For those of you who made it out to the open air town hall in Portland today, you heard me give a quick version of this earlier post. Allow me to elaborate a bit here.
If done via the obscure rules of budget reconciliation, repealing the ACA requires only 50 senators’ votes to pass in the Senate vs. the 60 typically needed to overcome a filibuster. Before the inauguration in January, the Senate voted along party lines–with the help of Senator Collins–to start the process of ACA repeal via a reconciliation bill. The next step is for the Senate Finance Committee and HELP Committee (of which Collins is a member) to work together to draft an actual ACA repeal bill to be voted on. Thankfully, that process has been stalled considerably due to delays in the cabinet confirmation process and massive infighting and hesitation among Republicans about the path they should take forward; the resolution recommended a deadline of January 27th for the repeal bill to be written by the two committees*, but no draft has been completed by either committee and they seem to be falling further and further behind. The repeal process is still slowly churning forward, though, and until Collins and two other Republicans come out unequivocally against it, ACA repeal is very much a possibility.
ACA replacement, however, is a pipe dream. That’s because any true replacement that addresses non-budget related aspects of the ACA, such as banning preexisting conditions or establishing lifetime limits, can’t be passed via reconciliation and therefore needs 60 votes to pass. That would require 8 Democrats to vote for it, which simply will not happen in the Senate as it stands today. Republicans seem to think that if they pass their repeal bill and it blows up the insurance markets as economists expect, Democrats will be forced to come to the table and vote for a replacement bill, but Democrats have stayed true to their original strategy: if you break it, you own it. Therefore, no comprehensive replacement bill is passing. Not Collins’ bill, or anyone else’s.
If you ask Senator Collins about the ACA, as a group of representatives from Mainers for Accountable Leadership did yesterday, she will happily talk at length about her own replacement bill, but will not mention the fact that it needs 60 votes. She did let slip in the MFAL meeting the fact that the reconciliation-friendly parts of her bill would need to be separated out in order for them to pass (see 36min video here, starting at at 13:40):
It’s difficult because we’re doing it using a process call reconciliation. And so, it may have to be, some of the provisions would be in the bill and some–some would not–would follow on…
Just how she envisions getting the 60 votes she’d need for the bits that would “follow on” is unclear. But she’s been in the Senate long enough–having witnessed the year-long saga Harry Reid had to endure to pass the ACA when he had 59-60 Democrats–to know that replacement is not politically possible, making all her efforts to focus attention on her dead-on-arrival bill seem like an elaborate smokescreen, distracting the media, and Americans, from the real imminent threat: repeal without replacement.
We can all happily discuss the merits of the Cassidy-Collins bill, or any other good-faith efforts to repair or improve the ACA to which many Democrats might well be open, but first, Collins and her Republican colleagues must drop the threat of repeal. If they truly wanted to replace or repair the ACA, they could just focus on passing legislation for that without first passing a bill to destroy the whole thing. With repeal, Republicans are threatening to toss a grenade into insurance markets, then ask for help from Democrats in reconstructing them. It’s time to put down the grenade, Senator.
So I’m changing our action item back to asking the Senator to commit to vote against ACA repeal. Though it may take weeks, Collins is gettable on this. If we can get her to oppose the reconciliation bill publicly, it will make it much easier for other R’s to jump ship, too. Nationally, the constituent blow back on ACA repeal is massive and growing, not to mention the push back from insurers, hospital groups, big pharma, and all the other health industry groups who all have a strong interest in keeping the ACA in place. And if we stop ACA repeal, we will throw the entire Republican legislative agenda off track, since they are counting on repealing the ACA taxes on the wealthy to allow them to fund tax cuts for corporations and the wealthy. We Mainers just need to convince the first domino to fall.
Thanks for all you do,
*Just prior to the first reconciliation vote, Collins got press for joining a group of several nervous Republican senators in proposing an extension to the deadline from January 27th to March 3rd, but, in classic scared-of-McConnell fashion, they pulled the amendment before it could actually be voted on.