The effort to repeal the Affordable Care Act, which fell apart earlier this year in a convulsion of Republican finger-pointing, has risen from the dead thanks to an effort that one Republican Senator positively compared to a grave robbing. To be honest he's describing something closer to necromancy, but that's probably a minor point at the moment.
Senate Minority Leader Chuck Schumer called the latest effort at repealing Obamacare a "red siren moment" at a press conference yesterday, in which he also called the proposed bill from Republican Senators Bill Cassidy and Lindsay Graham "meaner than ever."
Schumer also promised that Senate Democrats would use any tool they had to gum up the works in the Senate to slow down a possible vote on the bill, while also calling on Republicans to have the "courage and decency" to wait for a Congressional Budget Office score on the bill. The CBO announced this week that while they would be able to provide a provisional analysis of how the bill would affect the national budget deficit by next week, they won't be able to come out with a study of how the bill would affect things like health insurance coverage or premiums "for at least several weeks," after the September 30th deadline for a simple majority vote.
The Graham-Cassidy bill relies on giving states block grants to fund their own individual health insurance markets, ending the individual subsidies for health insurance on the private market. The proposed bill would also begin paying less and less money to states that chose to expand Medicaid starting in 2020. The changes to Medicaid funding would hit New York and California particularly hard since both states have taken full advantage of the opportunity to expand Medicaid under the Affordable Care Act.
The bill would also eliminate the federal individual mandate for individuals to have health insurance, as well as the mandate that employers with 50 or more full-time employees provide health insurance to those employees. It would also only prevent insurance companies from setting premiums on the basis of sex and other protected classes, essentially allowing the return of higher premiums due to preexisting conditions.
Under this bill, people with metastatic cancer will pay $142,650 more a year to get coverage.
That is not reform. That is a death sentence. https://t.co/XN3mVv0F2t
— Eric Schneiderman (@AGSchneiderman) September 18, 2017
And while proponents of the bill have suggested this is a way for states to take control of their own health insurance systems, one senator is attempting to make sure states like California and New York wouldn't be able to create single-payer health insurance systems:
Sen. Kennedy (R-LA) says he's submitted amendments to Graham-Cassidy that would bar states from using $ to create single-payer systems
— Jeff Stein (@JStein_Vox) September 19, 2017
The fate of the bill is somewhat fluid at the moment, like the original attempt to pass the American Health Care Act earlier this year. A handful of Republican senators such as Rand Paul, Susan Collins, Lisa Murkowski and Rob Portman are publicly undecided on the bill, which would need 50 votes to pass (with a tiebreaker coming in the form of Vice President Mike Pence). When Trumpcare failed to pass this summer, Murkowski, Collins and Senator John McCain were the only three Republicans who voted against it. However, McCain has not publicly said he'd vote against the bill, and speculation remains that he would vote for it since Lindsay Graham is his best friend and Arizona Governor Doug Ducey announced his support for the bill yesterday.
A vote on the bill has to take place before September 30th, the end of the fiscal year, which is when the procedural tool called budget reconciliation will expire. Without that fast-track ability to send the Senate bill to the House, the Senate would need 60 votes to pass the Graham-Cassidy bill, a seemingly impossible task given that there are 46 Democrats in the Senate currently.
— igorvolsky (@igorvolsky) September 18, 2017