employees. These are unintended consequences.”

Oklahoma’s James Lankford, Republican

“The health care debate happening in America [is] individuals who used to be able to afford health care coverage, but now they cannot and no longer have health care anymore. The Affordable Care Act did cover a new group of people that were not covered before, but it also pushed out another whole group that used to have coverage and now does not. This is an extremely personal issue. This is not a political issue. These are families and lives and children. These are people who have cancer and diabetes and history of genetic diseases in their family. They are very concerned about what happens politically in this room because it affects their family.

“What does this look like in my state? Well, in my state, premiums went up last year by 76 percent. One year increase… In fact, since Obamacare fully rolled out in 2013, insurance in my state has gone up 201 percent. That’s not the Affordable Care Act. That’s a recipe to be able to push people out of insurance and keep them out. Obamacare was designed to force healthy people to buy to increase the risk pools for those insurance companies. But when you can’t afford the premiums, you’re forced to pay this big tax.

“Now the question is who is paying this tax? Originally, Obamacare said people who didn’t want to buy the insurance and take the risk on their own and wealthy individuals would have to pay the extra tax. Really? What does that end up looking like? Well in my state, 96,000 Oklahomans are currently paying the tax to the IRS because they don’t have their health care insurance. Who are they? Eighty-one percent of the people who pay the penalty make less than $50,000 a year. These are people who cannot afford the insurance and cannot afford the fine that is coming down from the IRS. It is a poverty tax that the Affordable Care Act created to try to force these people into insurance they cannot afford, and when they can’t afford that they get a big hit on their taxes as well. It is a no-win situation for them.”   

Will Republican Ideologues Win?

The senators’ comments reveal the wide gap between those who want to actually help Americans with fact-based arguments—the Democrats—and those who are reverting to twisted accounts that mistakenly blame Obamacare for the insurance industry’s greed while ignoring that Republicans have been blocking health care coverage in their states.  

Take Blunt’s comments. The shrinking of insurance buying pools, when fewer people are paying into them—as repealing coverage mandates would lead to—will lead to premium costs going up for everyone left in them. That, in turn, will prompt other people to drop their coverage, not just those who buy insurance through exchanges, but also on the private market. His smearing of the CBO estimates intentionally ignores this reality, which is what medical industry lobbyists said Thursday.

Lankford is disingenuous in a different way. Oklahoma didn’t expand Medicaid under the Affordable Care Act to help the lower-income families he now claims to defend. But that’s another inconvenient truth. Nor does he hold price-gouging insurers accountable for the rate increases he bemoans. What he and Blunt are doing is laying the groundwork for McConnell’s so-called skinny repeal. This is not just talking past the Democrats like ships passing in the night; it’s also avoiding facts and analysis about what’s going on, although it sets the stage for Friday’s final vote on the GOP’s health care plans.

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