- The Affordable Care Act (ACA) repeal bill known as Graham-Cassidy is on thin ice in the Senate as key Republicans said over the weekend they will vote no on the bill or are still uncommitted. There is a hearing on the legislation Monday afternoon and a vote is expected Wednesday.
- The authors of the bill have drafted new text in an attempt to sway those senators still on the fence, Politico reported. The only policy change is less protection for people with pre-existing conditions, but funding has been shifted to the benefit of the states the swing voters represent.
- The healthcare industry is maintaining stiff opposition to Graham-Cassidy, and several major organizations, including the American Hospital Association, American Medical Association and America’s Health Insurance Plans, wrote a joint letter to lawmakers strongly condemning it.
In the joint letter, industry organizations said the bill should be rejected because it does not protect people with pre-existing conditions, dramatically cuts Medicaid, weakens the individual market and has an unworkable timeline. “While we sometimes disagree on important issues in healthcare, we are in total agreement that Americans deserve a stable healthcare market that provides access to high-quality care and affordable coverage for all. The Graham-Cassidy-Heller-Johnson bill does not move us closer to that goal,” they wrote.
The newest version of the bill will only fan the flames of opposition. It makes it easier for states to allow insurers to decide how much people with pre-existing conditions are charged and what benefits they have. It also creates multiple risk pools, which would likely lead to higher costs for sick people as they are separated from pools with healthier people. With the new text, states don’t have to get a waiver approved for these major changes.
The bill is likely the last chance Republicans have at ACA repeal this year, as the deadline for the budget reconciliation process is Saturday. The expedited legislative process has left no time for a full score from the Congressional Budget Office, but outside analyses estimate the bill would remove coverage for about $30 million. It gives broad authority to states, which would be allowed to roll back essential health benefit requirements and the ACA’s requirement that people with pre-existing conditions are able to afford coverage.
The overall funding the bill provides is less than the ACA’s, and there is a cliff in 2027, after which the bill provides no funding mechanism. States would receive block grant funds that are eventually given a per capita cap.
These provisions only worsen the outcomes that pushed three senators to vote down the latest version of ACA repeal in July. While time is short, GOP leaders are still trying to negotiate with the holdouts.