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Senators still don't know what health care bill they're voting on

When Congress passes a bill to rename a post office, it takes more care than this.
The dome of the U.S. Capitol Building is reflected in a puddle on a rainy morning in Washington.
The dome of the U.S. Capitol Building is reflected in a puddle on a rainy morning in Washington.

Last week, when Senate Republican leaders announced plans to begin a series of health care votes today, their schedule immediately became the subject of ridicule. Senate Majority Leader Mitch McConnell (R-Ky.) knew he wanted the legislative fight to begin in earnest on the chamber floor, but just days ahead of the showdown, no one -- including McConnell and his members -- had any idea what they'd be voting on.

As of today, with just hours remaining before the floor process gets under way, that mockery has led to genuine and widespread bafflement. As Dylan Scott explained, senators still don't know.

Senate leaders are bent on holding a vote. But after the plan was drafted in secret, it now needs substantial revisions under the Senate budget rules. And yet the White House and GOP leadership insist on forcing members to vote on Tuesday.It is an unprecedentedly opaque process to try to pass legislation that overhauls an industry worth more than $3 trillion, which would undercut a law that has extended health coverage to more than 20 million middle-class and low-income Americans in the past seven years.... [As] the vote approaches, there is no final text, no Congressional Budget Office score.

The scale of this absurdity has no precedent in the American tradition. The Huffington Post, noting that the United States Senate used to describe itself as "the world’s greatest deliberative body," explained quite accurately that the institution "gives more care and consideration to bills renaming post offices than it has to legislation with staggering consequences for the health care system."

Making matters worse, some members not only don't know what they'll be voting on; they also don't care. Sen. Richard Burr (R-N.C.), asked about not know the specifics of his own party's plan, said yesterday, "It doesn't concern me. As I said, I'll vote for anything"

An inspiring approach to modern governing in a global superpower, to be sure.

What we have is some basic understanding of how the process will begin. There will apparently be a procedural vote this afternoon -- on what's called a motion to proceed -- that will need 50 votes. Technically, this will be the House health care bill, but the Senate is really just using that legislation as a vehicle and the plan is to replace its text with a Senate alternative.

As recently as yesterday, there were some doubts about whether GOP leaders would even be able to clear this initial hurdle, but with Sen. John McCain (R-Ariz.) returning to the chamber, and Sen. Rand Paul (R-Ky.) agreeing this morning to vote with his party on this preliminary step, Republicans seem well positioned to get the votes they'll need.

This won't have any meaningful impact -- it's just a procedural vote -- but it will prevent the GOP gambit from dying a quick and early death.

At that point, we think Republicans will consider a series of amendments on alternative proposals, none of which is expected to pass. Why bother? Because McConnell and GOP senators would basically be going through the motions.

In theory, those votes would be the precursor to the vote on the final, official health care proposal, backed by the Senate Republican leadership, but as of right now, that doesn't appear to exist.

The latest chatter is about something called a "skinny" repeal bill, which basically involves eliminating a few specific parts of the Affordable Care Act that Republicans have convinced themselves they don't like. From NBC News' report:

The plan after those two votes, according to sources, is for senators to proceed to votes on a series of amendments to create what leadership has called a “skinny” repeal with the goal of eliminating Obamacare's individual mandate penalty, employer mandate penalty and the tax on medical devices.Such an approach would do real and systemic harm to health care market, but Mitch McConnell apparently believes this, if nothing else, can probably get 50 votes.

And then what? The original plan in Republican circles was for the House to simply take up the House bill, as-is, ending the fight and sending a bill to Donald Trump to become law. The latest chatter, however, suggests that if the Senate can pass nothing but a "skinny" repeal bill, the House and Senate would go to a conference committee to resolve the differences between the chambers and craft one final health care bill to be approved by both chambers.

If today's motion to proceed fails, the mess will end. If it passes, the mess is likely to continue for a while.