Michael A. Cohen

Why are 13 men — behind closed doors — writing the health care bill?

Laurel Smith, 56, of Medford, N.J., attends a protest outside the office of Rep. Tom MacArthur of R-NJ., in Marlton, N.J., Friday, April 28, 2017. She says she's concerned that repeal of the Affordable Care Act could affect health insurance coverage for her son, 26-year-old son, Jamieson Smith, who has a rare sickness called mitochondrial disease. (AP Photo/Mike Catalini)
Mike Catalini/AP
Laurel Smith of Medford, N.J., attends a protest outside the office of US Rep. Tom MacArthur of New Jersey in April.

Look, I get it: Maintaining public outrage in the era of Trump is a largely Sisyphean endeavor. Once you push one rock up the hill — whether it’s on Trump’s Russia connections, his unprecedented fear-mongering after the recent terrorist attack in London, the evidence of public corruption, or his increasingly unhinged tweets — another boulder comes rolling down to knock you over.

But what Senate Republicans are trying to do to American health care is the scandal, outrage, “you’ve got to be kidding me” moment that we all need to be talking about.

Literally behind closed doors, 13 Senate Republicans (all men) are writing a piece of legislation that could upend the entire US health care system and deprive millions of Americans of access to care. Like their counterparts in the House, Senate Republicans have eschewed any element of legislative transparency. I asked Massachusetts Senator Elizabeth Warren, who as she reminded me is a member of the Health, Education, Labor and Pensions Committee, if she knows anything about the pending legislation. She told me she has “no idea what’s in the bill. Doors are locked, window are sealed. There’s been no public debate, no hearings, no committee process, no opportunity for a fresh set of eyes to read” as to what Republicans might be proposing.


From a mere good governance perspective this is simply astounding. The US health care system represents around one-sixth of the nation’s GDP. More than 140 million Americans rely directly on some form of public health care — be it Medicaid, Medicare, the Children’s Health Insurance Program, or the Obamacare exchanges.

Get Today in Opinion in your inbox:
Globe Opinion's must-reads, delivered to you every Sunday-Friday.
Thank you for signing up! Sign up for more newsletters here

Writing a bill that could impact the health care coverage of so many Americans without even a whiff of transparency is policy-making at its absolute worst. That the basis for this effort is the oft-repeated Republican lie that Americans need to be rescued from access to affordable health care coverage provided by Obamacare makes it so much worse.

Yet all of this practically pales next to breathtaking hypocrisy of the GOP’s legislative machinations.

For eight years, Republicans incessantly complained that Democrats rammed Obamacare through on a party-line vote and made no effort to bring Republicans into the process. Like pretty much all of the GOP’s claims about Obamacare, this is a lie. Democrats repeatedly tried to work with Republicans, so much so that some on the left would argue it hamstrung the entire effort.

Even in the face of GOP obstructionism, amendments proposed by Republicans were voted on and added to various iterations of the legislation, and the support of Maine Republican Senator Olympia Snowe, in the Senate Finance Committee, helped bring Obamacare to the floor of the Senate. But the truth of the matter is that Republicans never had any interest in working with Democrats on health care reform and, in the end, opposed it en masse.


This time, Republicans aren’t even pretending to involve Democrats. According to Oklahoma Republican James Lankford, “We know there’s not going to be bipartisan support for this.” Since Democrats won’t support eviscerating a bill that has helped tens of millions of Americans get health insurance coverage, Lankford, says, “There’s not a reason to do this through a committee hearing process.”

One might argue that informing the American people about far-reaching congressional legislation — and, in particular, the potentially 23 million who might lose health insurance because of this repeal effort — is what legislators are supposed to do. But of course, the GOP’s health care plans have nothing to do with policy and everything to do with politics.

Indeed, last month the former Senate finance chairman, Senator Chuck Grassley of Iowa, chastised House Republicans — who wrote their health care bill behind closed doors, didn’t wait for a CBO score, and held no hearings on it before voting — for being too transparent.

“The House made a public relations disaster a month ago,” said Grassley, “when they said they were going to bring it up on Wednesday and then Thursday and then Friday and then they didn’t bring it up until a month later. We’re not going to go through that.” According to Grassley, Republicans will only bring a bill to the floor that can win over 51 members of the GOP caucus. Once that happens, one can expect an absolute minimum of public debate and a quick vote in the Senate.

In fact, Republicans have made clear that they want everything wrapped up by the July Fourth recess, which is less than a month away.


Senator Warren says she’s “never seen anything even close to this. It takes every norm of the Senate and every sense of courtesy” to fellow senators from states that might be affected by this legislation and throws them out the door. The assumption is that “there’s no way to get Democratic votes and there’s no reason to seek their input.”

To be sure, the other issues taking up so much public debate in Washington are pretty important. The president of the United States possibly obstructing justice is not nothing, as we prepare for Thursday’s Comey-Ghazi on Capitol Hill. But less than a month to write and vote on legislation that could literally be a life or death issue for millions of Americans?

If that’s not a scandal and an outrage, those words have lost all meaning.

Correction: An earlier version of this article misidentified Chuck Grassley as the chairman of the Senate Finance Committee. Grassley is the former finance chairman. Senator Orrin Hatch now heads that committee.

Michael A. Cohen’s column appears regularly in the Globe.