The clock is ticking for Senate Republicans to be able to repeal and replace Obamacare, following through on their almost 7-year campaign promise, through a special process that requires fewer votes. The deadline to pass the bill with a simple majority of 51 votes is September 30.
For Republicans who worked around the clock in July to try to pass an repeal of the Affordable Care Act, also called Obamacare, it’s déjà vu. Sen. John McCain, R-Ariz., Sen. Susan Collins, R-Maine and Sen. Lisa Murkowski, R-Alaska, are on the fence once more about supporting the GOP’s latest health care proposal.
This time, those Republicans are considering a very different option with the Graham-Cassidy bill, a repeal effort led by Sen. Lindsey Graham, R-S.C., and Sen. Bill Cassidy, R-La.
What’s new, old and controversial about the Graham-Cassidy bill:
Similar to previous Republican repeal efforts, Graham-Cassidy immediately removes the individual and employer mandates to sign up for health insurance, two tax penalties tied to the ACA that continue to be unpopular with the public.
Graham-Cassidy also repeals the medical device tax, which some said was prohibitive to medical innovations. The plan repeals Medicaid funding for Planned Parenthood for one year—just as the ‘skinny repeal’ was designed to do and would increase the amount of money that people can put into Health Savings Accounts, or HSAs, that are popular with Republicans, and consumers could also use that savings money to pay health insurance premiums.
Like past repeal efforts, health insurance premiums for older and disabled Americans would go up with cuts to Medicaid expansion, Medicare would not be changed, and the bill would repeal cost-sharing subsidies in 2020, which give discounts for deductibles and copayments.
The Graham-Cassidy bill would give states more discretion with health care funds. The tax credits, Obamacare-era subsidies and Medicaid expansion dollars would be eliminated. Instead, states would receive block grants of money to allocate as they determine. How much money each state would receive depends on a complicated formula that factors in population size and resident wages, and states would not have to spend money to increase health insurance coverage. Graham-Cassidy block grants would expire in 2026.
“It takes money that previously would have gone to premium tax credits and the Medicaid expansion and divides that up to states in a block grant, but…