As of Thursday morning the Trumpcare debate playing out on the Senate floor is moving full steam ahead, with Republican plans changing by the hour. So far they have held a vote on both a full repeal of the Affordable Care Act and the Senate’s version of Trumpcare, officially known as the Better Care Reconciliation Act. Both have thankfully failed to garner enough votes.
Now they will move on to considering a number of Republican amendments. Minority Leader Chuck Schumer announced Wednesday night that no Democrats would be offering any amendments, accusing the entire process thus far of being a sham and demanding that the debate be scrapped and both parties go back to the drawing board to craft an actual bi-partisan healthcare bill.
That is almost certain not to happen before the end of the week, as Majority Leader McConnell is dedicated to pushing through the rest of debate and holding votes on as many amendments as possible, trying desperately to summon 51 votes and craft a bill that complies with budget reconciliation rules. If the Senate Parliamentarian finds that a bill or amendment is intended to change policy as opposed to balance the budget, McConnell will have to either drop that provision or earn 60 votes in order for it to pass.
Right now, the strongest option on the table for Republicans appears to be what is called the “skinny repeal.” Dozens of amendments will be voted on before we know what this skinny bill will look like, but the plan will likely include a few of Republicans’ main goals in dismantling healthcare.
One of the top goals for the skinny repeal will be to end the individual mandate in the Affordable Care Act that required all Americans to purchase health insurance or pay a tax penalty. Ending the individual mandate would likely lead to many young, healthy people opting out of insurance coverage and fleeing the marketplace, causing premiums to skyrocket. Health insurance provider Blue Cross Blue Shield released a statement Wednesday saying that the skinny repeal would disastrously dismantle the insurance marketplace.
Another top goal is to repeal the employer mandate in the Affordable Care Act that requires all businesses with 50 or more employees to provide health insurance. Democrats point out that by ending both the employer and individual mandate, Republicans are essentially sabotaging the private insurance marketplace and financially barring these small business employees from then purchasing their own health insurance individually.
As always, the other top priority of Republicans has consistently been to defund Planned Parenthood. This would be done through language barring any women’s health organization as large as Planned Parenthood that offers abortion care services—of which there are no others—from receiving reimbursements for serving Medicaid patients. The government is already barred from funding abortion care through the long-standing Hyde Amendment, so this provision would exclusively cut funding to birth control services, cancer screenings, pre-natal health programs and STD testing and treatment. While the Senate Parliamentarian announced late last week that defunding Planned Parenthood would not comply with budget reconciliation rules, it appears they are nonetheless moving forward with that plan.
Right now, as has been the case throughout this Trumpcare legislative process, it is unclear if all, part or none of the skinny repeal will pass the Senate. But even this trimmed down plan to dismantle healthcare would have a devastating impact on insurance premiums, small business employees and the millions of families who are now able to purchase health insurance for the first time through the individual marketplace.