Senate’s Health Care Bill ‘Is Not Dead by Any Stretch of the Imagination,’ Mayors Warn

U.S. Senate Majority Leader Mitch McConnell wanted to call a vote on the Better Care Resolution Act before the July 4 recess. But this week, the Kentucky Republican acknowledged that the bill would not be moving forward on that timeline.

Senate Republican leadership is now said to be aiming to send a revised version of the legislation text to the Congressional Budget Office before Friday, to be able to have a Congressional Budget Office score by the time lawmakers return from a holiday recess. That would give the body two weeks to get to a vote before the next recess in August.

It remains unclear if the revisions under consideration will tilt the bill rightward, toward looser regulations and greater federal budgetary savings, or to the left, toward more coverage protections and access. And, as seen this week, the July voting timeline could be subject to change.

But, at least one thing is without debate—this vote postponement is not the last you will be seeing of this bill.

This was a fact that New York City Mayor Bill de Blasio hammered home in his remarks on a conference call organized by the U.S. Conference of Mayors on Wednesday.

“This bill is not dead by any stretch of the imagination,” said de Blasio, adding that lessons should be learned from the way in which the American Health Care Act, the House of Representatives’ version of the bill moved through that chamber.

“We saw a trajectory with the House bill that is cautionary,” de Blasio told his fellow city leaders, along with members of the media. “The first time around it didn’t work, the second time around it didn’t work, the third time around it did.”

So, while the Senate may be delaying its vote, mayors from around the country aren’t delaying their efforts to make it clear how their communities stand to be affected by the health bill.

On a conference call that brought together a bipartisan group of city leaders from across the country, the single issue that each mayor mentioned over and over again was the opioid epidemic.

The Word of the Hour: ‘Opioids’

John Giles, the Republican mayor of Mesa, Arizona, began his remarks on the call with a sobering statistic. The mayor returned on Monday from the USCM annual meeting in Miami Beach to headlines announcing that 191 Arizonans had experienced drug overdoses over the weekend, and 15 of those people had died.

“This is a daily and a weekly tragedy that is occurring in cities and towns of the United States,” said Giles. “Unfortunately the legislation that is pending in Washington right now ignores those facts.”

Giles condemned the way the Senate’s bill would impact cities in their efforts to stem the flow of drug-related deaths in no uncertain terms:

“The federal government, in this situation, is trying to run away from a burning building,” said Giles. “That is not what cities do. That is not an option for the mayors of this country.”

Nan Whaley, the Democratic mayor of Dayton, Ohio—a city that has been called an epicenter of the opioid crisis—echoed Giles’ sense of urgency. As of now, as many as 220,000 Ohioans are receiving their addiction treatment through Medicaid, Whaley pointed out.

That’s treatment that the city and state governments of Ohio can’t afford to provide on their own—and Ohio is not alone on that score.

“With no Medicaid we would not be able to deal with this, with the sparse safety net we have today,” Whaley said.

If that Senate bill passes, Whaley said, that could mean as many as “220,000 people without services that really save their lives every single day.” Put plainly she said, this is a life or death situation for places like Dayton.

Whaley and Giles weren’t alone.

Huntington, West Virginia, Mayor Steve Williams, a Democrat, called the federal government’s choice not to be a full partner in fighting the opioid epidemic “political malpractice.”

Reno, Nevada, Mayor Hillary Schieve, also a Democrat, called the scope of the problem in her city “astronomical.” And Joe Baldacci, the Democratic mayor of Bangor, Maine wondered how the “gutting of Medicaid” would affect his city’s ability to provide drug treatment resources.

“The bottom line on opioids, is that we are struggling,” said de Blasio. “All of us as mayors are struggling to address this crisis. But imagine if we had a hand tied behind our back because it became a lot harder to connect people to care.” That’s the reality, he said if the Medicaid expansion is rolled back and the federal spending on the program is capped.

Currently, de Blasio said, there are over 25,000 New Yorkers who are getting treatment for addiction with Medicaid as their form of insurance.

“Medicaid is a lifeline for so many people,” said Mayor de Blasio “and if that’s taken away, we’re going to lose more people to opioids.”

Moving beyond the issue of opioids, several mayors also questioned the economic implications for this legislation.

‘That’s Not Savings … ’

Giles, in his remarks acknowledged that “as a Republican,” he likes the fact that the legislation reduces the deficit by over $300 billion.

But, he’s wasn’t the only mayor on the call to wonder whether that federal deficit reduction figure tells the whole story.

“I think if you take a closer look at this,” said Giles, “what you’ll see is that the proposed legislation in fact is going to increase health care costs.”

“When we have 22 million additional uninsured people in this country, that creates a crisis that is going to have a significant fiscal impact.”

And, connecting the fiscal issue back to the subject of cities having to figure out how to deal with mental health and opioid abuse crises, Giles said, “any savings that are reflected in this legislation are going to be more than eaten up by the increased public safety budgets of communities like Mesa, Arizona.”

Overall, Ethan Berkowitz, the Democratic mayor of Anchorage, Alaska, agreed calling the federal savings built into the Senate’s BCRA a “false economy.”

“That’s not savings,” Berkowitz declared. “It’s cost-shifting to the private sector and to other levels of government.”

Mayors too, lamented the effect this legislation might have on the health care industry, a staple of many of their local economies.

In Bangor, Maine, Mayor Joe Baldacci said, local hospitals stand to lose as much as 62 million in revenues if this bill passes. And, Giles was quick to point out that the hospital association is his city’s single largest employer, a fact which is also true for many towns around Dayton, said Mayor Whaley.

And de Blasio did not sugarcoat his predictions for the fate of many health care systems:

“In some parts of the country,” he said, without a doubt “hospitals will close … This is a matter of urgency to all of us.”   

For these mayors, with this urgency, comes a sense that now is not the time for partisan bickering.

For Berkowitz, the calculation is simple: “Republicans get sick, Democrats get hurt.” And, he said, “what’s going on in Washington, D.C. is not the way this debate should be waged,” adding “health care is fundamentally a problem we’re trying to solve together, not an issue to be won.”

“You hear a lot of unity from the mayors because we understand life as it’s lived on the ground” de Blasio said.