After much anticipation, the Congressional Budget Office released their score of the Senate’s healthcare plan Monday. The report showed that the bill has almost the same effect as the House version, leaving 22 million more Americans uninsured by 2026. However, the announcement of a revised bill Monday morning means the new CBO information is based on an now-old version of the bill.
Much of the process to repeal and replace Obamacare has been opaque, with important decisions taking place in private meetings behind closed doors — something Republicans criticized the Democrats for during the creation of the Affordable Care Act.
But looking back, these processes aren’t even close to comparable in terms of transparency.
Affordable Care Act
The ACA made it out of committee in the House of Representatives in July 2009, after a month-long markup and 160 Republican amendments. The House didn’t vote on it until November 7th.
In 2010, the Senate health committee spent nearly 60 hours over the course of 13 days marking up the legislation that would become the ACA.
The Senate Finance Committee held 53 meetings about the ACA and an eight-day markup of the bill, which was the longest markup for the committee in over 20 years. The committee considered 130 amendments and held 79 roll-call votes.
There were 44 hearings and public events about the plan in the Senate alone.
The bill was signed into law in March 2010, 8 months after it emerged from committee in the House.
American Health Care Act of 2017
For the AHCA, the two House committees conducted markups of the bills simultaneously. Representatives voted within 48 hours of the bill’s release to the public — before seeing a CBO report.
Republicans in the 2017 Congress positioned the healthcare legislation as a reconciliation bill, limiting the total possible debate in the Senate for the AHCA to 20 hours. That is, if any public debate occurs.
Senate Majority Leader Mitch McConnell and other Republican leadership don’t seem to have plans to bring the conversation into the public eye.
“Look, we’ve been dealing with this issue for seven years,” McConnell said earlier this month, noting that there had been "gazillions of hearings on this subject."
The Senate’s version of the AHCA passed by the House is being crafted by just 13 Republicans. There have been no markups by committees and no meetings with representatives across the aisle.
Members of Congress from both parties are alarmed at the lack of transparency.
"Seems like around here, the last step is getting information, which doesn’t seem to be necessarily the most effective process,” said Sen. Ron Johnson (R-WI).