This is the web version of VoxCare, a daily newsletter from Vox on the latest twists and turns in America’s health care debate. Like what you’re reading? Sign up to get VoxCare in your inbox here.
Republican senators say they're getting frustrated with the chamber's closed, secretive health care process.
“I’ve said from Day 1, and I’ll say it again,” Sen. Bob Corker (R-TN) told the New York Times. “The process is better if you do it in public, and that people get buy-in along the way and understand what’s going on. Obviously, that’s not the route that is being taken.”
Sen. Ron Johnson (R-WI) told the Times, "I come from a manufacturing background … I’ve solved a lot of problems. It starts with information. Seems like around here, the last step is getting information, which doesn’t seem to be necessarily the most effective process.”
"Would I have preferred a more open process? The answer is yes,” Sen. Bill Cassidy (R-LA) told NBC.
Republican senators are complaining about the secretive health process as if they have no power to affect it. The exact opposite is true: Every senator has lots of leverage in the health care debate, and could use it to demand a more open discussion if they so desire.
There are 52 Republicans in the Senate, and at least 50 of them need to support an Obamacare repeal bill for it to pass. This means a few senators can wield a lot of power in this process. Let's imagine Corker, Johnson, and Cassidy, for example, teamed up and told Senate leadership that they wouldn't vote for a bill that didn't go through regular order or didn't get at least one committee hearing.
This would put Senate leadership in a bind. They would either have to acquiesce to these demands or give up on a years-long campaign promise of repealing Obamacare.
But so far there is little evidence of any aggressive bargaining. If anything, there is resignation to a closed process. I reached out to spokespeople for these three senators to ask whether they've requested a more open process from Senate leadership. Only Sen. Corker's office responded.
"He does wish the process included public hearings and has consistently communicated that to Senate leadership, but does not lead any of the committees of jurisdiction," spokesperson Micah Johnson said.
The health care bill only gets to remain secret if Republican senators allow it to. They could force it into the sunlight if that was their desire. A decision not to do so is tacit consent to a closed process, no matter how much Republican senators criticize that process to the press.
Chart of the Day
Three-quarters of individual market plans didn't cover maternity care before Obamacare mandates. The Kaiser Family Foundation has a new brief looking back at the pre-ACA individual market and what plans covered. Forty-five percent of plans did not cover substance abuse services and 38 percent did not provide mental health coverage. Read more here.
Your daily top health care reads, with research help from Caitlin Davis
News of the day
- "Senate likely to miss its Obamacare repeal deadline": "The Senate left Washington on Thursday with a seemingly insurmountable health care to-do list: When they return on Monday, Republicans will have just two weeks before the Fourth of July recess to overcome the remaining big divides on policy — including what year to roll back Medicaid expansion and how deeply to cut the program that covers health care for people with low incomes." —Jennifer Haberkorn, Politico
- "Schumer asks for all 100 senators to meet on health care": "In a new letter to Senate Majority Leader Mitch McConnell (R-Ky.), the New York Democrat is asking all 100 senators to gather in the Old Senate Chamber next week to discuss health care — a tactic Democrats hope will pressure Republicans to drop their push to repeal Obamacare and instead work on fixes to the seven-year-old law." —Seung Min Kim and Jennifer Haberkorn, Politico
- "Insurers Look to Ramp Up Premiums in Health Law Exchanges": "As Republicans try to pass a health-care bill to overhaul the ACA, the attention has focused on insurers’ withdrawals from a few states that risk leaving some consumers with no exchange plans next year. But the rate requests by major insurers show stress on the marketplaces stretches beyond those trouble spots." —Anna Wilde Mathews and Louise Radnofsky, The Wall Street Journal
- "Trump administration preparing executive order on drug pricing": "President Trump is set to meet on Friday with key officials including Health and Human Services Secretary Tom Price and White House budget director Mick Mulvaney to discuss the order, which is expected to be issued in the coming weeks, possibly before the July 4 congressional recess." —Nathaniel Weixel, The Hill
- "Nevada just passed one of the strictest drug pricing transparency laws in the country": "Unlike others that focus on drug prices in a general sense, the hybrid bill focuses on two specific groups of drugs that are used to treat diabetes: insulin and biguanides. It's the latest milestone in government actions at the local, state, and national levels that attempt to change the way we spend money on prescription drugs." —Lydia Ramsey, Business Insider
Analysis and longer reads
- "As Costs Mount, States Warily Eye Changes to Medicaid in GOP Health Plan": "The Medicaid program has become a mounting headache for states, as Congress debates a slew of far-reaching reforms, including the repeal and replacement of Obamacare, more than $800 billion of long-term cuts to Medicaid and revolutionary changes in the way states and the federal government share the overall cost of the program. For now, governors and state legislators must cope with the reality that state spending on Medicaid continues to outstrip incoming general revenues." —Eric Pianin, The Fiscal Times
- "Seesawing Family Income Threatens Kids’ Medicaid Coverage In Texas": "The verification checks pose logistical hassles, require greater resources and save little money upfront. Still, some say there is value to the approach, at least on paper. “Texas is not wrong to check eligibility,” said Robert Moffitt, a senior fellow at the right-leaning Heritage Foundation. “It just seems that going through this every month is an administrative burden that is probably not necessary.”" —Shefali Luthra, Kaiser Health News
- "It’s the most expensive congressional race ever, and it may hinge on health care": "The most expensive congressional race in U.S. history may hinge on the wonky topic of preexisting conditions. Democrat Jon Ossoff, trying to seize a suburban Atlanta seat held by Republicans since 1979, has spent weeks railing against the GOP health care bill passed by House lawmakers this spring." —Max Blau, STAT
- "Doctor Who Wrote 1980 Letter On Painkillers Regrets That It Fed The Opioid Crisis": "[Author Dr. Hershel] Jick says when the letter was published in 1980, it was almost inconsequential. "Only years and years later, that letter was used to advertise by new companies that were pushing out new pain drugs," he says. "I was sort of amazed. None of the companies came to me to talk to me about the letter, or the use as an ad."" —Taylor Haney and Andrea Hsu, NPR
Join the conversation
Are you an Obamacare enrollee interested in what happens next? Join our Facebook community for conversation and updates.