Senate leaders will supposedly vote on a major health care reform bill next week. But as of today, very few people know what’s in the bill. Why should you be concerned?
As someone who has had a front row seat for many health policy debates over the past 20 years, I am dismayed by the U.S. Senate’s willingness to craft their version of the American Health Care Act (AHCA) in secrecy. The move doesn’t allow time for constituents to raise their concerns and for the Congressional Budget Office do its important work of explaining the financial implications of the bill to members of Congress. In other words, lawmakers won’t fully understand what they are voting on.
I started my professional career working as the lead health policy advisor to the Wisconsin State Senate in 1995. Back then, we required every single bill to be released in public and to provide at least one week’s notice for at least one public hearing. This gave all stakeholders time to read legislation and consider and communicate the impact on their lives and industries. Complex or high impact bills received several hearings and months of debate. We did this not because it was required, but because it was the right thing to do for democracy’s sake. We wanted to understand all the implications of legislation – good or bad – before the vote was taken.
Many unpopular bills were introduced, but lawmakers from both parties typically held their noses and voted for them anyway if they were good public policy. Afterwards, they sent letters to all the people who wrote or called on the issue and explained why they felt they had to take that vote.
Those contacts from constituents meant a lot to every lawmaker I knew. If you heard from more than 20 people back home on an issue, you knew it was pretty important to the people of your district. The truth is that few people write or call their legislators, but those that do hold a lot of power. They, along with the state and local press and the people showing up at town hall meetings or district office hours, hold their lawmakers accountable to explain their votes and actions.
This is a good system. That’s why it so hard to grasp why the U.S. Senate is now working on health care reform behind closed doors. As of today, the vast majority of Americans are completely in the dark on the bill’s provisions. Thirteen members of the US Senate have been sworn to secrecy to craft a bill that, if passed, will have profound impact on millions of Americans’ financial security and ability to pay for health coverage.
I have spent my entire career, public and private, trying to help individuals and small business owners gain access to more affordable health coverage. It works best when all stakeholders are at the table, both sides of the aisle are represented, meetings and discussions are held in public and participants set their own self-interests aside. Is this a thing of the past?
The past four years have been difficult for those of us that care about consumers and their insurance security to navigate. The uncertainties and problems with the Affordable Care Act are too numerous to mention here and partisan politics have gotten in the way of much needed fixes. More importantly, we haven’t even started on the most important goal: addressing the high cost of health care that drives up insurance rates. Seven years after passage of the ACA, politicians are still playing politics around insurance reform rather than addressing the underlying cause of the problem.
It’s certainly high time for changes to the law – no dispute there. Why not debate changes in the open with good public policy at the center of decision-making? It’s time for Americans to demand this of their politicians, and to hold them accountable for representing us in Congress. A letter or phone call may be more powerful than you think.