The series of events is familiar to anyone who cares about health care: Republicans unveil a plan to repeal the Affordable Care Act; partisans on the right get excited; health care advocates start to panic; the media notes that the bill has momentum; and then the Congressional Budget Office pours a bucket of reality on the whole endeavor.
This time, however, will be a little different. GOP senators are moving forward with Graham-Cassidy -- arguably their worst repeal proposal to date -- but data from the Congressional Budget Office won't save the day this time. The Washington Post reported:
Congress's nonpartisan budget analyst said it is working to provide a "preliminary assessment" of the latest Republican health-care bill by early next week but will not estimate how the measure would affect health insurance premiums or the number of people with medical coverage until later.The notice Monday from the Congressional Budget Office angered Democrats, who planned to use the complete figures to hammer the Graham-Cassidy legislation, which is picking up steam in the Senate ahead of a possible vote within two weeks.
As the New York Times added, under the budget reconciliation process -- the process that allows Republicans to advance their bill with 50 votes instead of 60 -- the legislation will need some kind of cost estimate from the CBO. The budget office intends to comply "early next week," just days before the Senate's health care deadline, with some kind of data.
But unlike the other recent health care fights, this CBO "score" won't say how many Americans will lose coverage under Graham-Cassidy or how much the bill will hurt consumers trying to buy coverage.
To be sure, the CBO could provide senators with those figures, but the data won't be available before the Senate's Sept. 30 deadline. And that leaves Republican leaders with a choice between governing responsibly, with a full understanding of their bill's consequences, or legislating in the dark.
Take a wild guess which approach the GOP is prepared to embrace.
I suppose some of this seems predictable, and the instinct towards cynicism is easy, but it's worth pausing to appreciate the degree to which these circumstances are stark raving mad. The Senate majority is prepared to uproot the American health care system -- roughly a sixth of the world's largest economy -- without a detailed understanding of what their legislation would do.
And that's crazy. It's not how a global superpower is supposed to govern in the 21st century.
And yet, it keeps happening. House Republicans could've waited for a CBO score before passing their health care bill months ago, but they deliberately rushed it so lawmakers wouldn't have a full picture before voting. They at least had some excuse: House members could plausibly say they knew the Senate would change their bill, so the information from the CBO would be dated almost immediately after its release.
Senate Republicans have no comparable claim: given the truncated schedule, they're trying to make this bill -- the one they don't fully understand -- law over the course of two weeks.
We're poised to discover if there are still GOP lawmakers capable of feeling shame.