John McCain Comes Out Against Graham-Cassidy Healthcare Bill, Potentially Killing It
Update, September 22: John McCain, the Republican senator from Arizona and one of the critical swing votes in the GOP's latest attempt to repeal and replace Obamacare (and the vote that sunk the previous effort), has come out against the bill, saying he "cannot in good conscience vote for the Graham-Cassidy proposal":
Update, September 21: IJR and Crooks And Liars are reporting that Republicans are attempting to placate on-the-fence Alaskan Senator Lisa Murkowski by allowing Alaska and Hawaii to keep selective aspects of Obamacare. Read more of the details here and here.
Previously: The Republican effort to repeal and replace Obamacare is back from the dead again. On Monday, chances for the Graham-Cassidy bill — introduced by Senator Bill Cassidy (R-LA) and Linsey Graham (R-SC) — seemed to improve at a rapid pace. So what's different about the bill and why are people embracing it? Here's what you need to know.
What's In The Bill?
It Eliminates The Health Care Mandate: The bill would eliminate the individual and employer mandates, that require individuals to have health care coverage and larger employers to supply it.
It Reduces Subsidies And Medicaid Coverage: The bill would also eliminate federal subsidies that the federal government has given insurance companies that lower out-of-pocket health care costs.
Additionally, it would reduce Medicaid funding that has been used by a majority of states to give coverage to individuals making less than $16,000 a year.
It Moves Health Care Funding To Block Grants: Subsidies and expanded Medicaid would be turned into equal block grants for states under the bill, allowing states to propose their own ways of spending the money. Republicans argue that this gives states more freedom, but Democrats argue that overall, less money will be given out, and it makes benefits that were once guaranteed by the federal government into a choice made by the states.
It Alllows Medicaid Work Requirements And Would Defund Planned Parenthood: Two of the most controversial proposals in the bill are freezing Medicaid funding of women's health care provider Planned Parenthood for 1 year, and allowing states to pass work requirements to receive Medicaid.
Pre-Existing Conditions Are Back: Under the Graham-Cassidy bill, insurance companies could once again charge more for those with pre-existing conditions, but they'd still be required to provide coverage. It's estimated that prices would go up for the elderly, and down for the young.
It Would Cut Taxes: The bill would get rid of taxes on non-prescription medicines, health savings accounts (whose maximums would increase), and medical devices. It would keep Obamacare tax increases on the wealthy and health insurers.
Who's Supporting It?
The last ditch effort by Republicans is nail-bitingly close to the 50 votes it needs to pass. There are 52 Republicans in the Senate, but the last attempt to repeal and replace Obamacare failed after three Republicans — John McCain (AZ), Susan Collins (ME) and Lisa Murkowski (AK) — voted against the bill.
The Undecided
All three Republican senators above are still undecided, but some are receiving notable pressure, and giving hints to how they might vote.
On Monday, Arizona Governor Doug Ducey came out in support of the bill, putting pressure on Arizona's John McCain to vote yes:
McCain has gone back and forth on whether or not he actually supports the bill. Two weeks ago he told reporters that he supported the bill, then on the same day said he still needs to see its final form.
Before Ducey's approval of the bill, McCain said he may "reluctantly" vote for the bill if it was backed by the Arizona governor. After Ducey's endorsement, however, McCain told CNN that he may still not support the bill, and that he wants "regular order" that includes committee review, weeks of deliberation, and a CBO score.
On Monday, Lisa Murkowski told reporters that she was still undecided, and that she wants to see the CBO projections first (which won't come until after the vote).
Susan Collins is similarly remained undecided, also complaining about not having a CBO score.
President Trump and Vice President Pence have reportedly been making furious call in an attempt to influence the undecided senators.
Hard Pass
Rand Paul (R-KY), who voted for the previous Republican health care bill, announced early that he would not support this version because it still allocates large amounts of money to Medicaid.
The Congressional Budget Office Will Can't Complete A Full Analysis By The Time Republicans Want To Vote
After a ruling by the Senate parliamentarian, Republicans now only have until September 30th to pass the health care bill with a simple majority. So far, Republicans have been relying on the budget reconciliation process, which allows the Senate to pass a budget-related bill with only 50 votes instead of the usual 60. The parliamentarian ruled that this would expire on September 30th.
Now, the Congressional Budget Office, which has provided key figures (such as how many people will lose coverage) on the practical implications of previous health care bills, has said that it won't be able to provide those same figures for the Graham-Cassidy bill until after September 30th — meaning that the Senate will essentially be voting blind on the bill.
