When Congress writes a bill, it often makes some mistakes. The bigger the bill, the more there tend to be. They're like legislative typos — some unclear phrasing, provisions that don't line up from one part of the bill to the next, even some policy glitches.
What's happening: Policy analysts, Hill staffers, industry experts, and journalists are already starting to find some in the Graham-Cassidy bill. And though Republicans aren't sweating the small stuff, those little mistakes can have big consequences if a bill actually becomes law. Just ask the people who implemented the ACA.
- "We spent a significant amount of time working through the places where the language just didn't work. In part, that contributed to the fact that we didn't get the regulations and the IT infrastructure lined up so that it all launched when it was supposed to launch. Implementation is hard under the best of circumstances," said Yvette Fontenot, who helped write the ACA as a Finance Committee staffer and then implement it in the Obama administration.
Why it matters: These little things can become big things.
- One of the ACA's many funding formulas contained one somewhat circular definition — which grew into a Supreme Court case that threatened a central pillar of the law.
- They can also add up and become time-consuming. What's left murky or contradictory in the statute has to be resolved by the executive branch, and states have to wait for that guidance before they can even begin setting up their own new systems.
There was a time when Congress would simply and easily pass technical corrections to clean up its work on big bills. But Republicans wouldn't pass such a bill for the ACA, and that makes it hard to envision Democrats doing so for Graham-Cassidy (if it comes to that, of course).
The bottom line: Graham-Cassidy has come together so quickly, and its effects would be so sweeping, that it's almost certain to run into a lot of these problems. And they're a whole lot easier to address in a bill than in a law.
- "There's undoubtedly a number of provisions — as there would be in any piece of legislation that addresses this large a part of the economy — that will not work," Fontenot said.