Republican leaders in the Senate Mitch McConnell (R-Kentucky) and John Cornyn (R-Texas) say a vote on health care will be scheduled early this week. But Senators are unclear about which proposal will be voted on. (Senate photo)
Here we go again. Another week and the United States Senate is ready to vote on legislation to remake the entire healthcare system, including Indian health. The Senate will do this without a draft, public hearings, or common sense.
So what does the healthcare bill look like at this point? I have no clue. Neither do the 100 senators who will make that call.
This is Trahant Reports.
There will be a vote to at least repeal the Affordable Care Act. And perhaps replace it, too. But what the bill looks like is unclear.
Last week the National Indian Health Board, the National Congress of American Indians, and the National Council of Urban Indian Health, wrote that one of the Senate proposals, the Better Care Reconciliation Act of 2017, would change the formula for funding Indian health programs.
The three intertribal organizations called the proposal a “radical departure from over 40 years of federal policy” and it “should not be undertaken without nationwide tribal consultation.” The bill’s language shifts the funding formula for Indian Health Service patients who are funded by Medicaid. This change would take away from the unique incentive for states to work with tribes to create Medicaid innovations that best support the Indian health system. States could create new rules that could even ignore the Indian health system as a partner and create new barriers that would sharply reduce funding.
It would be one more costly strike to an Indian health system that’s already underfunded.
Back to the math:
There are 100 members of the Senate. The 48 Democrats are certain to vote no. And of the 52 Republicans, it’s unlikely Sen. John McCain would leave his cancer treatment in Arizona to vote on a motion to proceed (that’s the opening of the debate and consideration of amendments).
That leaves 51 votes. Sen. Susan Collins of Maine is a certain no. That reduces the number to 50 (and 49 no votes).
There are lots of questions about Senators Lisa Murkowski of Alaska, Rob Portman of Ohio, and Shelley Moore Capito of West Virginia. Capito tweeted: “I will only vote to proceed to repeal legislation if I am confident there is a replacement plan.” Portman said he’ll review whatever bill comes up. Murkowksi has said she is concerned with the process — and the impact of a bill on families.
Does that sound like three no votes? Right now, I’d only count all three as a firm maybe. Then again only one needs to be the “no” vote.
I am Mark Trahant.