The GOP is making a push for the Graham-Cassidy proposal
Groundhog Day for Obamacare Repeal
By RUSSELL BERMAN
The GOP is still missing the crucial 50th Senate vote for the Graham-Cassidy proposal. But a looming deadline is providing new momentum, and the legislation has advanced from no-shot to long-shot.
Two things can simultaneously be true about the latest, back-from-the-dead attempt to repeal the Affordable Care Act. One, Republicans are very close to passing a proposal that would sharply curtail the law and result in millions fewer people having health insurance. And two, they are no closer than they were two months ago, when the party fell a single vote short of advancing legislation that would have repealed Obamacare’s core insurance mandates.
The proposal unveiled last week by, among others, Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana has undeniably been gaining momentum in recent days. The White House has reengaged Republicans in an effort to push it over the top. Senate Majority Leader Mitch McConnell, after giving up on repeal in July, is assessing the bill’s support within the conference and has asked the Congressional Budget Office to prioritize its analysis of the Graham-Cassidy proposal so that Republicans can have a score—and thus a vote—on the legislation before a September 30 deadline to pass it with just a simple majority vote. And on Monday, the legislation won the endorsement of a key Republican governor, Doug Ducey of Arizona, which could bring with it the support of Senator John McCain, who effectively killed the last repeal bill.
Democrats and their allies in the health-care advocacy community have taken notice, sounding alarms in a bid to mobilize the same level of opposition to the new bill as they were able to do successfully against previous GOP proposals.
“This is a red siren moment for the entire country,” Senate Minority Leader Charles Schumer said at a press conference Monday. “If this bill becomes law, our health-care system will be dramatically curtailed, and there will be chaos in many states.”
The Graham-Cassidy bill would repeal Obamacare’s individual and employer mandates for health insurance but differs from some earlier proposals by keeping most of the law’s tax increases. That revenue is then converted into a block grant for states, which could choose how to use it to best fit their needs. Graham and Cassidy are trying to appeal to the conservative preference for federalism and attract the support of governors by offering them maximal flexibility. They could keep Obamacare’s standards and requirements, or they could ditch almost all of them, including some of the protections intended for people with preexisting conditions. But as my colleague Vann Newkirk explains, the proposal is not as much of a compromise as it might appear to be, since the measure scales back funding for Medicaid over time, and the states that would be most likely to keep Obamacare’s structure would receive substantially less money from the federal government.
“Senator Collins has a number of concerns with the Graham-Cassidy proposal, including the cuts to the Medicaid program and the impact to the requirement that insurers provide coverage to people with preexisting conditions,” Collins spokeswoman Annie Clark told me on Monday. “She will be examining the forthcoming CBO analysis.”
Murkowski has not said much about the proposal. But like Collins, she has pushed for the Senate to take a bipartisan approach to health care and criticized the push to pass legislation without hearings and on party-line vote. She has also opposed efforts to cut off federal funding for Planned Parenthood, which is part of the Graham-Cassidy bill. And perhaps most importantly, states like Alaska that expanded Medicaid under Obamacare would stand to lose the most under Graham-Cassidy, and Murkowski has emphasized that her home state’s interests will be crucial to her vote.
McCain is a more curious case. The Arizona senator, who is undergoing treatment for brain cancer, provided the dramatic and decisive vote to kill the last GOP repeal plan in July. At the time, he excoriated the process Republicans used to go after Obamacare, calling for hearings, bipartisanship, and “regular order” going forward. But McCain is Graham’s best friend in the Senate, and he spoke positively about the proposal earlier this month. With Ducey’s support on Monday, McCain’s vote could be up for grabs. Appearing on CBS’s Face the Nation on Sunday, McCain signaled his preference for the bipartisan approach to fixing Obamacare that Senators Lamar Alexander, a Republican from Tennessee, and Patty Murray, a Democrat from Washington state, are pursuing in the health committee.
