Among GOP lawmakers' most vocal criticisms of the Obama administration's Affordable Care Act was that it was crafted too fast, in secret and without bipartisan cooperation. Empirically, congressional Republicans' current effort to repeal and replace the ACA with their own health care bill has been far less transparent, more partisan and occurring over a much shorter timeline.
In March 2010, the ACA was signed into law by former President Barack Obama. At the time, many GOP lawmakers blasted the drafting process of the bill and accused their Democratic colleagues of shutting them out from helping shape the health care law, according to The Washington Post.
"Rather than try to build consensus for a bill that could broad based supported, they toiled in secret," Republican Sen. Charles Grassley of Iowa said of his Democratic colleagues in November 2009.
Then in February 2010, Republican Rep. Devin Nunes of California accused Democrats of trying "to rush legislation through Congress without public input."
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In March 2010, the current House Speaker, Republican Rep. Paul Ryan of Wisconsin, asserted that the ACA legislation "was crafted in secret, behind closed doors."
Later, Republican Rep. Michael C. Burgess of Texas stated in April 2010 that the only goal of the ACA "was for the president to sign a bill during his first term... [Democrats] didn't care what was in it."
Forbes reports that current efforts by the GOP to repeal the health care system closely mirror the same methods Republican lawmakers criticized during the ACA process.
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In July 2009, the House marked up the ACA in committee for a month, with 160 amendments proposed by GOP lawmakers included. The House waited until November 2009 to hold a vote on the legislation. In 2010, both the Senate Health Committee and Finance Committee spent a cumulative 21 days marking up the ACA, considering 130 amendments and holding 44 hearings on the bill.
Meanwhile, GOP lawmakers have sought to replace the ACA through reconciliation, which would significantly limit the hours of Senate debate and would require fewer votes to get it to President Donald Trump's desk.
On May 4, the House passed the American Health Care Act without a single Democratic vote. The chamber had brought the bill up for a vote two days after it was finalized and before the Congressional Budget Office could release an estimate of its impact on the health care market.
Senate Republicans chose to not consider the AHCA, opting instead to craft their own health care bill. 13 GOP senators worked exclusively on the legislation, titled the Better Care Reconciliation Act, while the amount of debate over the bill has been limited to a maximum of 20 hours. The BCRA has undergone no markups and no Democratic Senator has been invited to propose an amendment.
On June 8, Democratic Sen. Claire McCaskill of Missouri blasted her GOP colleagues for not inviting any bipartisan participation in helping craft the BCRA. The Missouri lawmaker noted that Democrats had extended Republicans the courtesy during the ACA process.
"Dozens of Republican amendments were offered and accepted in that hearing process and when you say you're inviting us... that you want our support -- for what?" McCaskill said in the Senate chamber, according to Business Insider. "We don't even know. We have no idea what is being proposed. There's a group of guys in a backroom somewhere making these decisions. There were no hearings in the House."
McCaskill added "this is hard to take because I know we made mistakes on the Affordable Care Act... and one of the criticisms we got over and over again was that the vote was partisan. Well, you couldn't have a more partisan process than what you're engaged in right now."
On June 27, the Senate Majority Leader, Republican Sen. Mitch McConnell of Kentucky, announced that he would push back a vote on the BCRA until after the chamber's July 4 recess. The decision arrived a day after the CBO found that the health care bill would result in 22 million fewer Americans having health insurance by 2026 than if the ACA was kept in place, The New York Times reports.
Following McConnell's announcement, Trump met with all 52 Senate Republicans at the White House. During the meeting, the president said he would understand if GOP lawmakers were unable to form a consensus around the health care bill.
"This will be great if we get it done," Trump said. "And if we don't get it done, it's just going to be something that we're not going to like. And that's okay, and I understand that very well."