As the battle over Republican legislation to dismantle the Affordable Care Act rages this week on Capitol Hill, only one member of the Maryland congressional delegation is involved in the minute-by-minute machinations: Rep. John Sarbanes (D), a member of the Energy and Commerce Committee, one of two House panels working on the GOP’s American Health Care Act.
Sarbanes is not happy.
He’s disgusted by the legislation itself and by the process that produced it.
“They’re coming with a product that’s certainly a nonstarter for the Democrats on our committee and I think would be a nonstarter for most Americans when they learn what’s in the bill,” Sarbanes told Maryland Matters Wednesday during a break in the committee’s round-the-clock markup of the bill.
Sarbanes believes that states like Maryland, which created a health care exchange and expanded its Medicaid program under Obamacare, are especially vulnerable under the Republican plan. There are estimates that show 400,000 Marylanders are in jeopardy of losing their insurance. Scaling back Medicaid will not only strip thousands of people off the health care rolls, but will hurt the state’s ability to address the growing problems of opioid addiction and mental illness, Sarbanes argued.
“It’s crazy to try to do that kind of crude surgery to the Medicaid program,” he said. “There are so many dimensions of this that are wrong-headed. I think Americans are starting to see this.”
With few parliamentary tricks at their disposal, Democrats are trying to slow-walk the bill to the extent that they can. In Energy and Commerce, they demanded that the full text of the bill be read, a rare maneuver that ate up two hours on Wednesday. They say they plan to offer about 100 amendments to the bill in an attempt to make Republicans take some tough votes – fully aware that the amendments are almost certainly going to fail. The markup could last through the weekend.
“They gave us about a 36-hour notice on this bill,” Sarbanes fumed.
But there is only so much Democrats in the House can do. The fate of the American Health Care Act, which was generated by Republican leaders, rests for now with the GOP caucus’ most vocal conservatives – many of whom want the government out of the health care business altogether and won’t be happy if there isn’t an outright repeal of Obamacare.
“At this point Democrats are just concentrating on a unified message and letting people know what’s at stake here,” Sarbanes said. “We’ll see where all this lands. The most important thing is making sure the public knows what’s at stake and what’s being proposed.”
Asked if he had had an opportunity to discuss the GOP legislation with the Maryland delegation’s lone Republican, Rep. Andy Harris – who is also the delegation’s lone physician – Sarbanes said he hadn’t. But he wondered whether Harris, a member of the conservative House Freedom Caucus, might oppose it.
In fact, Harris issued a statement Tuesday supporting the leadership bill, and on Wednesday appeared on CNBC, expressing confidence that conservatives would be able to improve it during the next two weeks as the legislation is being debated.
“I support the general framework,” Harris said. “It’s still just a work in progress.”
Asked on the cable network whether the bill can pass in the Senate, where the margin between majority Republicans and minority Democrats is slimmer than it is in the House, and where an array of Republican senators has already expressed skepticism about the House legislation, Harris suggested President Trump and his Cabinet would have to get to work.
“The president’s going to have to spend some political capital there,” he said, later referring to the process as “the art of the deal” – the title of Trump’s best-selling book. Trump and his lieutenants are already hard at work trying to woo House conservatives.
Democrats are especially aggrieved that Republicans are proceeding with the measure in the House even though the Congressional Budget Office has not “scored” the bill – meaning the nonpartisan office has not yet estimated how much eliminating Obamacare and adopting the GOP plan will cost.
Harris dismissed the Democrats’ concerns, echoing the Republican talking point that the CBO has lost credibility – especially since, in the GOP’s view, it underestimated the Obamacare price tag.
“We’ve given up on the Congressional Budget Office years ago,” Harris said.
That GOP line of attack incensed Sen. Chris Van Hollen (D-Md.), a member of the Senate Budget Committee and formerly the top Democrat on the House Budget panel. In a statement Wednesday, he called out two architects of the Republican health care reform plan — House Speaker Paul Ryan (R-Wis.) and Health and Human Services Secretary Tom Price. Both are former chairmen of the House Budget Committee.
“Speaker Ryan…knows just how invaluable CBO’s work is,” Van Hollen said in a statement. “So does Health and Human Services Secretary Price, another former Chairman of the House Budget Committee, who helped select CBO Director Keith Hall as part of the Republican consensus choice. I call on both of them to immediately stop these attacks from House Republicans and stand by the CBO. In this era of alternative facts, if Republicans are serious about deficit reduction it is essential that they rely upon the accurate cost assessments of the nonpartisan CBO experts. Republicans should not advance Trumpcare until Congress and the people we represent understand the full scope of its impact.”
Maryland’s congressional delegation – minus Harris – is also calling on Gov. Larry Hogan (R) to address the implications of the GOP health care plan in the state. The nine Democrats wrote to him in February urging him to oppose the repeal of the Affordable Care Act [see letter here]. This week, Sarbanes followed up with a letter asking Hogan to address how the state would respond if certain provisions of Obamacare are lost [see letter here].
“The residents of Maryland are looking to you for support in preserving the important ACA reforms that have allowed so many of them to access affordable, accessible and high quality health care reforms,” Sarbanes wrote.
Hogan by now is used to Democrats – especially those in the General Assembly – pressuring him to weigh in on Trump policies and their potential impact on the state. Many Democrats are unabashedly using Trump as a political cudgel against Hogan – and Hogan so far has tried to avoid getting dragged into the debate.
Hogan has not directly responded to the congressional lawmakers’ written queries on health care, though his communications director, Douglass Mayer, told The Baltimore Sun in an article published Wednesday that the administration sees the bill under the debate in the House as a “first draft.”
“The governor doesn’t want to see anyone losing health care,” Mayer said. “But he wants a system that works.”
When Hogan and the congressional delegation met earlier this year, Sarbanes said the governor expressed concerns that Maryland’s Medicaid waiver – which enables the state to serve certain Medicaid recipients in home or community-based settings rather than in institutions – could be jeopardized by the GOP’s bid to repeal Obamacare.
Just last week, the delegation met with Dennis Schrader, Hogan’s new secretary at the Department of Health and Mental Hygiene, and Chet Burrell, CEO of CareFirst Blue Cross/Blue Shield, to further discuss the implications of health care reform. Sarbanes said Schrader “indicated” that the administration recognizes the benefits of expanded Medicaid coverage in Maryland and the potential burdens that the Republican health legislation could impose on states like Maryland.
“The governor, given all the independent analysis that’s been done, could stand up and say this is not the answer,” Sarbanes said.