Although the House narrowly passed its own healthcare legislation, the American Healthcare Act (AHCA), last month, the Senate immediately decided to draft its own bill rather than take up the AHCA. Considering the low popularity of the AHCA, that may be a good move. But the decision to keep the Senate’s version shrouded in mystery has added another controversial dynamic to the healthcare overhaul.
“I think it’s being written, uh, by someone somewhere but I’m not aware of who or where,” Sen. Rand Paul, R-Ky, told NBC News. “If you get a copy of it, will you send me a copy?”
Since this thing could secretly pass under the dead of night, now’s a good time to get up to speed on the key details. Here are seven quick facts you need to know about the Senate Republicans’ healthcare bill.
1) It could pass without any Democratic support
A crucial part of the political gamble the Republicans are making is for their healthcare bill to be budget neutral, which means they can pass it through a process called budget reconciliation. Doing it that way only requires a simple majority vote, meaning at least 50 of the 52 Republican senators would have to vote for it. It’s unlikely to receive support from any Democrats.
2) The healthcare bill is being crafted by 13 men
The bill is being written by just 13 senators, all of whom are men. This includes the Senate leadership, three committee chairmen, and others, including Sens. Ted Cruz of Texas and Mike Lee of Utah—two of the Senate’s most conservative lawmakers.
The senators working on the Senate health care bill:
— Dylan Scott (@dylanlscott) May 5, 2017
Two female senators (out of five total), Sen. Shelley Moore Capito of West Virginia andIowa Sen. Jodi Ernst, were invited to join at least one meeting, but they are not in the official 13-man group.
3) It doesn’t allow insurers to refuse people with pre-existing conditions
Unlike the AHCA, the Senate’s bill reportedly excludes a provision that would have allowed insurers to not cover Americans with pre-existing conditions, eliminating one of the most significant changes instituted by Obamacare. However, the bill does still allow states to choose whether to require insurers to cover essential health benefits, which include emergency room care, hospitalization, maternity care, and prescription medicines.
4) Trump wants it to be less “mean” than the AHCA
Despite the fact that Trump threw a big party after House Republicans passed the AHCA, the president isn’t entirely sold on the bill. Trump recently called the bill “mean” during a closed-door meeting with GOP lawmakers, the Associated Press reported. This is likely due to the fact that, because of pressure exerted by the hardline House Freedom Caucus, the AHCA would hit poor and elderly Americans the hardest. Trump reportedly asked senators to make their version “more generous.”
5) The secrecy tactic is working
Democratic lawmakers are fed up with the Republicans keeping their healthcare bill secret. But the tactic appears to be working—at least in terms of keeping activists from generating a serious resistance. Vox reports that progressive activists who came out in force against the AHCA are struggling to build enthusiasm against a bill that no one has read.
6) A vote could come before July 4
Senate Majority Leader Mitch McConnell (R-Ky.) said earlier this month that he hopes to hold a vote on the legislation by July 4, when Congress goes on summer recess. However, Politico reports that much work lies ahead, meaning Republicans may miss their own deadline.
7) They might let it fail—on purpose
Making the Senate’s version of an Obamacare replacement “more generous,” as Trump put it, would mean excluding some provisions that conservative lawmakers are pushing for, such as eliminating some taxes imposed under Obamacare or even allowing states to exclude protections for people with pre-existing conditions. Doing so means risking a vote on a bill that may not pass, even with the lower simple-majority threshold.
The reason? According to some lawmakers who spoke to CNN, holding a vote on a doomed Obamacare replacement bill lets moderate Republicans at least say they tried to fix Obamacare while more conservative can vote against it on the ground it’s simply another version of “Obamacare-lite.”
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