A small group of Senate Republicans are writing a new version of the American Health Care Act in unprecedented secrecy and with a large dose of deception, hoping to attract minimal public attention before a quick Senate vote.

Iowa’s senior Senator Chuck Grassley hasn’t seen the bill. He has no idea whether the revised legislation, like the House-approved AHCA, would cause “people of all ages and incomes” to lose coverage and make insurance several times more expensive for older or sicker Americans. He can’t be sure it will keep promises he has repeatedly made to Iowans, such as “The American people deserve a long-term solution that gives them more choice for less cost.”

But Grassley’s not hung up on small details.

In a brief interview with Jeff Stein of Vox, he defended the bill he hasn’t read, claiming it would offer “certainty.”

You really must click through to read today’s Vox post in its entirety. Reporters “asked 8 Senate Republicans to explain what their health bill is trying to do.” Across the board, they found the GOP senators “can’t answer simple and critical questions about the health care bill they’re crafting in secret.”

Jeff Stein began his interview of Grassley with “a very broad question: What do you think this health care bill will accomplish that will improve America? What’s the positive case for this bill?”

Grassley cited the implosion of Iowa’s individual health insurance market–a common tactic for House Republicans as well. The House bill wouldn’t guarantee that any companies sell individual policies here next year, so Stein had a solid follow-up question.

Jeff Stein
How do you think the bill will fix that problem?

Chuck Grassley
Well, by bringing certainty to the insurance market. They don’t have that certainty now.

A short back-and-forth followed, as Stein tried to get Grassley to elaborate on what he meant by “certainty.” Then, the punch line:

Chuck Grassley
No, it. Well, yeah — it gives them certainty that you’ll have a lot higher rates than if you pass the bill.

Jeff Stein
So you’re saying [the bill] will lower the rates?

Chuck Grassley
Um, if you’re talking about lowering the rates from now down, no. The rates could be way up here. [Points to sky] And if they — if we get a bill passed, it maybe wouldn’t go up or would go up a heck of a lot less than they would without a bill.

Jeff Stein
By “rates,” are you talking about premiums?

Chuck Grassley
Yeah, premiums. … I’m sorry I have to go.

That exchange is comedy gold, until you remember that at least 117,000 Iowans could lose their Medicaid coverage, not to mention many thousands more who would find individual health insurance unaffordable if the Republican proposal becomes law.

Keep calling, e-mailing, writing letters to the editor, and speaking directly to Grassley and Senator Joni Ernst, if possible. In this post, you can find contact information for all the senators’ Iowa offices, along with many facts and figures about the GOP’s tax cut for the rich disguised as a health care bill.

UPDATE: The form letter Grassley’s office has been sending constituents this week repeats some of the promises on health care policy he’s been making for months. In a hilarious new twist, Grassley says, “I’d like to see bipartisan support for a bill.” That’s hard to accomplish when your colleagues are writing the bill in secret without allowing Democrats to see it, let along offer amendments during a committee markup.

Grassley also says, “I have been talking with patient advocates and insurers in Iowa.” Noam Levey and Lisa Mascaro reported for the Los Angeles Times on June 16,

Major physician groups, hospitals, consumer advocates and organizations representing millions of patients with cancer, diabetes, heart disease and other serious illnesses have been pleading with Republican leaders for months to open up the process and listen to their concerns.

This week, a group of more than 15 patients groups — including the American Heart Assn., the March of Dimes, the American Lung Assn. and the American Diabetes Assn. — asked [Senate Majority Leader Mitch] McConnell’s office to meet with them next week, proposing any time between Friday and June 22.

A representative from McConnell’s office told them staff schedules were too busy, according to representatives of several of the organizations.

Latest version of health care form letter from Grassley’s office:

June 15, 2017

Dear [constituent who contacted office]:

Thank you for taking the time to contact me. As your Senator it is important for me to hear from you.

I appreciate hearing your thoughts about the American Health Care Act (AHCA), legislation proposed to replace the Affordable Care Act, or Obamacare.

The AHCA passed the House of Representatives on May 4, and the bill is now under consideration in the Senate. Under the budget reconciliation process, the House had to act first. The passage of the AHCA in the House now gives the Senate the opportunity to repair the damage that Obamacare has caused. Obamacare, or the Affordable Care Act (ACA), isn’t working as time passes and its structural deficiencies are revealed. In Iowa, premiums were 19 percent to 43 percent higher in 2017 than they were in 2016 and many individuals continue to have deductibles and copays so high that it makes their insurance too expensive to use. And now, many Iowans who have Obamacare will have no options for or access to health insurance in 2018. Nationwide, 32 percent of counties in the United States will have just one insurer offering plans on the exchanges. In the Senate, a health care bill will need the support of at least 51 senators to pass. I’d like to see bipartisan support for a bill. I have been talking with patient advocates and insurers in Iowa, as well as the Iowa insurance commissioner and the governor’s office, about all of the considerations to take into account. Their insight is important as the Senate works on a bill that helps make health care more affordable and more accessible for Iowans and other Americans.

As the Senate continues its work on health care reform, I believe that there are a few principles that should guide our work.

First, no one should be disqualified from getting insurance for having a pre-existing condition. If you have children under the age of 26, they should be allowed to stay on your insurance.

Second, any health care reform plan has to address the rising cost of healthcare. There is nothing in place to address the underlying causes of the high cost of health care – that is, what it costs for a hospital or doctor to purchase and maintain medical equipment, purchase medicines, carry malpractice insurance, and the like. Lowering the costs of things like those I just listed would drive down the cost of health care, emergency room visits, and health insurance premiums.

Third, health care reform has to reestablish states as the main regulators of health care. All states have different demographics and healthcare needs and reform must begin with the idea that states know what’s best for their constituents. This principle also applies to Medicaid. In general, I prefer allowing states to have the option to manage Medicaid as they know best what the residents of their state need and I will work to preserve Medicaid for the most vulnerable in our society.

I believe these are the principles that Congress needs to follow as we reform our health care system. The American people deserve a long-term solution that gives them more choice for less cost, and empowers individuals and states to make their own health care decisions.

Thank you again for contacting me. Please keep in touch.

Sincerely,

Chuck Grassley