OUT OF ORDER: Senate Parliamentarian Guts Repeal And Replace Effort
July 21, 2017

Good news! Almost everything the Senate and House want to do to gut health care for the entire country has been ruled out of order by the Senate parliamentarian, meaning it would be subject to the 60-vote threshold.

Here's the high-level overview of some of what they can't pass with 51 votes:

  • Defund Planned Parenthood
  • Remove tax credits for policies that cover abortion care
  • Dropping Essential Health Benefits (EHB) coverage for Medicaid
  • Requiring a "six-month lockout" for anyone whose coverage lapses
  • Allowing states to determine the Medical Loss Ratio (what insurers can spend on overhead and marketing instead of health care)
  • Allowing states to roll over unused Medicaid block grant funds to the following year and spend them on anything, including things which are unrelated to health care.
  • State-specific buyoffs like the House-based "Buffalo buyout"

The only provisions which can pass with 51 votes are the Medicaid work requirements, the extra money allocated to non-Medicaid expansion states, repealing cost-sharing subsidies, and some reporting requirements.

The Parliamentarian is still reviewing the state waivers for Essential Health Benefits, Association health plans, the Age Tax allowing insurers to charge older people 5 times what younger people pay, and the Medicaid block grant provisions.

In a statement, Senator Bernie Sanders blasted Republican leadership for continuing to flog a dead bill. "The parliamentarian’s decision today proves once again that the process Republicans have undertaken to repeal the Affordable Care Act and throw 22 million Americans off of health insurance is a disaster."

"It is absurd to believe that you can pass legislation which impacts one-sixth of the American economy, over $3 trillion a year and affects the lives of every person in our country, without one public hearing or open debate. How do you pass a 'health care' bill without hearing from doctors, nurses, hospital administrators or health care economists? How do you pass 'health care' legislation behind closed doors without any input from Democrats? It is time for the Republican leadership to junk this bill and work with the American people on legislation which improves the Affordable Care Act, not destroys it."

The House bill is gutted. The Senate bill is dead. Is it time for Republicans to admit they can't deliver on this promise, nor do their voters really want them to? Or will they keep going, because it's what the billionaires demand?

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