Dive Brief:
- Another key Senate Republican on Monday announced opposition to the Graham-Cassidy bill to replace the Affordable Care Act (ACA), leaving the last-ditch effort on its last legs.
- Also Monday, the Congressional Budget Office (CBO) released a preliminary analysis of the bill, which found it would cause millions to lose insurance, particularly after 2020. The agency said it did not have time to perform a regular analysis before a planned vote this week.
- During a Senate Finance Committee hearing for Graham-Cassidy, protesters filled the nearby halls chanting in opposition to the bill. The lengthy hearing produced no proposed policy changes, but gave a visual representation of the numerous polls showing opposition to the bill amongst the public.
Dive Insight:
The bill lost one path to success with Maine Sen. Susan Collins’ commitment to vote no on the bill. With Sens. Rand Paul of Kentucky and John McCain of Arizona also on record against the proposal, it’s unlikely it will have the votes to proceed.
ACA supporters are not standing down, however, as some GOP leaders have vowed to continue their efforts to repeal the law regardless of what happens this month. The deadline for the budget reconciliation process needed to pass repeal is Saturday, but some procedural maneuvers could provide another opportunity later this year.
In her statement, Collins cited the healthcare industry’s universal opposition to Graham-Cassidy. She said she was also concerned with the changes to Medicaid and the weakened protections for people with pre-existing conditions.
The CBO score broadly backed up outside analyses of the bill, which have estimated about 30 million people would lose coverage. The agency looked at an earlier version of the legislation, but the new text did not appear to have significant policy changes. The report also agreed with numerous health policy experts who have said the bill would not maintain protections for people with pre-existing conditions, despite the authors’ insistence it would. The CBO said states would be allowed to modify “restrictions on insurers’ ability to vary premiums on the basis of health status, age and other factors.”
The bill would give states block grant funding to create their own health coverage systems. That funding would be restricted with per-capita caps and would end entirely after 2026. The proposal would also repeal the individual and employer mandates.
An S&P analysis released Monday found Graham-Cassidy would result in 580,000 lost jobs and $240 billion in lost economic activity by 2027, “ensuring that the GDP growth remains stuck in low gear of around 2% at best in the next decade.”