A new phrase gripped Georgia advocates for and against Obamacare repeal Thursday — "Skinny Repeal".
After two Senate votes on previous proposals to scale back the 2010 health care law failed solidly, Senate Majority Leader Mitch McConnell was said to be heading toward this stripped-down incarnation of a bill to roll back portions of the federal health care law as soon as Friday morning.
Details of the proposal remained murky on Thursday evening, but the plan appeared to rest on the core principle of eliminating the mandate that every American have health coverage and sunset the requirement that all employers offer insurance. It would reportedly drop the GOP’s previous attempts to scale back the Medicaid program while repealing the law’s medical device tax.
Many Georgia observers, for and against repeal, see ending the mandate as a significant step in itself. But they also see it as a foot in the door for keeping the repeal effort going, and reviving the broader provisions approved in the House of Representatives.
On both sides, they now feel that with Skinny Repeal they’re walking a tightrope.
“I’m for the Skinny bill as a vehicle to get to conference,” said U.S. Sen. David Perdue, referring to a House-Senate committee that could be appointed to iron out differences in the legislation passed in both chambers.
But the Georgia Republican joined several other prominent GOP senators including John McCain and Lindsey Graham in insisting that House leaders provide the unusual assurance that they would not pass the Skinny bill as-is and instead agree to enter into conference negotiations with the Senate.
“Given all the conversation and innuendo this afternoon, I’d like to have some assurance that the House is not going to take it up. And I’ve just been told I think we’re going to get that,” Perdue said at dinnertime Thursday.
U.S. Sen. Johnny Isakson, R-Ga., indicated he was on the same page.
“It’s not the solution but it’s the means to an end,” he said of Skinny Repeal.
On the other side, supporters of the health care law, liberals, insurance companies and others erupted with press releases and advocacy letters warning that the bill still went to far, and was a dangerous foot in the door.
A spokeswoman for the Fulton-Dekalb Hospital Authority, which oversees Grady Hospital, noted that the Congressional Budget Office had issued a preliminary estimate that the Skinny Repeal could lead to 16 million fewer Americans having health insurance. “While we are sensitive to the need to control health care cost, we are even more sensitive to providing quality health care to all citizens,” the authority’s chairman, Thomas Dortch, said in a statement.
The CBO also said it could lead to 20 percent higher premiums. A liberal group, the Center for American Progress, said that would lead to $1,132 premium increases for Georgia households. However, the CBO noted that it had no bill to work off of, and only issued estimates on an outline Democrats submitted based on preliminary reports. The provisions are highly likely to change.
Insurance companies on Wednesday warned the Senate that the only way to keep meaningful insurance affordable was to make sure healthy people buy it too. Without mandating or luring healthy people into insurance markets, the only people who buy it are the sick ones — the expensive ones to cover.
“A system that allows people to purchase coverage only when they need it drives up costs for everyone,” the Blue Cross Blue Shield Association, a group that includes Blue Cross Blue Shield of Georgia, wrote Wednesday.
Janel Green, a social services worker and member of the Georgia Alliance for Social Justice, was planning to lead a “Die-In” protest on Decatur Square Saturday. She said she didn’t understand why people accept a mandate for car insurance but not health insurance. “Its very existence is depending upon those of us who don’t use it subsidizing those who do,” she said. “That’s how it works.”
“Skinny repeal will still harm people,” she added. “It will still cause distress. It will still cause a lack of access to care.”
But other Georgians couldn’t disagree more. Some are convinced that government has no place telling citizens what insurance products to buy. However, they dislike “Skinny” repeal from that standpoint: It doesn’t go far enough.
“If this is the best that the Senate can (pass), it’s very concerning,” said U.S. Rep. Barry Loudermilk, R-Cassville.
Rep. Jody Hice, R-Monroe, is a member of the House Freedom Caucus, a deeply conservative group, and was the last Georgia GOP holdout on the House repeal and replacement bill. That bill did far more than Skinny Repeal and it still fell short of Hice's desires. He eventually voted for it.
“I’ve got to see it first, but I don’t like it,” Hice said of Skinny Repeal. “It’s not fair for me to comment without really knowing what we’re dealing with. I’m not keen on the idea. That’s not what we’re here to do.”
Hice and his House colleagues will eventually have to face whatever the Senate sends them, and see if it’s something they can negotiate to a compromise. House members were expected to meet Friday morning to talk about it.
"We'll see what happens," said Sen. Richard Shelby, an Alabama Republican. "A lot of people are surprised we got this far this week on a motion to proceed. A lot of us weren't sure that we'd get to 50 votes. We did. Don't count out McConnell ever. He's great at what he does and knows how to do it."
