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Senate Republicans are facing increasing criticism for ducking public scrutiny as they craft legislation to roll back the Affordable Care Act with little input from outside experts, patients, physicians and others most affected by healthcare legislation.

The GOPs secretive process marks a sharp departure from the traditional way the Senate has developed large, complex bills, which are often debated for years with multiple committee hearings to ensure broad input and careful analysis.

The closed-door approach, which is even more opaque than the process used earlier this year in the House, is all the more remarkable given the bills likely impact on tens of millions of Americans, many of whom could see their health insurance protections substantially scaled back or eliminated altogether.

It is deeply disturbing, said Erika Sward, assistant vice president of the American Lung Assn. Patients groups like ours need to make sure that our patients needs for healthcare will be met. We cant do that if we cant see what is being proposed.

The lung association is among 120 patient groups that this week sent a letter to senior Republican senators expressing deep concerns about GOP proposals to fundamentally restructure Medicaid, which provides health coverage to more than 70 million poor Americans.

Although Senate Majority Leader Mitch McConnell (R-Ky.) has indicated he wants to vote on a bill in the next two weeks, Senate Republicans thus far havent disclosed details of their Medicaid plans, or any other part of their healthcare legislation.

Obamacare vs. Trumpcare: A side-by-side comparison of the Affordable Care Act and the GOPs replacement plan

The Obamacare repeal bill passed by the House in May, which has helped guide the Senate discussions, would slash federal healthcare assistance to low- and moderate-income Americans by nearly $1 trillion and increase the number of uninsured by 23 million over the next decade, according to the nonpartisan Congressional Budget Office.

Speaking to reporters at the Capitol this week, McConnell who had previously vowed a much more open legislative process for the healthcare bill denied there was any effort to conceal the Senate legislation.

We'll let you see the bill when we finally release it, he said. Nobody's hiding the ball here. You're free to ask anybody anything.

But even some GOP senators have voiced increasing frustration about the lack of public debate about the specifics of how Republicans plan to replace Obamacare, as the healthcare law is frequently called.

Sen. Lisa Murkowski (R-Alaska) lamented in an interview with online news site Vox this week that she couldnt even answer basic questions about the bill.

None of us have actually seen language, she said. My constituents expect me to know, and if we had utilized the process that goes through a committee, I would be able to answer my constituents' questions.

It remains unclear if any GOP lawmakers will try to hold up the healthcare legislation, however, as no Republican senator has yet demanded publicly that McConnell slow down or hold hearings on the legislation.

Before voting, the Senate, unlike the House, will have to wait for an independent analysis from the CBO.

The lack of public debate appears to be a deliberate strategy by McConnell and his lieutenants to minimize opportunities for critical evaluation of their bill, which is likely to be highly controversial.

Senate Finance Committee Chairman Orrin Hatch (R-Utah) said holding public hearings about the legislation would only give Democrats more opportunity to attack the bill.

We have zero cooperation from the Democrats, he said. So getting it in public gives them a chance to get up and scream.

But interest in the GOP healthcare legislation extends far beyond Democratic politicians on Capitol Hill.

Alex Brandon / Associated Press

Senate Majority Leader Mitch McConnell speaks during a news conference on Capitol Hill.

Senate Majority Leader Mitch McConnell speaks during a news conference on Capitol Hill. (Alex Brandon / Associated Press)

Major physician groups, hospitals, consumer advocates and organizations representing millions of patients with cancer, diabetes, heart disease and other serious illnesses have been pleading with Republican leaders for months to open up the process and listen to their concerns.

This week, a group of more than 15 patients groups including the American Heart Assn., the March of Dimes, the American Lung Assn. and the American Diabetes Assn. asked McConnells office to meet with them next week, proposing any time between Friday and June 22.

A representative from McConnells office told them staff schedules were too busy, according to representatives of several of the organizations.

McConnell spokesman Don Stewart said the majority leaders schedule is full. Numerous meetings are already booked well in advance, he said.

Dick Woodruff, vice president of the American Cancer Societys advocacy arm, said even when he and others have sat down with Republican congressional aides, it is often fruitless.

The Senate staff generally dont know anything, Woodruff said. There are so few people who understand what is going on that having meetings isnt particularly productive. This is such a closed process.

Another representative of a leading patient group compared the experience to talking to a wall.

The concerns about the healthcare legislation extend to the broader public as well, polls suggest.

The House bill is extremely unpopular, with voters disapproving of the legislation by nearly 4 to 1.

Just 17% of registered voters backed the House bill in a recent nationwide poll, compared with 62% who disapprove of the legislation. This week, Trump reportedly called that legislation, which he celebrated six weeks ago in a Rose Garden ceremony, mean.

Rutgers University professor Ross Baker, who has spent decades studying Congress, said lawmakers have traditionally used committee hearings and public debate over legislation to help educate voters and build support for complex and controversial legislation such as the civil rights bills of the 1960s.

That is what makes the current GOP effort so remarkable, he said. I cant think of another piece of legislation of this scope and magnitude that affects so many people that has been drawn up behind such a dense veil of secrecy.

Obamacare 101: A primer on key issues in the debate over repealing and replacing the Affordable Care Act.

Don Ritchie, historian emeritus of the Senate, said not since the years before World War I has the Senate taken such a partisan, closed-door approach to major legislation.

A century ago, Senate Democrats, at the urging of President Woodrow Wilson, drew up major tariff reforms while shutting out Republicans. But when Democratic leaders tried that again when they had large majorities during the Great Depression, rank-and-file senators revolted. It hasnt happened since, he said.

Even the deeply partisan debate over the development of the Affordable Care Act, which ended with Democrats alone voting for the bill, had Republicans at the table for much of the process.

That included 53 hearings and meetings about healthcare in the Senate finance committee, according to a tally assembled by the committee.

The committee a group of Democratic and Republican senators who spent months in 2009 trying unsuccessfully to develop a bipartisan compromise then spent seven days marking up final legislation, the longest mark-up of a bill in more than two decades.

In the end, the Senate devoted nearly 15 months developing the Affordable Care Act before it was finally enacted in March 2010.

noam.levey@latimes.com

@noamlevey

lisa.mascaro@latimes.com

@LisaMascaro

ALSO

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Column: Government actuaries say you'll pay a whole lot more for health insurance if the GOP repeals Obamacare

UPDATES:

1:25 p.m.: This article was updated with a comment from a spokesman for Senate Majority Leader Mitch McConnell (R-Ky.).

This article was originally published at 10:20 a.m.

See more here:
Republican secrecy faces mounting criticism as GOP senators work behind closed doors to repeal Obamacare - Los Angeles Times

Kevin DrumJun. 16, 2017 3:12 PM

The fun folks at Vox asked eight Republican senators to explain what they want their health care bill to do. That is, what problems should it solve and what benefits should it provide for ordinary Americans? The results are mostly pretty hapless, and Chuck Grassley in particular is getting lots of Twitter play for his usual Grampa Chuck schtick.

But if you read closely, it turns out that all of them aside from John McCain actually do have a common goal:

McCain: What are the big problems it is trying to solve? You name it.

Grassley: The rates could be way up here. [Points to sky] And if they if we get a bill passed, it maybe wouldnt go up or would go up a heck of a lot less than they would without a bill.

Boozman: Weve got so many people in Arkansas, premiums have gone up 128 percent in the past four years.And so hopefully well deal with some of those problems.

Wicker: It will moderate prices for premiums.

Murkowski: I continue to hear stories of great frustration. Increasing premium costs. Increasing share of deductibles.When you ask Alaskans about their stories and what they want, they need increased affordability. Because we are slammed in every category, with premiums and the cost of care.

Cruz: The most important objective in repealing Obamacare is to lower health insurance premiums.

Capito: First of all, weve got to stabilize the market of the placeswhose premiums are skyrocketing, whose deductibles are through the roof. This is a real phenomenon.

Portman: Its the cost of health care. Premiums and copays and deductibles have skyrocketed compared to what was promised.

Seven out of eight Republicans surveyed agree that rising premiums and deductibles are the key problem theyre trying to solve. In the House bill, Republicans actually did deliver this. However, they did it by reducing coverage levelswhich naturally makes policies cheaperand by making coverage too expensive for older people, who have the highest premiums. In other words, they did it in a way that produces a mathematical reduction, but not in a way that actually helps people in the real world. It was a bit like reducing average outlays on Geritol by cutting the recommended dose in half and ending sales to anyone over 50.

Will Senate Republicans do the same? Or do these senators want to reduce premiums on the coverage people actually have right now? I think you know my guess, but I suppose well just have to wait and see. So far its still a secret.

Mother Jones is a nonprofit, and stories like this are made possible by readers like you. Donate or subscribe to help fund independent journalism.

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Republican Senators: AHCA Must Reduce Cost of Health Coverage - Mother Jones

A close Virginia gubernatorial primary that saw a fervent supporter of President Trump nearly upset a well-funded and organized Republican establishment candidate is being seen as a sign that Trump's support could put some incumbent Republicans in jeopardy.

Former Republican National Committee Chairman Ed Gillespie barely beat Prince William County Chairman Corey Stewart Tuesday by a little over 1 percentage point, a victory margin of just 4,323 votes out of 366,114 cast. Polls and GOP politicos had predicted that the establishment-backed Gillespie would win in a rout.

Now there are worries that Gillespie will struggle to motivate hardcore Trump supporters to turn out for him in southern parts of the state this November and at the same time will face hostile liberal voters in the Northern Virginia suburbs of Washington, D.C.

That would be bad enough for Republican prospects in Virginia this year and in similar races across the country in 2018. But Stewart's unexpectedly strong showing also revives the possibility of Republican incumbents facing pro-Trump primary challengers, with or without the president's blessing, with the GOP majority in the House on the line.

"I think Corey's strong showing should be yet another wake-up call to the Republican establishment," said Chris Barron, a Virginia-based conservative operative who is supportive of the president. "The establishment might not like Trump, but the grassroots loves him. This is not their Republican Party anymore; it is his."

Another Republican consultant described a "double squeeze" in which GOP incumbents face both a surge of motivated anti-Trump voters in the general election, but first have to deal with a primary electorate dominated by voters who wonder when the party's congressional wing is going to start backing Trump. While the first group gets the most media attention, the consultant said, the second is angry that Capitol Hill Republicans haven't delivered on things like the border wall.

Past Trump imitators have not fared as well in Republican primaries as the president himself. House Speaker Paul Ryan, R-Wis., defeated businessman Paul Nehlen in an 84-16 landslide last year. Sen. Marco Rubio, R-Fla., dispatched self-funding millionaire developer Carlos Beruff 71-19 after deciding to seek a second term.

Neither challenger had Trump's endorsement. In both cases, he at least nominally supported the incumbent, though Nehlen did receive a Trump Twitter shout-out. But these defeated candidates seemed to expose the limits of running like Trump without the future president's unique political talents, fame or vast earned media advantage.

In Virginia, Stewart wasn't endorsed by Trump either. He was fired as Trump's state campaign chairman because his protest against "establishment pukes" at the Republican National Committee went too far even for the most combative and unconventional major-party presidential nominee in recent memory.

None of this stopped Stewart from winning big in Trump Country. In Southwest Virginia, Trump's stronghold in the state, Stewart more than doubled Gillespie's support, and he received more votes than both Democrat candidates combined (though 177,000 more Democrats voted than Republicans statewide).

This showing may embolden Trump-friendly Republican primary candidates elsewhere. Kelli Ward, a GOP state senator who lost a primary bid against Sen. John McCain, R-Ariz., last year, appears to be gearing up for a challenge to Sen. Jeff Flake, R-Ariz., in 2018.

In Tennessee, Republican state Sen. Mae Beavers linked herself to Trump when she announced last month that she was running for governor. "President Donald J. Trump is taking the lead in Washington, D.C., to 'drain the swamp' there, but we have our own swamp in Tennessee and I intend to do the same thing in the Volunteer State," she said in a statement.

Gillespie won the Virginia GOP primary by beating Stewart by a 2-1 margin in Arlington and Alexandria. He also carried Richmond and its suburbs. He beat Stewart 48-39 in vote-rich Fairfax County. These were mainly areas that voted against Trump in last year's Republican primary and the general election against Hillary Clinton.

"Ed Gillespie ran a primary campaign that was focused on what he was going to do as governor," said Chris LaCivita, a Virginia-based Republican strategist. "It was positive, issue-focused and never once in any paid media attacked Corey Stewart. That will serve him well as the general election gets underway."

"That being said, it was obvious that in pursuing a strategy which had to be based on internal numbers, the campaign was operating under the assumption that it could take the risk," LaCivita added. "Its surveys clearly missed the mark and this should serve as a classic lesson for future campaigns that no matter the advantage you may hold over your opponent, if you ignore their constant attacks (as Ed did on Corey) and do not respond and set the record straight, you're playing with fire."

Republicans may be playing with fire in Virginia, where the "double squeeze" certainly holds. It will be hard for Gillespie to win without those southwest Trump-Stewart voters turning out in big numbers. At the same time, 59 percent of Virginians polled by the Washington Post and ABC News said they disapproved of Trump's performance in office.

It is a circle Trump supporters maintain Republicans are going to have to square.

"The base at least in Virginia, and I suspect elsewhere is fiercely loyal to President Trump," Barron said. "Incumbents, like [Virginia Rep.] Barbara Comstock, who have made it a point to distance themselves from the president do so at their own electoral peril."

Follow this link:
Close Virginia race shows Trump poses risks to Republican incumbents - Washington Examiner

Supercharged Republican donors broke another fundraising record last month, leaving the National Republican Congressional Committee with the most cash on hand ever in an off-year.

Officials reported Friday that NRCC raised $6.5 million, the best for a May since 2005.

For the year, the committee has raised $52.5 million, nearly double its take for the same election off-year period in 2015.

And much of that money has come from House Speaker Paul Ryan, who wrote a $2 million check in May to add to the $20 million he previously transferred this year. Ryan has been on a non-stop effort to raise money for 2018 Republican candidates in addition to helping those in special elections this year.

Despite polls showing Democrats in a good position to challenge Republican control of the House, the GOP fundraising successes are giving the party faith that it will maintain its majority in the House.

"With yet another historic fundraising effort, House Republicans are on the march towards a successful 2018. Thanks, as always, to Speaker Ryan and all of House leadership who continue to step up to defend our majority and expand the playing field into Democratic territory," said Rep. Steve Stivers, NRCC chairman.

The details:

Paul Bedard, the Washington Examiner's "Washington Secrets" columnist, can be contacted at pbedard@washingtonexaminer.com

Originally posted here:
Record House Republican fundraising, most cash on hand ever in off-year - Washington Examiner

Jay Butera (left), a former businessman who now lobbies Congress to act on climate change, shakes hands with with a staff member of Citizens' Climate Lobby. Shawn Reeder/Courtesy Citizens Climate Lobby hide caption

Jay Butera (left), a former businessman who now lobbies Congress to act on climate change, shakes hands with with a staff member of Citizens' Climate Lobby.

Climate activist and citizen lobbyist Jay Butera believes in the power of polite persistence. Nearly every week for the past 10 years, he's taken the train down to Washington D.C. from his home in suburban Philadelphia to convince Congress members to act on climate change.

Butera says he's had hundreds of conversations with Republican aides and congressmen.

"There were times when it felt like this is not going to happen," said Butera. "This is impossible, this is the most polarized issue in Congress."

But despite the recent election that resulted in Republicans controlling both houses of Congress and the White House, Butera is suddenly having some success. Democrats have been more favorable to action on climate change, but Butera is getting Republicans on board too.

"It's not enough to try and advocate for one party or another because nothing substantive can happen unless it has support from both parties," he said.

'Civil conversations with solutions'

Butera is a successful entrepreneur, having created and sold two businesses. But these days instead of courting investors, he now spends all his time volunteering with the Citizen's Climate Lobby.

This week, Butera joined with thousands of climate activists who traveled to Washington, D.C. to visit their members of Congress to encourage them to do something about warming temperatures, rising seas and melting ice caps.

They held an annual lobbying day for the Citizens Climate Lobby, which has 400 chapters across the country, and citizen lobbyists in every congressional district. Butera says instead of confrontation, they take a friendly, calm approach to an issue that has been mired in partisan roadblocks.

"If we could get members together and talk about this in a calm way we could break this log jam," he said.

Four years ago, Butera got the idea for a new bi-partisan caucus that would have the goal of pushing for climate solutions, specifically economic solutions. It wasn't hard to get Democrats on board, but he spent three years looking for a Republican. By design, the caucus is now half Republican, half Democrat.

Having people voice outrage, that's OK, but we also need civil conversations with solutions.

Jay Butera

Butera says he's taking the middle ground.

"I understand citizens are outraged and I respect their fierce advocacy," he said. "But it doesn't move the conversation forward. Having people voice outrage, that's OK, but we also need civil conversations with solutions."

Butera began his quest for a Republican caucus member in Florida, a place where rising seas already cause nuisance flooding in urban areas. Starting at the local level, he talked to township commissioners and Chambers of Commerce. He spoke their language.

"It has definitely helped me to have a background in business," he said. "From a business person's point of view, climate impacts and the disruptions they are causing present a big risk to our economy."

He found his first Republican last year. Carlos Curbelo from South Florida represents a district already witnessing the impacts of rising seas. Curbelo and Democrat Ted Deutch, another South Florida Congressman, formed the Climate Solutions Caucus in April, 2016. Since then the caucus has grown to 42 members.

It's a small, but growing group.

"I see this wall coming down now," Butera said. "Since the beginning of this year 14 Republicans have joined the Climate Solutions Caucus. That's a startling fact. That gives me a lot of hope."

Butera also worked with members of the Citizen's Climate Lobby to visit their local representatives in their home offices and lobby their campaigns. Some, like freshman Republican congressman Don Bacon from Nebraska, made it a campaign pledge to join the caucus.

Butera, along with other members of the Citizen's Climate Lobby, recently visited Bacon in his new office on Capitol Hill to thank him for joining. Bacon said he would keep an open mind.

Freshman Republican congressman Don Bacon from Nebraska, made it a campaign pledge to join the House climate caucus. Nati Harnik/AP hide caption

Freshman Republican congressman Don Bacon from Nebraska, made it a campaign pledge to join the House climate caucus.

"I know I'm not 100 percent on every one of your issues," Bacon told the group that included Butera and a few of the congressman's constituents. "But I try to look at each one, individually, and weigh it."

So far, Bacon has voted 100 percent with Trump on environmental issues. Like many in the Climate Solutions Caucus, Bacon is from a swing district and just narrowly beat his Democratic opponent. In joining, he highlighted his experience tackling environmental issues on airbases he commanded.

He opposed the U.S. pulling out of the Paris agreement and he wasn't alone 21 members of the Climate Solutions Caucus wrote a letter to President Trump urging him to remain in the Paris Accords.

"Remaining in the UNFCCC will strengthen American leadership on environmental stewardship and help transform today's low-carbon investments into trillions of dollars of clean energy prosperity," wrote the caucus members. "Withdrawing would mean squandering a unique opportunity to promote American research, ingenuity, and innovation."

Citizen Climate Lobby member and Omaha resident Kay Carne helped convince Bacon to join the caucus. Carne says when she speaks to people like Bacon, she describes how personal this issue is for her. She has two daughters and her youngest is just 7 weeks old.

"My youngest will be Congressman Bacon's age in 2070," said Carne speaking outside Bacon's office after the meeting. "2070 seems so far away but she'll be 53 then and she may even live to see 2100, which is the time a lot of these scientific projections are saying temperatures will increase by 10 degrees Fahrenheit. So just thinking about their lifetime and what they could see makes this issue so much more urgent than some others realize."

Republicans on board

One surprising member of the caucus is Darrell Issa, a California Republican who has denied the scientific consensus on climate change. The League of Conservation Voters once gave him a "Climate Change Denier" award. Issa narrowly won re-election in November against his Democratic opponent.

In suburban Philadelphia, where Hilary Clinton beat President Trump, all three swing districts' Republican congressmen have joined the caucus.

Freshman Republican Brian Fitzpatrick says it's part of his mission to pursue bipartisan environmental protection.

"We really need to get past the antiquated way of thinking of this Hatfields vs. McCoy brand of politics where people are stuck," he said, referring to the bitter family feud of the 1800s. "I don't think that's a good thing. We need to take a fresh look at how to grow the economy and protect the environment at the same time. And groups like the Citizens Climate Lobby are all about that."

Fitzpatrick credits his time as an Eagle Scout for his passion for environmental preservation. A former FBI agent, he has not voted lock step with Trump on the environment.

Pennsylvania Republican Ryan Costello also joined the caucus but is less optimistic about Congress acting on climate. He says he and his climate caucus colleagues will try to push Congress to act on things like carbon capture. But there's little support for climate legislation in the Republican controlled House.

Looking to 2018

While Democrats are eager to take back seats in the 2018 mid-term elections, it's not clear how environmental issues will play out. Terry Madonna, director of the Franklin and Marshall College Poll, says in the past climate and environment were low on the list of priorities for voters.

"But I think this is going to be more important in 2018 and I think the Democrats in particular are going to make a big deal of it," he said.

Ultimately, the Citizen's Climate Lobby wants Congress to put a fee on carbon, which would then be funneled back to households in a monthly check or "dividend." Butera says, like air and water, the atmosphere should not be a dumping ground.

"I believe in the power of capitalism to move mountains," said Butera. "And if we can line that up to move us in the right direction, and have the profit motive drive efficiencies and drive us toward low carbon technologies that is the force that can stop climate change."

House Republicans joining this climate caucus are not committing to the idea of the carbon tax.

And there's still the behemoth counterweight lobbying of the fossil fuel industry, which has more funds at its disposal than the citizen lobbyists.

But Butera is optimistic.

"The fossil fuel lobby looms large on Capital Hill but I continue to believe the voice of voters is louder," he said.

Butera thinks with Republicans now controlling Washington, many realize it's up to them to do something about climate.

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Climate Activists Court Hill Republicans With 'Civil Conversations' - NPR