By: David Weigel
Senate Democrats have warned House Speaker Paul D. Ryan (R-Wis.) that they’ll oppose the “phase three” health-care bills, casting doubt on the Republican strategy to win passage of the American Health Care Act on the promise that big reforms will come later.
“Any assurances to your colleagues that future legislation to further scale back insurance coverage will pass through regular order if the AHCA is enacted are based on the flawed assumption that the Senate Democratic Caucus will vote to further erode the health care system and strip our constituents of coverage,” the Democrats write in a letter spearheaded by Sen. Jeanne Shaheen (D-N.H.). “We are writing today to inform you that our caucus will not support any efforts that jeopardize the consumer protections our constituents rely upon when they purchase insurance.”
(“Regular order” refers to the Senate’s traditional procedural rules, including the requirement for 60 votes to overcome a filibuster.)
All but five members of the 48-member Democratic caucus signed the letter; missing are Sen. Joe Donnelly (D-Ind.), Sen. Heidi Heitkamp (D-N.D.), Sen. Claire McCaskill (D-Mo.), Sen. Joe Manchin III (D-W.Va.), and Sen. Jon Tester (D-Mont.), all of whom are up for reelection in 2018 in states that President Trump won easily. Five more 2018 Democrats represent states that Trump won by single digits; by signaling that they’ll block “phase three,” they essentially would allow the most at-risk Democrats to cast votes against the ACA while ensuring that the bills failed to break a filibuster.
That cuts against an argument House Republicans hoped to make this week. With a little fanfare, they introduced and passed bills that they knew could sail through the House, and cited them as proof that the third phase was possible.
But the bill’s Republican critics in the Senate say that no phase three bill would get past a filibuster — similar to how the 2013 repeal effort saw “piecemeal” health-care bills pass the House and die in the Senate. Sen. Ted Cruz (R-Tex.), referring to the three phases as “buckets,” referred to the third phase as the “sucker’s bucket.” Sen. Tom Cotton (R-Ark.) brushed off the entire “phase” strategy as “spin.” And the 43 Senate holdouts are now on record against anything the GOP might try to get through regular order.
“We will oppose efforts to eliminate the ACA’s essential health benefits that ensure insurance companies cover maternity care, emergency services, substance misuse and mental health treatment, prescription drugs, pediatric dental and vision care and other vital services,” write the Senate Democrats. “We will also oppose any efforts to lessen our constituents’ access to basic preventative and primary care.”