The Senate Health-Care Vote Is A Travesty

When future historians look back on the early decades of the
twenty-first century in America, they will have many tragic and
troublesome episodes to dwell on: the hanging chads of Palm Beach
County, the invasion of Iraq, the passage of the Patriot Act, the
Citizens United ruling, the Republican-controlled Senate’s refusal to
grant Supreme Court nominee Merrick Garland a hearing, and the election of
Donald Trump and his subsequent dumbing down and demeaning of the
Presidency.

In this chronology, Tuesday’s health-care vote may also figure
prominently: it could well be remembered as a historic abuse of the
legislative process that the Founders spent so much time and energy
constructing. Mitch McConnell, the Senate Majority Leader, is asking his
colleagues to vote blindly and authorize consideration of a
health-care-reform measure that could dramatically affect the welfare of
tens of millions of Americans and shake up roughly a sixth of the U.S.
economy.

Officially, McConnell is presenting a “motion to consider” the American
Health Care Act of 2017, the bill that House Republicans passed in May.
But the motion is really just a way to start debate on a Senate version
of the reform measure—a version no one knows anything about. McConnell
is refusing to say what the bill under consideration will look like. It
could be the revised version of the Senate G.O.P.’s bill to repeal and
replace Obamacare, which was widely thought to have perished early last
week. Or it could be the repeal-only bill that was widely thought to
have died late last week. Or it could be some other proposal, or
many others, depending on how many senators are allowed to offer
amendments and put forward their own pet plans.

McConnell is refusing to clarify what he intends to do because he and
his colleagues in the Republican leadership believe that keeping things
uncertain gives them the best chance of bringing on board some of the
moderates and conservatives who scuttled their previous efforts. “We
have no earthly idea what we will be voting on tomorrow other than that
it’ll be moving to the House bill,” Senator Rand Paul, of Kentucky, who
was one of those conservatives dissidents, told Fox News on Monday. “But
everybody knows it’s not really going to be the House bill.”

It is a ludicrous situation, and one that makes a mockery of the idea of
the Senate as a hifalutin deliberative body. No major bill in recent
history has been railroaded through the upper chamber in such a
manner—conceived of and written in secret, and subject to no markups or
committee hearings. If McConnell were to succeed in getting some sort of
bill passed, it would be a travesty.

About the only thing that can be said for the lawmakers who brought
things to this juncture is that they have been pretty open about their
intentions. Indeed, they appear to wear their cynicism with pride.
“We’re trying to maximize the number of votes,” Senator John Cornyn, the
Majority Whip, told reporters on Monday. “What we’re trying to do is
convince everybody that if they’d like to get a vote on their amendment,
then they need to vote to proceed to the House bill.”

Senate Republicans, one would hope, haven’t descended so far that they
would fall for this ruse, and Paul, for one, said that he wouldn’t. “I don’t
think we should move to the bill with so many unknowns unless we’re
going to be told what exactly we’re going to move to,” he said. Maine’s
Susan Collins, one of the moderate Republican dissidents, also indicated
that she was likely to vote against the motion. There were reports that
Lisa Murkowski, of Alaska, was also going to vote no, but it later
emerged that she was still undecided. If three Republican senators
oppose the motion to proceed, it will fail. (The Republicans have a
majority of just two.)

It was clear by early Tuesday that the G.O.P. leadership and the White
House were making an effort to rally party loyalists and cajole the
holdouts. McConnell was said to be willing to sweeten the pot for
Republicans concerned about slashing Medicaid by adding back some two
hundred billion dollars of spending for the federal program. Trump,
meanwhile, spent some of Monday afternoon in West Virginia with the
state’s junior senator, Shelley Moore Capito, whose vote will be
crucial. And on Monday night, John McCain, stricken with brain cancer,
gave the party leadership a boost by announcing that he would return to
Washington for the health-care vote, in which he will almost certainly
join the yeas.

Thankfully, the opponents of the Republican designs—which, let us not
forget, could lead to at least twenty million Americans losing their
health-insurance coverage, and countless others ending up with skimpier
plans and astronomical deductibles—are also rallying. Democratic
politicians and activists are fired up and engaged, as are organizations
representing the people and interest groups that the reform would
affect. On Monday night, the American Association of Retired Persons,
which has about thirty-eight million members, called on all senators to
vote against the motion to proceed.

But this looks like a close one—perilously close given that opinion
polls show that a large majority of Americans prefer keeping Obamacare to
adopting any of the Republicans plans. If the vote goes McConnell’s way,
it will be another sign that American democracy is failing.

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