As Senate quietly drafts health care bill, Louisiana senators remain mum on its contents

In March, a group of doctors and nurses - some in scrubs and lab coats - second-lined their way down Basin Street, rallying behind the imperiled Affordable Care Act, aka Obamacare. There were demonstrations at congressional offices and die-ins; many citizens came forward to tell their personal health stories and explain their opposition to the American Health Care Act (AHCA), the legislation meant to repeal Obamacare that passed the House May 4.

In recent weeks, and as the bill has passed to the Senate for revision and consideration, the ruckus has died down somewhat. But it's not because lawmakers have crafted a bill that appeases the public. Rather, the Senate has offered an unusual lack of information about the drafting of the bill, in a process some observers think was designed to chill public outcry. To date, no public hearings on the bill have been held or scheduled, and as reported by The New York Times, CNN and Vox, even some Republican senators aren't sure what's in it.

Speaking to CNN, Sen. Lisa Murkowski (R-Alaska) expressed her confusion - and frustration.

"I have no idea if we even have a bill," she said. "I learned more from you all in this conversation that there may have, in fact, have been [a draft bill] submitted to CBO (Congressional Budget Office), but if that's the case, I don't know what it is nor what it says."

Here in Louisiana, senior Sen. Bill Cassidy has been a prominent voice in the health care debate, but he has not revealed what might be in the plan the Senate hopes to vote on before the July 4 recess.

Cassidy made headlines (and scored a TV appearance) with his call for a health care plan that passes the "Kimmel test." He also has put forth his own Patient Freedom Act health care plan. This plan repeals the individual mandate (which requires that everyone have health insurance or pay a tax penalty) and Obamacare's essential health benefits standards (which require health insurance policies to cover a minimum range of services, such as maternity care and mental health care). The plan preserves popular Obamacare provisions such as no lifetime limits on coverage, the ability to stay on a parental insurance policy through age 26 and protections for people with pre-existing conditions.

However, it's not clear whether Cassidy is advocating exclusively for his plan, leaning toward supporting the revised AHCA, or something in between. (His office did not respond to a voice message and emailed requests for comment for this article.) At recent town hall events he's parried angry constituent questions about health care by pointing to his own plan.

Speaking on the Senate floor June 6, Cassidy decried premium increases announced by many insurers for 2018 - increases several insurers say are a hedge against mixed messages from the Trump White House. He also called for "conservative" health care solutions such as price transparency from medical providers, returning power to the states and a simplified enrollment process, but his brief remarks stopped short of demanding these as firm conditions for the bill.

"The patient has to have the power. ... If the patient has the power, the system lines up to serve her," Cassidy said. "[As] the president said, we must have a much simpler way of going about this, much less expensive and much better."

It's worth noting that meeting even these vague requirements - "simpler," "much less expensive" and "much better" - would require dramatic changes to the AHCA as passed by the House. The CBO found that the Republican plan could drop as many as 23 million people from insurance rolls, mostly by making insurance unaffordable for older and sicker Americans.

Cassidy's counterpart, Sen. John Neely Kennedy, also has not revealed much about the inner workings of the bill, or publicly pledged his support. According to communications director Michelle Millhollon, Kennedy has been busy with his efforts to extend the National Flood Insurance Program. He also wrote a recent op-ed calling for work requirements for Medicaid recipients in the state, but proposed it as stand-alone legislation, rather than as part of the Senate's health care bill.

Speaking to KEEL-AMJune 12, Kennedy used his typically colorful idiom to attribute problems with the health care bill to Democratic obstructionism.

"[Democrats] think Obamacare's working. That's their right. They're wrong, but they're entitled to think that," he said. "Give me a chance to repeal Obamacare, I will do it in a nanosecond. ... If [the bill is] better than Obamacare, and it lowers premiums, and it covers preexisting conditions, I will be on it like a hobo on a ham sandwich."

For their part, Democratic lawmakers have pointed to statistics such as the estimated 20 million people who have gained insurance since the Affordable Care Act's passage. Most have called for repairs to the existing law, rather than all-out repeal. But whatever their perspective on the Affordable Care Act, they're sufficiently alarmed by the Republican health care bill to try and halt the chamber's business. Senate Democrats will hold the Senate floor Monday evening in an effort to draw attention to the bill and potentially relegate it to committee, buying more time for negotiations.

Past this all-out partisan warfare in Washington, Louisiana residents have serious cause for concern about this process and what the bill may hold. The Associated Press reported June 16 that Gov. John Bel Edwards recently joined a group of governors calling for a more open and bipartisan drafting process, amid fears of widespread loss of insurance and new costs being shouldered by an already-faltering state.

Whatever happens, thousands of people in Louisiana will be affected by the bill's passage, including the over 400,000 people who have gained health insurance coverage through the Affordable Care Act's Medicaid expansion. With ongoing public commentary, including petitions and op-eds, citizens statewide continue to raise grave concerns about the drafting process and the bill's ultimate effects.

But absent details of what the health care bill might contain, it's impossible for the public to register meaningful opposition or support - a failure which ultimately falls on both Cassidy's and Kennedy's offices.