Health care: Senators look for path forward during CNN debate

CNN held a prime-time debate Monday about something that has essentially already been decided: the GOP’s health care overhaul proposal.

But knowing that the Senate GOP plan appears to be dead before an expected vote this week freed the four senators participating Monday to grasp at something rarely seen in Washington these days: common ground.

In a civil, congenial tone not seen during televised political debates over the past two years, the senators — on opposite sides of the issue — talked about how to move forward in the likely event that the GOP bill known as Graham-Cassidy fails. They addressed each other by their first names, not by “senator” or with juvenile insults, as was common in the GOP primary debates.

This wasn’t how Monday’s 90-minute debate was promoted. For days, CNN teased the program as if it was a prize fight. In one corner were the Republican authors of Graham-Cassidy: Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La. In the other were Sen. Bernie Sanders, independent -Vt., who supports a single-payer, Medicare-for-all plan, and Sen. Amy Klobuchar, D-Minn., who prefers to shore up the Affordable Care Act.

However, it was Sen. Susan Collins, R-Maine, who delivered a technical knockout to the debate’s relevance when she said hours before the program that she would vote no on the bill. With three Republicans — Collins, Sen. Rand Paul, R-Ky., and Sen. John McCain, R-Ariz. — joining all of the the Democrats and independent senators in opposing the bill, Graham-Cassidy does not have the votes it needs to pass.

Graham appeared to allude to this reality several times during the debate, saying, “It’s OK to vote. It’s OK to fall short.”

Later, when asked about McCain, his close friend in the Senate, opposing the bill because it was rushed through with only one hearing and an incomplete analysis from the Congressional Budget Office, Graham addressed his friend watching at home, saying, “John, if we fall short, we’ll try to have a better process” next time. Graham said he wanted to take the process forward because “Obamacare is failing.”

“What I’m not going to do is continue the same old crap and tell you it’s fine,” he said. “The biggest winner under Obamacare was insurance companies, and I intend to change that.”

That prompted Sanders to pop up out of his seat and congratulate him.

“Lindsey is right,” Sanders said. “This system is designed to make billions in profits for the insurance industry.”

In that vein of tentative agreement, Monday’s debate often took on a tone of “what’s next?” as the senators found general agreement on two items: that the ACA needs to be repaired and the cost of pharmaceutical drugs is too high.

But they differed on how to make those changes.

Sanders, who this month introduced a 94-page plan modeled on the single-payer health care found in other countries, called for making it easier to import prescription drugs from Canadian pharmacies.

He wants Medicare officials to use their bargaining power to negotiate with pharmaceutical companies for better prices, a practice that is currently banned. Sanders noted that President Trump has called out pharmaceutical companies for price gouging. “Trump was right” on that, he said.

Klobuchar called for loosening the rules on allowing lower-priced generic drugs into the marketplace. Several times she referred to a bipartisan group of senators — led by Sen. Lamar Alexander, R-Tenn., and Sen. Patty Murray, D-Wash. — who were working together to make fixes to Obamacare. However, that work stalled as Republicans pulled the plug while they focused on Graham-Cassidy.

Cassidy, a physician, more ardently kept trying to prop up his bill, which would eliminate federal marketplace subsidies for people to buy insurance under the ACA and replace them with block grants to the states. States would have two years to set up their own health care systems to replace the current law.

“I trust governors” to make better decisions about health care than “faceless bureaucrats” in Washington, Cassidy said. “When you bring power to the person in the state, good things happen.”

But the congeniality could go only so far. Sanders and Klobuchar derided the Republicans for trying to rush through their legislation with little public scrutiny — only one hearing and no deep analysis from the nonpartisan Congressional Budget Office about its long-term impacts. An early report Monday from the CBO found that “millions fewer” Americans would have health care.

It appears, however, that Graham-Cassidy will not be around long enough for that analysis to occur.

Joe Garofoli is The San Francisco Chronicle’s senior political writer. Email: Twitter: @joegarofoli


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