How a health care bill becomes a law

While all eyes yesterday were on the Senate hearing where Attorney General Jeff Sessions was testifying, some actual legislating is taking place in Washington — or so we are led to believe.

The once-moribund Obamacare repeal-and-replace bill, which the House resuscitated last month, passed, and sent along to the Senate, may be moving toward a vote there in the next couple of weeks. But exactly what it will look like is unclear, mostly because the bill is being worked on with a level of secrecy that makes it look more like the Manhattan Project than an effort to figure out how to provide affordable health care access for Americans.

A Globe editorial labels the Senate deliberations the “GOP’s sneak attack on health care.” The Congressional Budget Office scoring of the House bill — issued after it was passed — showed 23 million Americans would ultimate lose coverage under it. That prompted Senate Republicans to say any version they passed would look significantly different. But knowing what the Senate bill will look like has so far mostly been a guessing game.

“There have been no hearings, no released drafts, no informational meetings,” says the Globe editorial. “What’s more, this week, the Senate bill-writers will finish their draft and send it to the Congressional Budget Office for analysis without releasing the legislation to the public.”

All in all, not signs of legislation that its drafters think will prove to be a popular sell with their constituents.

Vox has a rundown of how the Senate bill may be taking shape, with the goal being to win over moderate Republicans like Susan Collins of Maine. The report says that may involve extending the time for a phase-out of Medicaid expansion and maintaining the Affordable Care Act’s prohibition on charging higher premiums for sicker subscribers. One key moderate Republican, however, seemed no less in the dark than the public. Alaska’s Lisa Murkowski told reporters yesterday, “I have no idea if we even have a bill. I learn more from you all.”

Meanwhile, President Trump, who cares more about winning than any specifics of what’s been won, seemed to suddenly pull an about-face on the House bill he gushed over last month. Trump, who called the measure a “great plan” that was “very, very incredibly well-crafted,” yesterday told a gathering of senators at the White House that the House bill was “mean” and that he wanted them to come up with something more generous.

This would no doubt come as a shock to the author of The Art of the Deal, but Trump has now “injected himself in a brewing Senate battle that his fellow Republicans had prayed he would avoid,” according to this account in today’s New York Times.

Vox health care reporter Sarah Kliff says the Senate bill is still likely to look a lot like the House version, which means millions will lose coverage if it’s enacted. But she says Trump “cares less about policy and more about news coverage — how a bill is playing in the media.” He liked the House bill when it seemed “a ‘win” for Republicans,” she writes. “But now that it doesn’t feel like a win — the bill is hugely unpopular, with just 20 percent supporting the effort — Trump has apparently soured on the proposal. It doesn’t matter what is actually in the bill. What matters is what Trump reads about it.”



The Massachusetts House is unveiling a bill that almost completely rewrites the voter-approved ballot question legalizing marijuana, including raising the total tax rate from 12 percent to 28 percent and making it easier for communities to opt out without a referendum. The measure would also move medical marijuana oversight under the same regulatory umbrella. (CommonWealth)

The Legislature, meeting in Constitutional Convention today, is scheduled to take up the millionaire’s tax surcharge, which may appear on the 2018 state ballot. (Boston Globe)

A Lowell Sun editorial urges lawmakers to keep the film tax credit intact, particularly since a TV show has agreed to shoot at a studio in Devens. Preliminary numbers for last year suggest more than a third of the $61 million in credits paid out by the state — $26.7 million — went to a single movie, Ghostbusters. (Boston Globe)

A legislative committee hears testimony on bills that would update the state’s social studies curriculum and make passing civics a graduation requirement. (Salem News)

Lauren Baker, wife of Gov. Charlie Baker, plans to help raise money for a nonprofit that helps children being served through the state’s Department of Children and Families. (Boston Herald)


Two key votes on a new high school in Lowell are put off because of the illness of a city councilor, but backers of locating the facility outside of downtown at Cawley Stadium win a key convert on the panel. (Lowell Sun) What makes the proposed high school the most expensive ever? (Lowell Sun)

Worcester attorney Margaret Melican was denied a position on the city’s Zoning Board of Appeals because of ties to the blog (MassLive)

The Quincy Zoning Board of Appeals rejected a Chapter 40B project for the Wollaston neighborhood that was opposed by area residents and developers indicated they may appeal to the state. (Patriot Ledger)


US Rep. Steve Scalise, the House majority whip, was one of at least five people seriously wounded when a gunman opened fire at a Virginia ballfield where members of a congressional baseball team regularly practice. (Washington Post)

Attorney General Jeff Sessions, vehemently denying any wrongdoing before the Senate Intelligence Committee, admitted he didn’t know much about Russia and other things but what little he did know, he declined to say by claiming his conversations with President Trump were covered by executive privilege even if he didn’t invoke the privilege. (New York Times) Scot Lehigh says Sessions offered a good performance in stonewalling. (Boston Globe) A Herald editorial marvels at Sessions’ apparent lack of interest in the exchanges between Trump and then-FBI director James Comey, saying the AG may be “the least curious human being on the face of the planet.”

More than 200 Democratic members of Congress have filed suit against Trump claiming he is violating the Constitution’s Emoluments Clause because his businesses continue to profit from foreign entities. (New York Times)

Trump businesses are selling more properties to limited liability companies that shield the names of owners. (USA Today)


Southbridge voters oppose a ballot measure urging town officials to negotiate an expansion of the town’s landfill, but they approve a measure authorizing retail sales of recreational marijuana. (Telegram & Gazette)

A Barnstable County commissioner, incensed that state Rep. Randy Hunt parked in his designated space at the county complex, ripped off a scorching email to the Sandwich Republican and threatened to challenge him in the GOP primary because of his “Beacon Hill attitude of entitlement.” (Cape Cod Times)

Republican state Rep. Geoff Diehl says it’s a bit “disconcerting” to be followed by a tracker funded by a Democratic super PAC while still in the exploratory phase of a possible run against US Sen. Elizabeth Warren. (Boston Herald)


Adrian Walker says the backroom process wasn’t ideal, but the product — a possible deal to allow the 775-foot Millennium Partners tower in Boston’s Winthrop Square that would also send some funding to the Rose Kennedy Greenway — is a good one. (Boston Globe)

The family-owned Shattuck Pharmacy, a staple in Northborough for 119 years, is closing its doors, a victim of increased generic drug prices and reduced reimbursements from insurance companies and third-party administrators. (MetroWest Daily News) Todd Brown, the executive director of the Massachusetts Independent Pharmacists Association, wrote about the impact of “pharmacy benefit managers” on drug prices. (CommonWealth)


Wheelock College, which specializes in early childhood education and social work and has struggled with enrollment and finances, is selling some buildings, including its president’s residence in Brookline, and will rethink whether to continue its undergraduate program or focus only on graduate studies.

Brockton School Superintendent Kathleen Smith called the proposed budget by Mayor Bill Carpenter “completely irresponsible.” (The Enterprise)

Education Secretary Betsy DeVos tossed cold water on charter advocates, saying the publicly funded schools should not think they are the only viable alternative in the school choice debate. (U.S. News & World Report)


Lynn Hlatky, the Boston cancer scientist whose battle to save her lab and its valuable research was the subject of this story in the spring issue of CommonWealth, has won the first phase of her lawsuit against Steward Health Care System seeking millions of dollars in damages over the lab shutdown. (Boston Globe)

Nurses at Baystate Franklin Medical Center in Greenfield have scheduled a one-day strike for June 26 to protest what their union says is “bad faith bargaining” by the hospital. (Boston Globe)


The MBTA said an incorrect computer setting at its Haymarket garage caused nearly $41,000 in credit card payments to go uncollected. The T’s parking lot operator is eating the loss and reimbursing the transit agency for the missing funds. (CommonWealth)

Uber board member David Bonderman resigns after what is perceived as a sexist remark in a talk with employees. (Reuters)


The Everett casino, due to open two years from now, is starting to take shape. (Boston Globe)


Prosecutors want to lower the charge to involuntary manslaughter against Michael McCarthy, accused of killing 2-year-old Bella Bond. (Boston Herald)

Lori Ann Bannon, sporting a new look, goes on trial for running a brothel in Lawrence that masqueraded as a day spa. (Eagle-Tribune)


Dan Kennedy ponders the ethical implications of reporting on and speculating about a president’s mental health. (WGBH)