GOP Senators Avoid Angry Constituents During July Recess

Published in Woonsocket Call on July 9,2017

With Senate Republican leadership pulling their health care bill, titled “Better Care Reconciliation Act of 2017,” scheduled for vote before the Fourth of July recess, because they were unable find 50 votes, opponents continue their lobby against an anticipated rewrite of the unpopular Senate bill. Mobilization to oppose passage of a GOP health care bill began immediately after the House passed its legislation, titled “The American Health Care Act” in May.

“It is essential that all of those who oppose this dangerous bill have their voices heard,” said Richard Fiesta, Executive Director of the Alliance for Retired American, one of many aging groups mobilizing its membership during the Fourth of July recess. “The fact that most Republicans in the Senate are too afraid to show up in public should tell you everything you need to know. The Senate bill is dangerous to all Americans, particularly older Americans, and must be stopped,” he said.

Lawmakers Choose to Not Face Angry Constituents

Throughout the nation, thousands of constituents of GOP senators made it clear to their lawmakers returning to their home districts, “vote no on the Senate version of the healthcare bill,” that would repeal and replace President Obama’s Affordable Care Act of 2017 (ACA), popularly, called Obamacare. Opponents of Trumpcare held sit-ins (referred to as die-ins) to remind their GOP Senators that 22 million low-and medium-income Americans would lose their health coverage with the slashing of $800 billion from Medicaid, warning that there would be a significant increase in premium costs.

According to the Town Hall project, between January to May, 33 GOP senators have not held a single in person town meeting this year, these lawmakers choosing not to face angry constituents who oppose the Senate health care bill. During this 11-day recess, most Republican senators chose not to hold town meetings, most skipping their community’s Fourth of July parades, to keep away from hostile crowds.

But, Moderate GOP Sen. Susan Collins, of Maine, appeared at Fourth of July parade in Eastport, Maine and was overwhelmingly thanked for her opposition to the Senate health bill. At the parade, the Washington Post stated that spectators urged Collin’s “to stay strong” in opposing the GOP Senate’s version of the health care bill. The Post noted that only three other Republican senators, Ted Cruz, of Texas, Dean Heller, of Nevada, and Lisa Murkowski, of Alaska, also appeared in their community’s Fourth of July parades.

Seeing the Writing on the Wall

Political reality is now setting in for Senate Majority Leader Mitch McConnell, of Kentucky, who has shifted his position on repealing Obamacare if he cannot pull the 50 votes necessary to pass his health care bill. With all Democratic and Independent senators in their caucus opposing passage of the bill, GOP senate leadership can only afford the defection of two Republican senators if they want their bill to pass. Can he revise this legislation to satisfy the concerns of moderate and conservative members of his caucus to ensure passage?

The Washington Post reported, last Thursday, at a Kentucky Glasgow Rotary Club lunch, McConnell admitted to the attending Rotarians that Republicans would have to work with Democrats to stabilize the health insurance markets if they failed to pass the Senate bill.

As predicted with the GOP senators returning from recess, facing angry constituents, a growing number are now publicly withholding their support for the senate bill. At press time, there have been multiple reports that ten senators are now opposing the legislation.

“There have been little to no senator-level discussions on amendments to the Senate health bill during the July recess,” says Dan Adcock, Director of Government Relations and Policy for the National Committee to Preserve Social Security and Medicare (NCPSSM). He expects more negotiations to take place when the Senate reconvenes this Monday.

Adcock says, “there would be a delay between an announced “compromise” bill and Senator floor consideration since the Congressional Budget Office would first need time to perform a cost estimate on the amended sections of the bill.”

Senator Cruz’s Fix for Senate Health Bill?

According to Adcock, that is being most talked about in the corridors of the Capitol is Sen. Ted Cruz’s proposal to replace the existing language in Senate bill — that would allow insurance companies to pick and choose which Obamacare essential benefits they would offer — with a plan to require that insurance carriers offer at least one plan with Obamacare essential benefits and all other plans could decide which benefits to include and exclude.

But, Adcock sees a multitude of problems with the Cruz proposal, making it difficult to be inserted into a final Senate health bill.

“First, it really is not that different from the current language that allows insurance companies to offer plans without the required ACA essential benefits,” says Adcock. “Under the Cruz proposal, healthy people would enroll in health plans that aren’t required to cover all ACA essential benefits, while sick people or enrollees with pre-existing conditions would tend to enroll in plans with all of the ACA essential benefits. As a result, the latter plans would be very expensive and unaffordable for less healthy enrollees,” he says.

Adcock estimates that Texas Senator’s proposal and the Senate health bill’s essential benefits waiver provisions would be particularly harmful to the 40 percent of enrollees age 50 to 64 who have one or more pre-existing condition.

“Second, there is a good chance that the Senate Parliamentarian will rule that the Cruz proposal violates Budget Reconciliation rules because it is superfluous to reducing federal spending,” says Adcock, noting that if this happens his proposal in the form of an amendment would face a 60-vote point of order. The Senate Republicans do not have the 60 votes they need to waive this budget rule.

Another point that is being negotiated between Senate leadership and moderate and conservative senators is provisions that would restructure federal payments to state Medicaid programs, says Adcock, noting that the Senate bill and House-passed healthcare bills would restructure the way federal funding is provided to the states – changing from the current matching rate formula to per capita caps or block grants at state option.

Medicaid Cuts Hit LTC Sector

“Per capita caps limit federal funding for state Medicaid programs to an arbitrary per beneficiary funding level. This would ultimately shift costs to states by eliminating the guarantee of additional federal funds if state costs increase because of underlying health care costs, demography or complexity of care. We are particularly concerned about how these cuts would affect Medicaid long-term care coverage – both home and community and nursing home care,” Adcock added.

Adcock also sees other negatives of the draft Senate health care bill.

“From the year 2025 on, the senate bill bases the per capita cap on an even less generous measure than the House bill. While the House bill used a measure based on medical inflation, the Senate bill would allow Medicaid to grow only at the rate of general inflation. Medical inflation has historically grown at a higher rate than general inflation. And, even the index used in the House-passed AHCA would be unlikely to keep up with growth in health care costs,” notes Adcock.

Adcock added, “some moderate Republican senators object to linking Medicaid payments in 2025 and thereafter to general inflation. However, Sen. Pat Toomey – who drafted this provision – does not want to compromise on it.”

And, Sen.Portman and Capito also continue to express interest in increasing funding for Opioid substance abuse treatment, adds Adcock. The Senate health bill includes $2 billion for this purpose. Portman has called for $40 billion for treating Opioid addictions, he says.

With senators returning to Washington, D.C., after their roughly one-week Fourth of July recess, there are only 14 legislative working days before their month-long August recess begins on July 28 with their return Sept. 5.

Recently, ten Senate Republicans have called on Senate Majority Leader McConnell to cancel the upcoming August recess to allow them to focus on five priorities: fixing health care, funding the federal government by Oct.1 to avoid a shutdown, dealing with the debt ceiling, passing the budget resolution and improving the nation’s tax code.

This will not likely happen due to the Senate’s legislative workload.

According to Adcock, the Senate either needs to approve its health care bill or abandon it by the upcoming August recess because the repeal of Obamacare is holding up consideration of the FY 2018 budget resolution and tax reform.

“That’s because the Senate healthcare bill is being considered in the form of the FY 2017 budget reconciliation bill. There cannot be a conference agreement on the FY 2018 budget reconciliation bill until the FY 2017 budget reconciliation is either enacted or abandoned,” he says.

Finally, Adcock notes, “A conference agreement on the FY 2018 budget resolution is necessary to set in motion consideration of a FY 2018 budget reconciliation bill that would include tax reform and perhaps cuts to mandatory spending programs, like Medicare and Medicaid. Budget reconciliation bills are filibuster-proof in the Senate.”

Calling for Political Compromise

A recently released USA Today/Suffolk University poll at the end of June says that “just 12 percent of Americans support the Senate Republican health care plan. On the other hand, “a 53 percent majority say Congress should either leave the law known as Obamacare alone or work to fix its problems while keeping its framework intact.”

So, now it’s time for the White House and Congress to read the political winds. Americans want health care fixed for the right reasons, not for political reasons. Lawmakers must put aside their philosophical differences and craft a “win-win” compromise to fix Obamacare’s flaws.

It’s the right thing to do.

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Senate Health Bill Vote Expected Next Week

Published in Woonsocket Call on June 25, 2017

The long-awaited Senate health bill text crafted by a group of 13 GOP senators (all male) appointed by Senate Majority Leader Mitch McConnell of Kentucky to replace and repeal President Obama’s Affordable Care Act of 2017 (ACA), popularly, called Obamacare, was unveiled days ago. Republican lawmakers have worked for over seven years to dismantle the Democratic president’s landmark health care law. Supporters say that ACA brought health care coverage to an estimated 20 million Americans, covered between marketplace, Medicaid expansion, young adults staying on their parent’s plan, and other coverage provisions. Critics charge that Obamacare imposed too many costs to business owners.

Minority Leader Chuck Schumer and Senate Democrats lashed out at GOP Senate leadership charging that the Senate health bill, titled “Better Care Reconciliation Act of 2017,” was written behind closed doors without a single committee hearing being held or draft bill text being circulated to the public. Some Republican senators also expressed frustration for not seeing the details of the GOP bill before its release on June 22, 2017.

Like Senate Democrats, Health and Human Secretary Tom Price was left in the dark, too. At a Senate hearing before the release of the Senate bill the Trump Administration’s top health official stated that he had not seen any legislative language.

Senate Health Bill “Meaner” than House Version

Despite President Trump’s campaign pledge not to touch popular entitlement programs, like Medicare and Medicaid, he strongly endorsed the House Republican passed health bill, the American Health Care Act of 2017 (AHCA). At the eleventh hour, Trump twisted the arms of reluctant GOOP House members to gain their support of the controversial health care bill. Celebrating the passage of AHCA at the White House Rose garden, the president told the attending Republican lawmakers and guests that the GOP health bill was a “great plan,” adding that it was “very, very, incredibly well-crafted.” It was reported weeks later, after a closed-door luncheon with 15 Republican Senators, Trump had called AHCA “mean” and urged the attending Senators make their legislative proposal “more generous.”

With the release of the Senate health bill, Senate Minority Leader Schumer called the bill “meaner” than the House passed version, stressing its negative impact was far worse than AHCA. Trump called the House health bill “mean.” Schumer views the Senate’s version “meaner.”

GOP Senate leadership is pressing for a floor vote before the upcoming July 4th Congressional recess. To meet this deadline, this vote must take place by the end of next week, either Thursday or Friday, after 20 hours of debate. Early next week the Congressional Budget Office will release its score, detailing cost and coverage impact, on the Senate health bill. Moderate Republican senators might just be influenced not to vote for the bill if reduces health coverage for millions of Americans.

It usually takes 60 votes to pass a bill in the Senate. But, GOP Senate leadership is using a technical parliamentary procedure, referred to as reconciliation, to allow the Senate health bill to pass with only 50 votes, including the Vice President as a tiebreaker.

At press time, there are four conservative senators (Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah and Ron Johnson of Wisconsin) and one moderate senator (Dean Heller of Nevada)., who have publicly expressed their opposition to the Senate health bill. With all Democratic and Independent senators in their caucus opposing passage of the bill, GOP Senate leadership can only afford the defection of two Republican senators if they want their bill to pass.

Meanwhile, a 100-year old organization, Planned Parenthood, is gearing up to fight a provision of the Senate health bill that would cut $555 million in funding. Two moderate GOP Senators, Susan Collins of Maine and Lisa Murkowski of Alaska, are on the fence voting for the bill if cuts are made to Planned Parenthood.

Aging Groups See Writing on Wall if Senate Passes Health Bill

The released 142-page GOP Senate health bill, written hastily behind closed doors, will overhaul the nation’s health care system, impacting on one-sixth of the nation’s economy. Dozens of aging, health care and medical groups, including AARP, National Committee to Preserve Social Security and Medicare (NCPSSM), the American Medical Association, and the American Hospital Association, are voicing their strong opposition to the GOP Senate’s health care fix.

And this list keeps growing as next week’s Senate vote approaches.

The Washington, DC-based AARP, representing a whopping 38 million members, vows to hold GOP Senators accountable for a bill that hurts older Americans. The nonprofit group charges that “the legislation imposes an “Age Tax” on older adults – increasing health care premiums and reducing tax credits [that made insurance more affordable under Obamacare], makes cuts to both Medicaid funding, and yet gives billions of dollars in take breaks to drug and insurance companies.”

“AARP is also deeply concerned that the Senate bill cuts Medicaid funding that would strip health coverage from millions of low-income and vulnerable Americans who depend on the coverage, including 17 million poor seniors and children and adults with disabilities. The proposed Medicaid cuts would leave millions, including our most vulnerable seniors, at risk of losing the care they need and erode seniors’ ability to live in their homes and communities,” says
AARP Executive Vice President Nancy LeaMond, in a statement.

“The Senate bill also cuts funding for Medicare which weakens the programs ability to pay benefits and leaves the door wide open to benefit cuts and Medicare vouchers. AARP has long opposed proposals that cut benefits or weaken Medicare, adds LeaMond.

LeaMond says, “As we did with all 435 Members of the House of Representatives, AARP will also hold all 100 Senators accountable for their votes on this harmful health care bill. Our members care deeply about their health care and have told us repeatedly that they want to know where their elected officials stand. We strongly urge the Senate to reject this bill.”

Another Washington-DC based organization, the National Committee to Preserve Social Security and Medicare, an advocacy group whose mission is to protect Social Security and Medicare, issued a stinging statement criticizing the Senate health bill.

“The Senate’s version of AHCA is an exercise in political expediency that does nothing to safeguard access to quality healthcare for older Americans. President Trump rightly called the House-passed bill ‘mean’ and lacking ‘heart.’ Unfortunately, the Senate bill is only marginally less mean in some ways, and even more heartless in others, says Max Richtman, President & CEO of the National Committee to Preserve Social Security and Medicare.

Adds, Richtman, “The Senate health bill is “a lose-lose for seniors and the American people. The biggest loss is that the AHCA ends the Medicaid program as we know it. Astoundingly, the Senate bill makes even deeper cuts to Medicaid than the House did. This is devastating news for today’s and tomorrow’s seniors suffering from Alzheimer’s, cancer, the after-effects of stroke and other serious conditions who depend on Medicaid to pay for long-term care. Millions will lose Medicaid coverage over the next ten years.”

“Despite some tweaks to premium subsidies, the Senate legislation will make healthcare unaffordable for many near seniors aged 50-64. The legislation allows insurers to charge older Americans five times as much as younger adults. Though the Senate bill nominally protects people with pre-existing conditions, the waiver of essential benefits means older patients with pre-existing conditions like diabetes, cancer, and heart disease will pay sky-high premiums [making these premiums unaffordable to most]. Finally, the bill weakens Medicare by reducing the solvency of the Part A Trust fund,” notes Richtman.

Looking at a Crystal Ball

Darrell M. West, vice president and director of Governance Studies at the Washington, D.C.-based the Brookings Institution, says that the Senate health bill does not fix the issues critics had with the House version. “It moves Medicaid from an entitlement to a discretionary program. It uses a longer phase-in period than the House, but imposes deeper cuts on the program. This is very problematic from the standpoint of poor and disabled people who need help,” says West.

According to West, Republican Senators from more moderate states already have said they will not support the current version. There also are conservative Senators who feel the bill does not go far enough in repealing Obamacare. If those positions hold up, it doesn’t look like the bill will pass.

West warns those who oppose the passage of the Senate health bill to not underestimate Senate Majority Leader Mitch McConnell. “He is willing to negotiate with individual Senators to get their votes so it is premature to call the bill dead. McConnell knows the Senate well and understands what compromises need to be made to get to 50 votes,” notes West.

If Senate Republicans pass their health care bill next week, I predict they might just find out that they have “awakened a sleeping giant,” the Democrats. When the dust settles after the 2018 mid-term elections we will find this out.

On the Political Art of Compromise

          Published on August 3, 2012, Pawtucket Times

          The bipartisan spirit is briefly alive and well inside the Beltway.  With the Presidential and Congressional elections looming, just a little more than three months away, top Democratic and Republican Leadership this week forged an agreement to pass a “continuing resolution” to keep the federal government afloat for six months after the current budget year ends at the end of September. 

          Politically speaking, who wants to face the wrath of American voters fueled by the possibility of a government shut down before Election Day on November 6, 2012?  Not our lawmakers.

           After the upcoming November election, America’s political system may well become more polarized creating Congressional gridlock, if Tea Party candidates come to Washington, DC supporting the philosophy of  “no-compromise.”  If this occurs major policy decisions like reforming the nation’s retirement system and keeping Medicare afloat might happen only when the proverbial “Hell freezes over.”

Tea Party on the Rampage

         Tea Party backed candidate, Ted Cruz, won the Texas Republican Senate primary this week, potentially tilting the Senate toward the right if he wins in November. Over the years, we have seen moderate Republicans toppled by candidates aligned to the Tea Party who view working across the aisle as a weakness and compromise as a political sin.

        In one instance, Sen. Richard Lugar of Indiana, a six-term GOP Senator lost his Republican primary race two months ago against State Treasurer Richard Mourdock, who was backed by a coalition of Tea Party-aligned groups.  In his concession speech, the 80 year old Lugar warned Mourdock  that his goal of riding “the Republican Party of those who stray from orthodoxy as they see it” won’t be able to problem solve or govern.” The longest serving Senator in the State’s history also warned that “unless he modifies his approach, he will achieve little as a legislator.”  

       Last February, Senator Olympia Snow, of Maine, chose voluntary to walk away from the U.S. Senate after being a moderate voice in that chamber of 33 years, noting her decision was based on intense partisan bickering that now echoes throughout the Halls of Congress. 

       “Politics has been defined as the art of the possible.  That means compromise on both sides is needed to move the public business forward,” says Susan Sweet, a well-know lobbyist and consultant for nonprofit agencies and causes.  While the Democratic Party encompasses people of wide philosophies, the Republican party has become a party of “intransient idealogues,” observes Sweet. “Their sharp turn to the right has distanced and alienated moderate Republicans who previously formed a bridge for compromise and progress.  Moderates, like the late Senator Nelson Rockefeller of New York and the late Senator John Chafee were examples of the politicians who knew the art of politics, how to negotiate and when to compromise.

Reaching Across the Aisle

         But wait, Senator Orrin Hatch, concludes in an opinion piece, “Ted Kennedy: Later Senator Sought Bipartisan,” in the October 22, 2009, published in US News, you can support your political party’s philosophy and still be bipartisan, too.               

         The Republican Senator from Utah, who has served his state since 1977, considered Kennedy, who fought for the principles and philosophy of the Democratic Party, one of the nation’s greatest leaders for reaching across the aisle.

        Considered to be one of the most liberal Democrats in the last 50 years, who spearheaded almost every Democratic cause, Senator Hatch applauded his friends “ability and willingness to set party aside when there was some good to be done.”

         According to Senator Hatch in his opinion piece, the failing of American politics results from “politicians being too willing to toe the party line,”  not wanting to compromise their political agenda, “even when accepting the ideas and contributions of those outside their Party will advance their cause.”

            Sen. Hatch also viewed the late Democratic Senator’s lasting political legacy was “his unwillingness to let partisanship ruin a good opportunity to help those in need, and his ability to inspire others to follow his example.”

           Also, noted in Sen. Hatch’s USNews opinion piece, when in the minority, Senator Kennedy successfully enacted legislation because of his willingness to “move to the center or even the center-right when he recognized that Republicans shared his goals, even if they had different ideas on how to achieve those goals.”

           When the Democrats-controlled Congress, Senator Kennedy reached out to the minority GOP to get his legislation passed.  Senator Hatch noted that Massachusetts Senior Senator “had the political courage to defy interest groups and even his own party in order to reach bipartisan compromise,” to move legislation, specifically, the Children Health Insurance Program, the Ryan White AIDS Act, the Americans with Disabilities Act, and, the Edward M. Kennedy Serve America Act.

          Darrell West, Vice President and Director of Governance Studies at the Washington, D.C.-based Brookings Institution, views Senator Kennedy’s most famous bipartisan legislation to be No Child Left Behind.  “He worked closely with President George W. Bush to pass this bill.  He reached across the political aisle and was able to bring Republicans and Democrats together to pass this education reform, said the former Rhode Islander, noting that this was one of many such bipartisan successes on the Senator’s part.  There are few people left in the Senate who have the interest in or credibility for this type of outreach.

Campaigns Gearing Up for Votes

            By now, political candidates are mailing campaign literature to aging baby boomers and seniors, hoping to effectively deliver their political messages and ultimately to influence their votes.

            As the nation pulls out of the economic doldrums, voters must educate themselves to the real issues and read in between the lines of campaign literature to learn more about the candidate’s background and issues.

           Marking the ballot in the voting booth becomes even more difficult in heated partisan campaigns where you must separate political bickering, rhetoric and negative innuendoes from the substance of issues.

           Keeping Social Security afloat, fixing a broken Medicare program, or bringing fairness to the nation’s tax codes, will not happen if Congress cannot compromise or negotiate on legislative proposals.   No longer can our elected officials view issues either black or white, but can be shades of gray.

Rising to the Political Occasion

         Even with his human frailties, Sen. Kennedy rose to the political occasion time after time and to confront legislative challenges by reaching out to both political friends and foes.  One might say he wrote the tome on the art of political compromise and negotiations, a guide for both his Democratic and Republican Congressional Colleagues to follow.

             The rise of the Tea Party and its political philosophy of  “no-compromise” and “torch and burn” to ensure ideological purity, will have an adverse impact on every generation, from today’s seniors, their aging baby boomer children, and finally, to their young grandchildren and great-grandchildren. 

                  Where are the Republican Congressional moderates of today when the nation sorely need’s them to do the public’s business.

             Herb Weiss is a Pawtucket-based freelance writer who covers aging, health care and medical issues.  This commentary was published in the August 3, 2012 issue of the Pawtucket Times. He can be reached at hweissri@aol.com.