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The ACA is a bipartisan solution to healthcare

posted by Jason Kottke   Sep 22, 2017

Arizona Senator John McCain has publicly come out against the latest Republican attempt to repeal the ACA. His statement begins:

As I have repeatedly stressed, health care reform legislation ought to be the product of regular order in the Senate. Committees of jurisdiction should mark up legislation with input from all committee members, and send their bill to the floor for debate and amendment. That is the only way we might achieve bipartisan consensus on lasting reform, without which a policy that affects one-fifth of our economy and every single American family will be subject to reversal with every change of administration and congressional majority.

I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment. But that has not been the case. Instead, the specter of September 30th budget reconciliation deadline has hung over this entire process.

Many opponents of the ACA repeal are hailing McCain as a hero for going against his party leadership on this issue. I don’t see it — he’d still support a bill like Graham-Cassidy that would take away healthcare coverage from millions of Americans if only it were the result of proper procedure — particularly because of what he says next (italics mine):

We should not be content to pass health care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009.

This is false. The NY Times’ David Leonhardt explained back in March during another Republican repeal effort:

When Barack Obama ran for president, he faced a choice. He could continue moving the party to the center or tack back to the left. The second option would have focused on government programs, like expanding Medicare to start at age 55. But Obama and his team thought a plan that mixed government and markets — farther to the right of Clinton’s — could cover millions of people and had a realistic chance of passing.

They embarked on a bipartisan approach. They borrowed from Mitt Romney’s plan in Massachusetts, gave a big role to a bipartisan Senate working group, incorporated conservative ideas and won initial support from some Republicans. The bill also won over groups that had long blocked reform, like the American Medical Association.

But congressional Republicans ultimately decided that opposing any bill, regardless of its substance, was in their political interest. The consultant Frank Luntz wrote an influential memo in 2009 advising Republicans to talk positively about “reform” while also opposing actual solutions. McConnell, the Senate leader, persuaded his colleagues that they could make Obama look bad by denying him bipartisan cover.

Adam Jentleson, former Deputy Chief of Staff for Senator Harry Reid, said basically the same thing on Twitter:

The votes were party-line, but that was a front manufactured by McConnell. He bragged about it at the time. McConnell rarely gives much away but he let the mask slip here, saying he planned to oppose Obamacare regardless of what was in the bill. Those who worked on and covered the bill know there were GOP senators who wanted to support ACA — but McConnell twisted their arms. On Obamacare, Democrats spent months holding hearings and seeking GOP input — we accepted 200+ GOP amendments!

For reference, here was the Senate vote, straight down party lines. Hence the “ramming” charge…if you didn’t know any better. Luckily, Snopes does know better.

According to Mark Peterson, chair of the UCLA Department of Public Policy, one easy metric by which to judge transparency is the number of hearings held during the development of a bill, as well as the different voices heard during those hearings. So far, the GOP repeal efforts have been subject to zero public hearings.

In contrast, the ACA was debated in three House committees and two Senate committees, and subject to hours of bipartisan debate that allowed for the introduction of amendments. Peterson told us in an e-mail that he “can’t recall any major piece of legislation that was completely devoid of public forums of any kind, and that were crafted outside of the normal committee and subcommittee structure to this extent”.

The Wikipedia page about the ACA tells much the same story.