Republicans Abandon Latest Attempt To Repeal Obamacare — Here's What You Need To Know
Update, September 26, 2:34 PM: Republican Senators are abandoning their latest attempt to repeal and replace Obamacare, Republican leader Senator Mitch McConnell told fellow Senators Tuesday. The announcement followed Republican Senator Susan Collins' announcement Monday evening that she would not support the Graham-Cassidy bill, making her the third Republican Senator to reject it and effectively killing its chances of being passed.
Previously: This Saturday is the deadline for Republicans in The Senate to pass a health care bill with a simple majority, and after John McCain (R-AZ) announced his opposition to a new version of the Graham-Cassidy Obamacare overhaul last week, Republicans have gone back to the drawing board. Sunday evening, the new version of the bill was released to media outlets. Here's what you need to know.
Update, September 25, 6:20 PM: Maine Senator Susan Collins Pledges To Vote 'No' On The New Bill
In a press release published on Twitter by NBC Nightly News writer Bradd Jaffy, Senator Susan Collins outlines why she opposes the Graham-Cassidy bill in both of its forms, despite its relatively favorable treatment toward her home state of Maine:
Previously: The New Bill Steers Funding To States Of Senators That Opposed Previous Versions
The revised version of Graham-Cassidy points more federal funding in the direction of Arizona, Kentucky and Alaska — all states of Senators that announced opposition or expressed skepticism towards the first versions of Graham-Cassidy. These states would have lost federal funding under the previous versions of the bill are now projected (by the bill's authors) to receive increases in funding.
New Funding Comes Through Three Channels
The additional funding doesn't target states specifically, but instead comes through funding that's directed by three tailored rules:
1. $750 million provided every year from 2023 to 2026 (totaling $3 billion) to states that expanded Medicaid under Obamacare after 2015.
2. $500 million for states that have set up an Obamacare waiver program — a provision likely directed at Alaska, which set up a reinsurance program through the law's waiver program.
3. Additional federal Medicaid funding made available to certain high-poverty states, which also appears directed to Alaska.
[Vox]
Some Say The Projections In The Bill Are Misleading
The Center of Budget and Policy Priorities, a left-leaning think tank, says that the projections found in the new Graham-Cassidy bill don't account for funding lost by transforming an open-ended entitlement into a series of budgeted block grants:
Medicaid spending caps in the previous version of Graham-Cassidy, which remain in the revised bill, would have reduced federal funds to states by $120 billion between 2020 and 2026 — and by more than $1 trillion through 2036, according to a recent study from Avalere Health… Alaska, Arizona, Kentucky and West Virginia would still receive less funding under Graham-Cassidy compared with Obamacare, according to Topher Spiro, a health analyst with the left-leaning Center for American Progress.
[Politico]
The Bill Is Worse For Those With Pre-Existing Conditions
Regulatory changes in the bill make it worse for those with pre-existing conditions. According to Axios, the new version of the bill allows for "multiple risk pools," which would inflict higher premiums on sick individuals. It would also allow states to raise the cap on out-of-pocket costs, and eliminate minimum coverage levels.
To adjust the rules, states would no longer need to apply for a waiver, they'd simply have to submit their own explanation of how the change helps supply "adequate and affordable" care for those with pre-existing conditions.
Republicans Have Some Lobbying To Do
Multiple Republican Senators have come out against Graham-Cassidy, appearing to put the bill below the 50 votes it needs to pass.
Rand Paul of Kentucky (R-KY) says the newest version doesn't cut it, and needs to cut spending on block grants — the primary aspect of the bill.
John McCain said Friday (before the release of the most current version) that he wouldn't vote for the bill because it is skirting regular Senate procedure — requiring only 50 votes and moving at a faster pace than 96% of laws passed in The Senate.
Susan Collins (R-ME) said Sunday that it would be "very difficult for me to envision a scenario" where she'd vote for the last iteration of the plan.
Ted Cruz (R-TX) said Sunday that the previous version of the bill didn't have his or Mike Lee's (R-UT) vote, urging the bill's creators to consider "consumer freedom." Neither has addressed the most recent iteration of the bill.
Lisa Murkowski voted against the last Republican health care bill that hit the Senate floor (along with Susan Collins and John McCain), but she has remained undecided on the most recent iteration of Graham-Cassidy. She has gone on record, though, speaking against policies in the bill. In June, ahead of the last full Senate vote against Obamacare, Murkowski noted the importance of covering pre-existing conditions, greater access and lower costs.
Even President Trump has expressed skepticism, telling the Rick & Bubba radio show: "Looks like Susan Collins and some others who will vote against… We're going to lose two or three votes and that's the end of that."
Prospects could get even worse for the bill as the Congressional Budget Office is expected to release a partial score on Tuesday.
