The Disturbing Process Behind Trumpcare

Since I came to Washington in 1969, I have been immersed in Congress and its policy process. I have seen many instances of unpopular bills considered and at times enacted. I have seen many instances of bills put together behind closed doors. I have seen bills enacted and repealed after a public backlash. I have seen embarrassing mistakes in bills, and lots of intended consequences.

But I have never seen a process like the one Senate Majority Leader Mitch McConnell is using in the Senate with his so-called Better Care Reconciliation Act, BCRA, to presumably repeal and replace the Affordable Care Act; nor have I seen lawmakers responding to the bill, and their own constituents, this way.

Let’s take a brief look at a couple of Congress’s greatest hits: one unpopular bill and one crafted in private. Perhaps the most notorious in terms of unpopularity was the aptly named Medicare Catastrophic Act of 1988, which was substantially repealed just a year later after an intense backlash from a group of more affluent seniors upset that their costs would go up. The visual imprinted in many minds was hundreds of enraged elderly chasing Illinois Representative Dan Rostenkowski down a street in Chicago as he sought refuge in his car after a rancorous town meeting.

Sure sounds like a parallel to today. But consider: The 1988 act was an open