Senate Healthcare Bill Drafting Process Filled with Problems

May 11, 2017; New York Times

With the passing of the American Health Care Act by the U.S. House, the Senate is now charged with following suit or drafting a new healthcare bill of its own. The Senate has opted for the latter; as Sen. Orrin G. Hatch (R-UT) sums it up, “Let’s face it, the House bill isn’t going to pass over here.”

Although it is estimated to be at least two months until a bill hits the floor, the Senate majority leader, Mitch McConnell (R-KY), has already put together a 13-member working group to focus on the bill. Not even one week into it, however, and the Senate’s healthcare bill drafting process is already rife with issues.

To start with, the group as initially announced was all male. Not one of the 21 current female senators, five of whom are Republican, was asked to serve. Even the GOP’s own members recognize this as strange, with South Carolina Republican Senator Tim Scott commenting, “I would have recommended some diversity there from a gender perspective.” California Senator Kamala Harris, a Democrat, turned to Twitter, “The GOP is crafting policy on an issue that directly impacts women without including a single woman in the process. It’s wrong.”

After facing criticism from both the left and right, female Republican Senator Shelley Moore Capito was invited to a working group meeting earlier this week, although it is unclear whether she will become a permanent member of the group. Considering all that is at stake for women’s health—the defunding of Planned Parenthood, the House bill’s classification of pregnancy as a pre-existing condition, and maternity care not considered an essential health benefit—it would be unwise for the GOP not to include women in their working group, both from a political standpoint and from the viewpoint of drafting the bill.

Diversity appears to be a general issue here, as Scott, who’s the only African American Republican senator, was not asked to serve on the working group either. It should be noted that Scott was an insurance agent prior to becoming involved in politics and has experience writing health insurance policies. Further, because of his work the field, he would bring some knowledge regarding what customers need their health insurance policies to cover.

As if the lack of diversity were not bad enough, Senate Republicans have also decided to write their version of the healthcare bill “behind closed doors,” according to The Hill. Essentially, this means that the bill will not go through the usual process of going through committee hearings to receive edits, and there will not be public hearings during which experts in the field could testify to the implications of this legislation. Instead, the bill would go straight from the GOP caucus to the Senate floor. It seems highly unusual that a bill of this magnitude, which would affect tens of millions of people, would be kept out of public sight, and two Democrat Senators, Ron Wyden of Oregon and Patty Murray of Washington, have already sent a letter calling for hearings:

The Senate Finance and Health Committees cannot abdicate our responsibility to hold public hearings on such sweeping health reform legislation. Before passage of the Affordable Care Act, the Senate held a thorough, collaborative, and deliberate process.

Sen. McConnell now indicates that the bill drafting work will be performed by all 52 members of the GOP caucus. This is smart. Otherwise, the Senate GOP would be taking a risky move, potentially alienating their own party members and their constituents in the public. If they lose the support of just two Republican Senators, the bill will not pass. It seems like it would be in the best interest of the GOP to be as open and collaborative as possible to ensure the necessary votes.—Sheela Nimishakavi