Although Republicans earned a dramatic victory driving their health care reform legislation through the House last week, the effort to repeal and replace the Affordable Care Act continues to face an uncertain future in the Senate.
The American Health Care Act was passed by a narrow margin by House Republicans, but members of both parties have balked at considering it in its current form in the upper chamber.
“This is the legislative process,” said Sen. Jim Risch, R-Idaho, predicting that the Senate will work independently from the House to craft its own version of the bill.
“I can’t really predict how it’s going to come out,” he added.
Sen. Luther Strange, R-Ala., is optimistic that the GOP will be able to introduce conservative reforms that provide relief to those whose costs have risen dramatically under the ACA, also known as Obamacare. However, he warned that it might take some time.
“It probably won’t go as quickly as some people hope,” he said.
Democrats are more worried about protecting those who have benefited under the law they passed seven years ago, but they fear the Republican majority will leave them out of the process of writing its replacement.
“There’s no reason why we can’t work together on a bipartisan basis,” said Sen. Tammy Baldwin, D-Wisc.
So far, the working group developing the legislation is all Republican and all male.
“I am not pleased with the signals being sent by Majority Leader Mitch McConnell,” Baldwin said.
According to Sen. Sherrod Brown, D-Ohio, hundreds of thousands of people in his state only have health insurance because of the ACA, including 200,000 who are receiving treatment for opioid addiction.
“What are you going to do with the 7 or 8 or 900,000 people [in Ohio] who are losing insurance under this thing?” Brown said, noting that Republican Ohio Governor John Kasich shares that concern.
The Congressional Budget Office estimated that 24 million fewer people would be insured in 10 years under a previous version of the AHCA, some voluntarily and some due to unaffordable premiums. House Republicans did not wait for an updated CBO score on the current version before voting, a decision that still rankles Senate Democrats.
“It was something that was passed without fully understanding the impact,” Sen. Gary Peters, D-Mich., said.
He called for reform that expands coverage, not reduces it.
“The American people deserve a health care plan that takes us forward, not backward,” he said.
Sen. Sheldon Whitehouse, D-R.I., expects Senate Republicans to move more cautiously, given the relatively negative response to the AHCA so far.
“I think they’ll wait to see how CBO scores this so they know how smelly a hand grenade they’re dealing with,” he said.
He also hopes Republicans will work with Democrats instead of jamming a bill through with a simple majority using reconciliation.
“There’s more good to be done in health care by Congress and we should get going on it,” he said.
Sen. John Boozman, R-Ark., said Republicans are working as fast as they can, but they do intend to wait for the CBO score on the House bill before proceeding. The CBO plans to release its analysis the week of May 22.
“I think the House bill is a good template to begin working from,” Boozman said. “The Senate bill will look very, very different once it’s done.”