UPDATE: Good news! The Senator has now come out against the Trumpcare bill! She is only opposing it “in its current form,” however, and is holding out hope that it can be revised enough for her to support it. Thanks to all who called and acted to move her in the right direction on this! We don’t want to let up the pressure entirely until ACA repeal gets taken off the table, but for now I’m revising the action item to be thanking her for coming out against the AHCA, and urging her to oppose any further efforts at ACA repeal.
I was on a business trip this week that made it very difficult for me to keep up with political news, and I clearly picked the wrong week! I’ve now caught myself up–at least on the health care front, where I think constituent pressure has the greatest potential to do the greatest good right now–and I want to take a stab at explaining where things stand.
After weeks of speculation about what the ACA repeal & replacement bill might look like (including Collins’ own not-entirely-awful bill which was always DOA due to its need for 60 votes), Republican leaders have finally decided on a revised plan for repealing the ACA: rapidly ram it through the House in a form that could pass the Senate with only 50 votes, then immediately take it to the Senate floor before the early April recess and dare Senate R’s to get in the way of the runaway train delivering their #1 policy goal. Given how slowly health legislation is supposed to be developed, and how much of a political quagmire health care reform is in this country–seven Presidents tried to do it before Barack Obama finally succeeded with the help of congressional supermajorities–this seems a hail mary pass strategy on the part of Paul Ryan and Mitch McConnell. But with the bill triggering $600 billion in tax cuts to the wealthy and enabling a massive $2.4 trillion in further tax cuts to the wealthy, there is definitely a chance that 50 Senate R’s will fall in line and it will pass.
The Ryan/McConnell gambit is truly extraordinary in the degree to which it is tossing aside the norms of the traditional legislation process. The bill–now known as the AHCA–was drafted in secret, with only certain House Republicans allowed to see it last week before its public announcement on Monday. Instead of getting deliberated and revised in House committees for months as was done with the ACA, the bill passed both its key House committees on party-line votes on Thursday, only three days after its unveiling. Next week, the bill will be voted on in the House Budget committee, followed by a vote in the full House by the end of the month. Incredibly, Mitch McConnell has even suggested that he may bring the House bill directly to the Senate floor for a vote, bypassing revisions and votes in the Senate HELP (on which Collins sits) and Finance committees. Finally, the Congressional Budget Office has not even completed its score of the bill to estimate how many people would be covered and at what cost, a step that has historically been fundamental to how bills take shape.
The strategy of racing forward with the bill’s passage is largely because the bill stinks. No one likes it. Even without the official CBO score, the consensus is that it will result in many millions fewer people having health coverage, and that older, poorer, and more rural Americans in particular will be much worse off. Many economists believe the AHCA’s current language will trigger a death spiral in insurance markets. The only people who are better off under the bill are the wealthy, to whom will flow $600 billion in tax cuts.
So where is Collins on all this? She sat with Katie Couric two days after the AHCA bill was released and admitted she “wasn’t crazy about it” but wanted to reassure America that it was very much a “work in progress.” She is clearly hoping to slow the legislative process down and improve the bill, but still seems supportive of repealing the ACA in general, which she falsely suggests is already “in a death spiral in many states” (at 2:20 in the interview). It seems as though she’s sat in so many caucus meetings over the years where she’s been fed negative Republican talking points about the ACA that she’s incapable of seeing it as the largely successful policy it has been. Some reverse-brainwashing from constituents who have benefited from the law is desperately needed.
The good news is that the AHCA is in danger of losing Senators on the right, too, with Paul and Lee signaling displeasure with the bill, Cruz needing serious convincing, and many House Republicans in danger of withdrawing their support if the measure to halt Planned Parenthood funding is removed–something that would likely be necessary to win over Collins and Murkowski. This all means that finding a final bill that 50 Senators will vote for is going to be extremely difficult.
Collins is not likely to take a clear position on the AHCA bill until 1) it’s been scored by the CBO and 2) it’s been passed by the House, both of which will likely occur in the next two weeks. If we can persuade Collins to come out against the AHCA early, the bill will most likely fail, which will in turn grind the Ryan/McConnell/Trump legislative agenda to a halt.
So let’s get to work and start calling on Collins to oppose the AHCA bill!
Thanks for all you do,