Senate Republican leadership’s so-called “skinny” repeal should be recognized for what it is: a door to open a conference committee. Passing a “skinny” repeal would give carte blanche to Senate Majority Leader Mitch McConnell (R-Ky.) and House Speaker Paul Ryan (R-Wis.) to produce a joint bill based on the House-passed ACA repeal which includes drastic cuts to Medicaid funding.
No one should be fooled by the machinations in the Senate. A vote for the “skinny” repeal is effectively equal to a vote for the House-passed bill (the bill even President Trump called mean). This is the bill that includes drastic cuts to Medicaid – more than $800 billion in cuts resulting in over 15 million people losing coverage plus imposition of per capita caps. Plus the House bill ended Medicaid expansion in two years. See our issue brief on the Top 10 Changes to Medicaid under the House Republicans’ ACA repeal bill.
This is McConnell’s goal – keep the efforts to repeal the Affordable Care Act going and ultimately force a vote on a final bill that will closely resemble the House version. Once out of the conference committee, the bill is on a fast-track, with only 10 hours of debate in the Senate without any ability to amend it.
A “skinny” repeal may not sound so terrible. But that is not the truth. Senator John Cornyn (R-Texas), a member of the Senate leadership, said his goal was “to make sure that we find something that 50 of us agree on that we can then pass as a vehicle to get to conference to do a more comprehensive bill.” Senators in Medicaid expansion states need to know that voting for the so-called skinny repeal is a vote to revive the reviled House bill, the one many senators have vowed they would not support.
While we may not know the exact substance of the “skinny” repeal bill yet, Senate leadership knows exactly what it is doing from a process perspective. And so should the tens of millions of individuals and families who rely on the ACA and Medicaid to survive in a country where the middle class is shrinking and the wealthiest continue to amass more resources. There is no such thing as “skinny” or “modest” repeal. It is a ruse, and one that if successful will make this a more unequal and unjust society.