Republicans in the Senate have been pouring cold water on expectations of producing a health care reform bill anytime soon, but a leading health care expert says the GOP realistically has just over three months to get it done.
“If they’re going to do this with only 51 votes in the Senate, they have to do it by September,” said Galen Institute President Grace-Marie Turner. “Frankly, I think they want to do it before the August recess so that they can get on with the rest of the agenda.”
The can officially start working on the bill now that House leaders have finally sent it to the upper chamber. It was on hold while lawmakers waited on the Congressional Budget Office scoring of the bill to make sure their calculations on how the legislation would impact the deficit were accurate. They were.
Despite moderate Republicans like Sens. Susan Collins, R-Maine, Lisa Murkowski, R-Alaska, and Dean Heller, R-Nevada, saying the House bill was a non-starter for them, Turner suspects the final Senate version will end up looking pretty familiar.
“They will make some changes to the House bill and they will very much call it their own, but I think a lot of those structural elements of the safety net, the bridge to new coverage, the state flexibility on regulations and the Medicaid reform, I think we’re going to see all of that in there,” said Turner.
She says those four components are critical and are in the House bill: providing help for individual market consumers who no longer have reasonable coverage options, creating a transition to a market-based system, giving states more power to define plans and foster competition and changing Medicaid so it doesn’t devour state resources for all other priorities.
Turner says the House crafted it’s bill with Senate rules in mind.
“The House did try very hard to bend over backwards so that it’s version of the legislation complied with Senate rules,” she said. “They didn’t want the Senate to have to change it too much.”
Still, Turner does expect the Senate to spend more tax dollars on providing for people with pre-existing conditions.
“The Senate is going to dial things back in different ways and probably provide even more protections than the House bill did for pre-existing conditions protections. I do think that that has been an inflamed issue that is very much overstated,” said Turner.
“The House bill provided $138 billion to the states to be able to take care of people who have pre-existing conditions and have high health care costs. All evidence is that would be more than enough to do it,” said Turner.
Turner also suspects the Senate may be less conservative in curtailing Medicaid expansion than the House bill. And another issue that GOP moderates are likely to fight is the slashing of tax dollars for Planned Parenthood.
With the House bill passing precariously in May, it’s unclear what impact any substantial Senate changes will have on final passage. But Turner warns the House that whatever they get back from the Senate – if they get anything back from the Senate – may be their one chance to get anything done this year and maybe in this Congress.
“I think everybody knows that whatever the Senate gets through, the House is going to have a very difficult time changing it. I think it’s very likely going to be take it or leave it,” said Turner.
If we get to that point, Turner suspects voter outrage over the possibility of getting nothing done will likely compel passage of an imperfect bill.
“I don’t think any of them want to go back to the voters in 2018 next year and say, ‘Sorry, for four elections we told you we were going to repeal Obamacare and we just kind of couldn’t figure out how to do it.’ They all know they have to figure out how to do it,” said Turner.