Many horror movies
Repeal-and-replace is back from the seeming-dead this week in the form of legislation drafted by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana. Senate leaders will try to ram it through by Sept. 30 to avoid a Democratic filibuster. It would replace Medicaid expansion with block grants to states, cap traditional Medicaid funding and repeal individual insurance market subsidies.
Although a vote will come before the Congressional Budget Office can tally the bill’s effects, or damage, critics say it would deprive millions of health insurance coverage. It would weaken guarantees of coverage for people with pre-existing conditions — a hugely popular aspect of Obamacare — and eliminate requirements for young, healthy people to buy insurance, which would undermine the marketplace.
Indeed, health insurers say it would greatly destabilize insurance markets; one insurance association said it could roil markets so badly that it might prompt “government-controlled single-payer health care to grow.” This is from insurers who, unlike Sen. Bernie Sanders, believe single-payer would be a disastrous outcome. Eleven governors last week urged the Senate to reject the legislation, as did the American Medical Association, the American Hospital Association, AARP and the American Cancer Society.
Graham-Cassidy does a neat trick, in that it will shift funding from states that have expanded Medicaid, Vermont and New Hampshire among them, to those (think Red States) that have not. But Medicaid expansion is crucial in providing effective treatment for opioid addiction; it would be folly to backpedal now.
New Hampshire Gov. Chris Sununu hopped on board the Graham-Cassidy bus early last week, expressing enthusiasm for Medicaid block grants. He hopped off soon after when it became clear that the block grants and Medicaid cap would bring sharp cuts — $1 billion in Granite State Medicaid funding between 2020 and 2026, according to the New Hampshire Department of Health and Human Services. Vermont likewise would fare poorly: The Kaiser Family Foundation says its federal funding would drop 31 percent from 2020 to 2026. It estimates that nationally, federal funding under block grants would be a reduction of more than $100 billion in that same period.
We remain perplexed by why Republicans wish to pursue policies that would harm millions of Americans — and American voters. Its right-wing base demands action after years of being fed slander about Obamacare, and pundits claim big donors are insisting on crippling it, undoubtedly a major motivation. Meanwhile, we think the public, if not yet entirely embracing the idea of health care as a right, has come to see the great good in making affordable coverage available to more and more of their fellow citizens. They see the alternative as cruel, and they are not wrong.
On Friday afternoon, Arizona Sen. John McCain announced he could not in good conscience support Graham-Cassidy, which observers said likely dooms it to failure. Let’s hope they are right, but we will not prematurely declare it finished. The Republican leadership never reaches the final stage of grief — acceptance — not with anything regarding Obamacare.
