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Toomey works on health-care bill being crafted in secret; Casey challenges process

WASHINGTON — Pennsylvania’s two U.S. senators agree on this much: There is a good chance in the next few weeks that Senate Republicans will craft — and possibly pass — a bill to repeal former President Barack Obama’s health care overhaul.

That’s about as far as the bipartisan consensus goes, however. Republicans hope to pass a measure before July 4, and it remains to be seen how much fire Obamacare defenders can train on a measure that is being crafted in secret.

Senate leaders hand-picked Pennsylvania Republican Pat Toomey to help craft legislation. His Democratic counterpart, Bob Casey, is fighting it at every turn.

Mr. Casey, a normally soft-spoken, mild-mannered lawmaker, is so angered by the proposal that it triggered a four-letter word that seldom crosses his lips.

The House Republican plan, which is the basis for Senate talks, includes big tax breaks for the richest Americans.

“Why the hell should that be part of a health care debate?” Mr. Casey said.

He was speaking to a handful of Pennsylvania reporters on a conference call Thursday. Joined by Pennsylvania Gov. Tom Wolf, Mr. Casey blasted the Senate Republicans’ effort, calling it a job killer that threatens the well-being of tens of thousands of Pennsylvania Medicaid recipients, nursing home patients, people with pre-existing conditions and drug addicts in treatment.

“This is a really big deal,” Mr. Wolf said.

Republicans have said that if Obamacare’s Medicaid expansion is so important, governors like Mr. Wolf will find resources to pay for it.

“That’s flawed logic and shows an incredible lack of care and concern,” Mr. Wolf said. “Washington Republicans need to come out of the back room, where this bill is being discussed in secret, and listen” to people who would be affected by the loss of coverage under their proposal.

Mr. Toomey has publicly offered some details of the discussion, including on Tuesday, when he spoke with Philadelphia talk show host Chris Stigall.

“I think there’s a reasonable chance that we will see a draft of legislative language as early as next week and we might vote the following week,” Mr. Toomey told Mr. Stigall. During that period, he said, “everybody can have at it and criticize, attack, praise, suggest changes.”

The Senate took up the repeal effort in May, after the House passed a bill so quickly that congressional researchers didn’t have time to analyze its effects. Projections since then say the bill would cost 23 million people their insurance coverage by 2026 and reduce federal deficits by $119 billion.

Although Senate Republicans said they would put forward their own measure, the language has so far been kept under wraps. A small group of senators, among them Mr. Toomey, has led efforts to draw up a measure out of the public eye.

This week, Mr. Casey sent a letter to Senate Majority Leader Mitch McConnell of Kentucky, writing, “Every indication is that you intend to jam this legislation through with minimal opportunity for debate.”

The letter noted that there had not been a single hearing on the legislation nor any discussions within Senate committees that would ordinarily handle it.

By Mr. Toomey’s reckoning, however, Republicans have been clear about their opposition to Obamacare for nearly a decade. “There is no single issue that’s been more thoroughly litigated in American politics in the last quarter-century,” he said on Mr. Stigall’s show.

Referring to Republican gains in Congress — and the White House — he said, “Every time it was on the ballot, the American people voted for Republicans who promised to kill it.”

Andy Carter, president of the Hospital & Healthsystem Association of Pennsylvania, said Mr. Toomey had been forthcoming about his position on health care. But even Mr. Carter’s organization, which represents health care providers, would struggle to assess a bill on the Republicans’ stepped-up time frame, he said.

“If it was a very modest effort to tweak the existing system, maybe we could digest it in a week,” Mr. Carter said. But “We’ve been building the modern health care financing system [since] 1965.” And when Obamacare was crafted, “There were many public hearings and mark-up sessions, a very robust debate that we’ve seen far less of in this round.”

But to date, there haven’t been the carpet-bombing TV ad campaigns that accompanied previous health care debates, or even more localized issues, including disputes between providers such as UPMC and Highmark.

Mr. Carter said such a campaign may follow once the Senate bill is revealed. “It’s easier to educate people when you know what you’re educating them about. … This is a very intense legislative process over a very short period of time.”

The Senate may tweak some elements of the House plan, delaying the withdrawal of Medicaid by a few years, but Mr. Casey expects the end result won’t be much different.

He acknowledged state projections that insurance premiums will increase 30 percent over this year under Obamacare, but said slashing Medicaid isn’t the way to fix it.

“When it comes to the larger issue about affordability and premiums going up or co-pays for doctors, there’s no question that Americans face that. But what we should do is take this repeal idea off the table and have negotiations about how to bring the rates down,” Mr. Casey said.

One way to do that is to provide a public option so there is competition in rural areas with limited choices from private companies. Another is to offset premium increases with more generous tax credits, he said.

“If Republicans were interested in doing anything of the like, we’d be having a different conversation, but they’re obsessed with repeal. They’re obsessed with pleasing a part of their political base who wants the trophy of repeal and they don’t care who gets hurt in the process,” Mr. Casey said. “That’s an insult to our country. We’re better than that.”