Almost No One Knows What’s in the Senate’s AHCA Bill

Since it’s being predicted that the Senate will soon vote on the Affordable Health Care Act, we wanted to give you a quick rundown of how that bill might impact people with Type 1 diabetes. But we can’t, because almost no one knows anything about what will be in the proposed Senate version of the AHCA legislation.

A handful of Republican senators are working in secret on the legislation to repeal the Affordable Care Act (ACA) and not sharing details of the legislation with their Republican colleagues, according to a June 12th report in USA Today. In the report, Senator Lindsey Graham (R-NC) and Senator Bill Cassidy (R-LA), certainly no GOP backbenchers, were quoted as saying they had not yet seen the legislation.

Health and Human Services Secretary Tom Price was asked in a June 15th hearing by Senator Dick Durbin (D-IL) if he had seen the proposed language for the bill, according to an Axios Facebook video post. Secretary Price responded to the question with a three-clause sentence: “I’ve had multiple conversations with senators who are interested in making certain that we have a health care system that works for patients, my staff has provided technical assistance, I haven’t seen any legislative language.”

Senator Durbin then retorted, “You haven’t seen it? You haven’t seen it, either?”

Read more: What the MacArthur Amendment in the AHCA Means for People with Diabetes

The lack of information about the bill is, perhaps predictably, upsetting the Democratic caucus in the Senate, who are on the whole opposed to efforts to repeal and replace the ACA. In the clip below, Senator Claire McCaskill (D-MO) expresses flabbergasted dissatisfaction after Senator Orrin Hatch (R-UT) said he wasn’t sure if the Senate Finance Committee would have a hearing on the AHCA before a vote.

The lack of details is also upsetting key patient and consumer advocacy groups, and they aren’t waiting for the release of legislation to take action. The American Diabetes Association joined seven other consumer, medical, and patient advocacy groups, including AARP and the American Medical Association, in staging events across the country “to highlight the need to protect patient access to affordable and adequate care as the health debate continues in Washington, DC.”

“People with diabetes need ongoing care to manage their disease and avoid complications. The American Health Care Act would be devastating for millions of Americans,” said LaShawn McIver, ADA’s vice president of government affairs in a press release. “We are proud to join our partners in encouraging the Senate to reject its dangerous provisions and develop viable, long-term solutions that protect affordable access to quality care, especially for people with diabetes.”

In May, House Republicans succeeded in passing their version of the AHCA, and the feat was celebrated in a Rose Garden ceremony hosted by President Donald Trump. Patient and physician advocate organizations have been nearly universal in their condemnation of the measure, chiefly because it would undo the recent expansion of Medicaid. It would also give states the option to allow insurers to charge more for older Americans and for those with preexisting conditions, and decline to offer coverage for what are now considered essential health benefits. The Congressional Budget Office predicts the House version of the AHCA bill will eventually leave 23 million more Americans uninsured than the ACA, while a Medicaid actuary said that number would be closer to 13 million, according to a report in Vox.

Read more: What the CBO Grade of the AHCA Means for People with Diabetes

After the House version passed, it had been predicted that Senate Republicans would largely craft their own version which would mellow out the harsher parts of the legislation. Republicans face a daunting calculus in the Senate, even though they may only need a simple majority to pass the AHCA. Republicans control just 52 of the 100 seats in the Senate, with Vice President Pence available to vote in the event of a tie. The drafters of the AHCA legislation must somehow come up with legislative language that appeals to both the right wing and the moderate wing of the Republican caucus, and Republicans can only afford three defectors in the final vote if the other 46 Democrats and 2 independents in the Senate vote as a bloc to oppose the bill.

Republican Senate leadership and the Trump administration are pushing for a vote on the AHCA as soon as possible. The Trump administration, eager for a legislative win while engulfed in scandal, wants to sign the AHCA into law before the summer’s out, so the focus can then move on to tax reform, according to a CNBC report. Meanwhile, Republican lawmakers are said to want a vote before July 4th, according to an Axios report.

Recently, President Trump said during a lunch meeting on the AHCA that he thought the House version of the AHCA was “mean” and that he hoped the Senate bill would be a bit more “generous,” according to a New York Times report. In the Rose Garden ceremony, Mr. Trump said the House version was a “great plan” and incredibly “well-crafted” according to the Times report. It’s unclear how this flip-flop, or the widening scandal involving the Trump campaign’s alleged collusion with Russia during the 2016 election, will affect the AHCA’s chances in the Senate.

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Craig Idlebrook is a past editor for Insulin Nation, Type 2 Nation, and Información Sobre Diabetes. He is now the community engagement and content manager for T1D Exchange.

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