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Don't Rest Easy. Health Care Repeal Isn't Dead Yet.

Mitch McConnell
Mitch McConnell
Georgeanne M. Usova,
Former Senior Legislative Counsel
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July 24, 2017

After last week’s roller coaster of surprises, confusion, and urgent negotiations in the Senate, lawmakers left D.C. with their plans for health care reform in chaos. As they return this week, much remains uncertain — including what exactly the Senate will vote on and whether it will have the votes to pass. Despite this lack of transparency, we’ve heard that a vote may come as soon as Tuesday. What we do know is that any version of health care repeal would be a disaster, and our resolve to kill it is unwavering.

If you weren’t following every twist and turn last week, here’s what you missed. On Monday evening, it became clear that the inaptly named Better Care Reconciliation Act (BCRA) — legislation that would gut Medicaid and endanger the lives of people with disabilities, shut down Planned Parenthood health centers, and repeal the Affordable Care Act — was doomed. Fifty senators are necessary to move the bill to the Senate floor for debate, and four of the 52 members of the Republican conference announced their opposition, meaning the bill could not proceed.

Then came Plan B. Senate Majority Leader Mitch McConnell announced that he would drop the BCRA and bring a different bill up for a vote: the Obamacare Repeal Reconciliation Act (ORRA), a.k.a. “repeal and delay.” Like the bill passed by the Senate in December 2015 and vetoed by President Obama, this legislation repeals the ACA but delays implementation for two years. The ORRA guts key parts of Medicaid, cuts off patient access to Planned Parenthood, restricts access to abortion, and kicks 32 million people off of insurance. And many agree that it would wreak havoc on the health insurance markets.

Within hours of McConnell’s statement, three senators said “repeal and delay” was the wrong approach, and they would not support the motion to proceed on this bill either, leaving ORRA effectively dead. Adding even more confusion, the Senate parliamentarian ruled that numerous provisions of BCRA, including the one that would block access to Planned Parenthood and restrict abortion coverage, violate Senate rules, and it’s unknown whether those provisions — in some form — will remain in the version of the bill that receives a vote.

But it’s not over.

Senators continue to huddle and negotiate. They’re contemplating changes to the BCRA, including adding billions of dollars for Medicaid, in an attempt to gain support from key senators. McConnell has said that he will hold a vote this week— perhaps tomorrow — on a motion to proceed (i.e. a request to formally begin debate on the bills) even though it’s not clear that there are 50 votes to pass the motion, or which bill (or bills) will be debated and get a vote, or whether any of the bills have the 50 Senate votes needed to actually pass, with Vice President Pence providing the tiebreaking vote.

Despite all these unanswered questions, we do know this: These deeply flawed and harmful health care repeal bills are in trouble because the people made their voices heard. Every phone call, every rally, every meeting, every email, every tweet, every town hall, every sit-in or die-in, every heart-felt story made a difference. The opposition could not be ignored.

And this week, that fight must continue. The bills being considered endanger the lives of millions of people with disabilities who rely on Medicaid for services and supports that allow them to live independently and with dignity in their homes and communities. The bills still harm women and families and may deny reproductive health care to millions who depend on Planned Parenthood health centers. The bills still leave millions more uninsured.

While Trumpcare supporters don’t yet have the votes they need, we know that any senator’s mind could change and arms are being twisted. In fact, it has been reported that key senators who said they were voting “no” are now wavering. So it’s absolutely critical that public pressure be kept up over the next few days. We can kill the repeal effort before it gets any further by urging senators to vote no on the motion to proceed. If that motion fails, there’s no floor debate, no amendments, no more back room shenanigans. The bill dies for the foreseeable future.

Everyone should be in contact with their senators today and tomorrow. If you live in key states like West Virginia, Alaska, Kansas, Ohio, or Nevada, you should be using every means of communication at your disposal. Tell your senators to safeguard the lives of millions of people and vote no on the motion to proceed, vote no on repeal and delay, and vote no on any version of the Better Care Reconciliation Act.

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