What You Should Read To Understand The Republicans' Latest Attempt To Repeal Obamacare
The Senate is expected to vote next week on what could be the final Republican attempt to repeal Obamacare of this Congress. The stakes couldn't be higher, and the vote count couldn't be closer. So what are we to make of the controversy surrounding the Graham-Cassidy bill? Here's what you should read to understand it.
Republicans Aren't Voting For Graham-Cassidy. They're Just Voting For Obamacare Repeal. (I think
At this point, it's become clear that the priority for most senators is simply winning the political battle to repeal Obamacare, writes Dylan Scott:
The underlying truth, the beating heart of Obamacare repeal that refuses to let it die, is: Republicans just want to pass a bill, any bill, to say they repealed Obamacare. Whatever standards they've set for their health care plan, whatever promises they made before, don't matter.
[Vox]
Scott points to numerous contradictions that senators are making by supporting the bill. One such contradiction can be found looking back at this summer, Republicans refused to make cuts to Medicaid and wouldn't budge on protections for people with pre-existing conditions. Graham-Cassidy would do both these things, revealing alternative priorities.
But you don't even need to read between the lines to understand that senators are prioritizing an Obamacare repeal over Graham-Cassidy's real effects, you can hear it straight from their mouths.
GOP Senators Are Rushing To Pass Graham-Cassidy. We Asked Nine To Explain What It Does.
Jeff Stein interviewed nine GOP senators voting for the bill, and a large number of them were very frank about the fact that they were voting for Graham-Cassidy because it's the best way to repeal Obamacare. Senator Pat Roberts (R-KS) told Stein:
Restoring decision-making back to the states is always a good idea, but this is not the best possible bill — this is the best bill possible under the circumstances.
If we do nothing, I think it has a tremendous impact on the 2018 elections. And whether or not Republicans still maintain control and we have the gavel.
John Kennedy (R-LA) made explicit that his first priority is to repeal Obamacare:
My position has always been that, number one, I think Obamacare has been a failure. Number two: First chance I get to vote for repeal it, I'll do it. And number three: If it's replacement, if replacement is better than Obamacare, I will vote for it.
Chuck Grassley (R-IA) said that Republicans had promised to voters to repeal Obamacare:
…Republicans have promised for seven years that we were going to correct all the things that were wrong with Obamacare, and we failed the first eight months. This is the last attempt to do what we promised in the election.
[Vox]
Republicans' New Health Care Plan Would Need To Move Faster Than 96% Of Laws
Senator John McCain (R-AZ) has yet to say how he'll vote on the bill, but has repeatedly criticized bypassing usual procedures. Ryan Struyk notes that the pace at which the Republicans are trying to pass Graham-Cassidy is certainly remarkable:
Only 4% of bills signed into law over the last four decades have taken 10 days or fewer from introduction to becoming a law on the books, according to a CNN analysis of almost 12,000 laws passed since 1977, when this data became available… The average bill signed into law since 1977 has taken 222 days to go from introduction as a bill in Congress to law on the books.
[CNN]
The Bill Would End Up Giving More Money To Republican States
Graham-Cassidy would rearrange how states get money for health care, combining three-sources of money into one grant that will allow states to spend money on whoever they choose. While states will receive money based on how many low-income people they have, they are not required to spend it in to aid those people. Anna Maria Barry-Jester points out in FiveThirtyEight that in many cases this will mean states with a track record of spending health-care funds on low-income people will get less money, and those without that record will get more money:
In many cases, states that did not expand Medicaid would end up with more money than they currently get, and states that did expand the program would get less. Since states' decisions to expand Medicaid largely fell along party lines, that means more money for many Republican-leaning states and less money for many Democrat-leaning states. But in some cases, it also means less money for some of the states with the most successful Obamacare marketplaces[.]
The Real Losers of the Graham-Cassidy Health-Care Bill
The Graham-Cassidy bill would also devastate red states that chose to expand Medicaid, often times because of dire health crisis:
The collection of red states that would lose under Graham-Cassidy is notable. Their governments fought for Medicaid expansion against the party line because they were often in dire need of those funds. Kentucky, New Mexico, and Louisiana are the three poorest states in the country, and Louisiana, Arkansas, West Virginia, Indiana, Ohio, and Maine are all among the worst 10 states in infant mortality. Many of those states score close to last in other health indicators. Additionally, West Virginia, Ohio, Kentucky, Maine, and New Mexico are on the front lines of the opioid epidemic, and have needed extra Medicaid funds to buoy health infrastructure that has been incredibly strained. The gains in those states have been palpable.
The GOP Bill Forces States To Build Health Systems From Scratch. That's Hard.
Not only would the law cause many people to lose their insurance, it would also wreak havoc on state governments, forcing every state to build health care systems from scratch in less than two years:
The language of the bill provides them with a nearly unlimited range of policy options to use the money in the service of providing health care access, and no templates or fallback options… The challenges would fall into two major categories. First, states would need to make political choices about what they want their system to look like. Next, they would need to submit applications, hire contractors and build new systems to run them. Neither would be easy… Under Obamacare, states had limited, rather binary policy choices, and even those were hard for state governments to make quickly.
The Graham-Cassidy Health-Care Bill Is A Potential Disaster
Aside from the millions of people who would lose coverage over time, the law would also raise costs for those with insurance. John Cassidy of The New Yorker outlines the costs:
The bill isn't just a smash-and-grab raid on the poor and nearly poor, though… allowing insurers to force people with preëxisting conditions to pay more… How much more? According to a new analysis by the Center for American Progress, a liberal think tank, opioid addicts and people with rheumatoid arthritis would face surcharges of more than twenty thousand dollars a year. (That's in addition to the regular premiums.) For people with serious heart conditions, the surcharge would be more than fifty thousand dollars a year. And for those with metastatic cancer, it would be more than a hundred and forty thousand dollars.
Catch up on where the bill stands in Congress and the basics of what's inside