Primer: What The Senate Health Care Bill Looks Like and Other Things You Need to Know Today | News
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Thursday, June 22, 2017

Primer: What The Senate Health Care Bill Looks Like and Other Things You Need to Know Today

Posted by on Thu, Jun 22, 2017 at 9:54 AM

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Morning, newshounds. I miiiiight have hit snooze a few too many times this morning, so my apologies for getting this posted a little later than usual. —Jeffrey C. Billman

1. HERE’S WHAT THE SENATE HEALTH BILL WILL LOOK LIKE.

THE GIST:
After spending weeks crafting their version of health care reform in secrecy, Senate Republicans plan to finally unveil their bill today, ahead of a planned vote next week. According to reports in The Washington Post and other outlets, it will look a whole lot like the hugely unpopular American Health Care Act that passed the House, with a few tweaks designed to mollify moderates. Like the AHCA, the Senate bill will gut Medicaid while repealing hundreds of millions of dollars in taxes on the wealthy. Unlike the AHCA, it would:
  • Peg subsidies to income, not age, like the Affordable Care Act does.
  • Lower the income threshold for subsidies—from 400 percent of the federal poverty line to 350 percent—but also provide subsidies to everyone not eligible for Medicaid, fixing the gap in states that haven’t expanded Medicaid under Obamacare.
  • Make Medicaid cuts more gradual but also steeper than the House version, possibly forcing states to cut services or coverage and leaving millions of poor Americans without health care.
  • Eliminate House language that would ban subsidized plans from covering abortion (for parliamentarian reasons, so that the Senate doesn’t need sixty votes to pass it).
  • Eliminate Medicaid reimbursements for Planned Parenthood for one year.

WHAT IT MEANS: The Congressional Budget Office is expected to release its analysis of the bill next week. But based on its similarity to the House’s bill—which the CBO projected would cause twenty-three million fewer people to have health insurance in ten years than under current law—the CBO will likely say the Senate plan will cover fewer people than Obamacare. The question will be how many fewer people. After all, the bulk of those who would lose insurance under the AHCA, fourteen million, stemmed from the same Medicaid cuts the Senate will make, albeit more gradually. On the other hand, the Senate’s plan to keep subsidies tied to income rather than age will help many lower-income Americans afford health care, and closing the current Medicaid gap will help as well.

WHAT WE DON’T KNOW: The House version allowed states to seek waivers for Obamacare mandates such as covering preexisting conditions, lifetime caps, and what are called essential health benefits, under the theory that this would lower premiums across the board (primarily by allowing insurers to offer skimpier plans that don’t cover much should you actually get sick). According to the Post, Senate Majority Leader Mitch McConnell has said he wants to keep the preexisting conditions mandate, Obamacare’s most popular feature, but it’s unclear what will happen to other Affordable Care Act regulations.

WHAT’S NEXT: Mitch McConnell has to count to fifty.
  • Nut graph: “But on the eve of the bill’s release, Senate Majority Leader Mitch McConnell (R-Ky.) faced the prospect of an open revolt from key conservative and moderate GOP senators, whose concerns he has struggled to balance in recent weeks. Republicans familiar with the effort said Senate leaders have more work to do to secure the 50 votes needed to pass the measure, with Vice President Pence set to cast the tiebreaking vote, from the pool of 52 GOP senators. No Democrats are expected to support the bill. Republican aides stressed that the plan is likely to undergo more changes to secure the votes needed for passage, but there were major concerns Wednesday from senators on opposite ends of the GOP spectrum.”
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2. NCGA KNEECAPS COOPER, STEIN.

THE GIST:
I touched on this briefly in yesterday’s Primer, but in a pair of stories this morning, The News & Observer takes a deeper dive into the legislature’s attacks on Governor Cooper and Attorney General Josh Stein.
  • Cooper: The budget essentially prohibits the governor from obtaining outside counsel and transfers control of both the Industrial Commission (which hears disputes filed by injured workers) and an education grant program from the governor’s office to the departments of insurance and public education, both of which are currently controlled by Republicans.
  • Stein: Even though the legislature is now requiring Cooper to use the attorney general’s office in any and all litigation, the budget cuts $10 million from the Department of Justice, which will force the new AG to lay off half of his attorneys. (The legislature could still hire outside attorneys.)
WHAT IT MEANS: You almost have to admire the Republicans’ audacity. They lost an election, then spent December hacking away at the incoming governor’s authority. And now, following a string of high-profile court battles—school vouchers, voter ID, redistricting, “Right to Choose” license plates—they’re rather brazenly trying to render the executive branch effectively impotent in weighing in on disputes like these, all the while saying this is about budget priorities, not politics.

Related: Senator Dan Bishop believes the N&O is part of the “jihad media,” whatever that means.

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3. BRUNCH BOOZE BILL GETS WATERED DOWN.

THE GIST: Having already shafted craft breweries who were seeking to circumvent wholesalers, the legislature is now turning its attention on the so-called Brunch Bill, which would enable restaurants to begin serving alcohol at ten a.m. on Sundays instead of noon, with local governments’ permission. But yesterday, the House Alcoholic Beverage Control Committee stripped from that bill language that would allow grocery stores to begin selling beer at ten a.m. as well.

UPSHOT: A provision allowing craft distilleries to sell up to five bottles to visitors to their facility a year, up from one currently. Also, craft breweries located on farms in dry counties will be able to sell beer on their farms if the local government issues a permit.

HOT TAKE: Blue laws are pointless, and this entire debate makes no sense to me.
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4. DEMS REEL AFTER GEORGIA LOSS.

THE GIST: Both The Washington Post and The New York Times have stories today looking at Democrats’ self-flagellation after narrowly losing the special election in the Georgia Sixth Tuesday. In the Post’s version, some Dems are rethinking their support for Nancy Pelosi as head of the party caucus, as Republicans have turned her into a boogeyman. In the Times, there’s some hand-wringing about Pelosi but also an emphasis on the need to drive an economic message that resonates.
  • Money quote 1: “I don’t know what we’d do without Pelosi. I hope she never retires. Another Democratic leader would not start with that level of name recognition.” —Corry Bliss, executive director of the Republican super PAC Congressional Leadership Fund.
  • Money quote 2: “It’s not enough to say, ‘I want jobs.’ You need more than that, particularly when you’re competing with a guy who is telling fantasies.” —U.S. Representative Jim Hines, D-Connecticut.
WHAT IT MEANS: The freakout is as predictable as sunrise, given that Dems have gone 0 for 4 this year in special elections. And yes, the Democrats certainly do have some things they need to sort out if they want to reclaim the House next year. But some perspective is needed. As Jonathan Chait writes for New York, “The reason the party has lost all four special elections is glaringly simple. It is not some deep and fatal malady afflicting its messaging, platform, consultants, or ad spending allocation methods. Republicans have won the special elections because they’ve all been held in heavily Republican districts.”

Related: Trump held a campaign rally in Iowa last night in which he complained about “phony witch hunts going against me.” He also pledged his support for a new law that would prohibit immigrants from receiving welfare benefits for at least five years—though that’s been the law since 1996.
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5. FOUR LOCAL HEADLINES.
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6. ODDS & ENDS.
Primer this week is sponsored by the Raleigh Flyers, the Triangle’s professional Ultimate Disc team. On Saturday night, they’ll take on the Jacksonville Cannons in their final home game of the regular season. Click the image below to purchase your tickets today.

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