The cruel reality of high-speed health care legislating


https://www.vox.com/policy-and-politics/2017/6/26/15865598/senate-health-bill-fast-speed

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Four days ago, Senate Republicans got their first glimpse at their leadership’s plan to repeal and replace Obamacare.

Three days from now, Senate Republicans are expected to vote on that plan.

Let that sink in for a moment: We are already more than halfway through the Senate Republicans’ consideration of their health care bill — and there’s still a lot we don’t know about it, and what it would do.

The Senate is running its health care process at breakneck speed. Republicans are aiming to introduce the bill, have it scored by the Congressional Budget Office, and vote on it in exactly one week. It is a compressed and highly unusual process, which some Republicans are rebelling against.

 “We don’t have enough information,” Sen. Ron Johnson (R-WI) told NBC’s Meet the Press on Sunday. “I don’t have the feedback from constituencies who will not have had enough time to review the Senate bill. We should not be voting on this next week.”

At the same time, the speed of the process appears to have produced some sloppy bill-writing. When it was unveiled Thursday, the Senate bill included glaring omissions in how it constructs an insurance market, which experts said could have caused that market to collapse. New policies were added over the weekend to patch those holes, but the public has not seen them.

 Other policy concerns are being discovered by the day — like that this bill might raise small business insurance premiums — as analysts scramble to make sense of the document.

I’ve heard from multiple former Republican aides, who served either for the Bush administration or on Capitol Hill, who were shocked to see such large omissions. Writing good policy takes time and deliberation, especially when it is something as complex as re-regulating the health insurance marketplace.

Considering policy takes time, as well. On Sunday at a Koch donor retreat in Colorado, Sen. Ben Sasse (R-NE) was asked onstage if he would vote for the bill. He refused to take a position — in part, he said, because he had only read about 40 percent of the text.

 At the same event, Sen. John Cornyn (R-TX) told reporters the hasty process was necessary in order to ensure stability in the individual health insurance exchanges created under the Affordable Care Act, which he said were in “meltdown.” But while the exchanges are being unsettled by deliberate actions from the Trump administration, they are nowhere near melting down.

The real reason for the speedy process is entirely political: to pass a health bill, in whatever form can get a Senate majority, before opposition can mount further. And there could be big consequences for millions of Americans as a result.

The Republicans are still writing major parts of a bill they want to vote on this week

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