(Last updated 07/28 at 8:45AM EST)
On Tuesday, Senate Republicans gathered just enough votes to proceed on the healthcare debate, with Vice President Mike Pence breaking a 50-50 tie. All Democrats voted against the motion, along with two Republicans, Sens. Collins (R-ME) and Murkowski (R-AK). Afterwards, the Senate voted on an amended version of the Better Care Reconciliation Act (BCRA), which failed on a 57-43 vote.
This version of BCRA had an amendment proposed by Sen. Ted Cruz (R-TX) that stipulated that the bill needed 60 votes to pass. The bill, which would cut Medicaid by $772 billion over a decade, failed after all Democrats and nine Republicans voted against it. The GOP didn't giving up though, as Senate Republicans proposed several bills and amendments to either fully repeal or repeal and replace the Affordable Care Act (ACA) throughout the debate process, which expired late Thursday. There was also a round of votes on amendments to the House bill, the American Health Care Act (AHCA), which passed the chamber earlier this year. Learn more about the debate process here and items of interest to be aware of here.
After the debate process expired, there was a rapid vote on amendments in a "vote-a-rama" fashion throughout Thursday evening and into Friday. During then, Sen. McConnell (R-KY) introduced yet another repeal bill, a “skinny” replacement bill. The Huffington Post says that this “skinny” repeal bill “will likely get rid of the individual and employer mandates, as well as a medical devices tax,” and “do much of the same” as BCRA. The idea was to pass a smaller, more palatable repeal bill that could get 50 votes so it could then enter into a conference process with the House bill. The conference process requires lawmakers to reconcile contradicting House and Senate provisions and draft a final compromise that takes from both proposals. This final bill could have had provisions for a larger repeal and replace plan, and could have cut Medicaid funding even if the Senate bill doesn’t have this language, since the House bill does. The New York Times notes, "By passing a so-called “skinny” repeal bill, Senate Republicans would keep the repeal effort alive long enough to try to negotiate a broader compromise bill with the House of Representatives."
The Save Medicaid in Schools Coalition (SMSC)* believes the real goal with a “skinny” repeal bill would have been to enter the conference process and produce a revised, larger repeal bill that would gut Medicaid funding and have a higher probability of passing than the House AHCA bill did on its own. In other words, the conference process was required for Republicans to dismantle Medicaid’s current funding structure and still have a chance of passing the bill through Congress. In light of the debate process and ongoing efforts to cut Medicaid funding, ASBO International executive director John Musso issued the following statement:
“ASBO International cannot in good conscious support any proposal that would gut Medicaid funding. Our members highlighted how critical Medicaid services are to students in a recent survey, explaining that school districts rely on these dollars for many reasons. Medicaid dollars help schools provide vital health services for all students, purchase equipment for students with special needs, and pay for the salaries of school nurses and other paraprofessionals who serve our children. Cutting federal Medicaid funding for states will jeopardize this funding stream that states provide for schools.
We are deeply concerned with the Senate’s vote to move forward with a bill that will cut Medicaid funding and put our nation’s students at great risk. We encourage the Senate to act in a way that represents the constituents they serve, and to reject any proposal that would significantly change the structure of Medicaid.”
The health care debate process wrapped up early Friday morning after Senate Republicans failed to gather enough votes to pass the skinny bill to move forward with the conference process. POLITICO reported early Friday, Senators Susan Collins (R-ME), Lisa Murkowski (R-AK), and John McCain (R-AZ) "sided with all 48 Democrats" to reject the "skinny bill" proposal, "tanking the measure by a vote of 49-51". Although Sens. Collins and Murkowski were expected to vote no, many of their Republican colleagues were unsure about where McCain stood on the bill. After his unexpected "no" vote, McCain explained that he did not believe the "skinny repeal" bill would increase competition, lower costs, and improve healthcare for Americans, even if it would repeal "some of Obamacare's most burdensome regulations. Afterwards, he called for more "committee work, hearings, and bipartisan input" as the way to move forward on health care reform.
While the Senate's healthcare proposal has been stopped in its tracks, it is unlikely Congress will give up on health care reform. Please stay tuned as we learn more about plans to fix or replace the ACA in the coming weeks. Please continue to contact your elected officials about preserving Medicaid funding and tell them what program cuts would mean for your schools. In the meantime, please stay tuned to ASBO International’s Legislative Affairs Community for further updates.
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*ASBO International is a member of the Save Medicaid on Schools Coalition (SMSC), which consists of more than 60 national education, civil rights, disability, child welfare, and healthcare organizations advocating to protect and preserve access to healthcare for our nation’s most vulnerable children.
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