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Graham-Cassidy: The GOP’s Last Stand on Trumpcare

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The United States Senate is about to consider one last attempt at Obamacare repeal. Legislation introduced by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) is the vehicle of choice this time around.

Republicans are facing an end of the fiscal year deadline (11:59 pm September 30), at which point the rules of the Senate will revert to needing 60 votes instead of the 50 (plus the Vice President) to get the job done. Apparently, we have to fight this battle one more time.

At the heart of the Graham-Cassidy bill is an old idea near and dear to Republican hearts: block grants for the states to administer largely as they see fit. It ends the individual mandate, allowing states to waive Obamacare’s essential health benefits as well as its prohibition on rejecting those residents with preexisting conditions. Medicaid expansion states (mostly blue) lose big. Non-expansion states (mostly red) get more federal money.

As Vann R. Newkirk II at the Atlantic explains:

Although the dismantling of the exchange markets and the Medicaid expansion, and their replacement with a more restrictive grant get the top billing on Graham-Cassidy, the bill’s changes to the underlying Medicaid program arguably will affect more people, and will also end up moving millions of people off of coverage. In that domain, Graham-Cassidy isn’t different from its predecessors, changing the Medicaid program to a per-capita cap-funding structure that would underfund the program over time and leave it less and less responsive to the health needs of low-income people.

And between those changes and the aforementioned changes to private insurance and expanded Medicaid, when states are forced to reckon with shrinking health budgets relative to the number of potential beneficiaries, the resultant cuts will tend to be on some obvious lines: People with mental-health problems, children above poverty but below middle class, and people in need of home-health services.

The bottom line: less funding, getting worse as time goes by, and fewer people covered.

There are three reasons why, politically speaking, Graham-Cassidy is different than previous incarnations of ‘Replace and Repeal.’

The ‘deal’ between the President, Sen. Chuck Schumer and Congresswoman Nancy Pelosi to get a debt ceiling increase and a government funding bill off the legislative docket actually cleared room for consideration of this last gasp effort.

Republicans, hoping to avoid future end-runs around their leadership, believe a ‘win’ will persuade the President to avoid further dealings with the Democrats. Trump, as you may have figured out by now, doesn’t care about the particulars of legislation as much as he does about being perceived as accomplishing something.

Finally, there’s the Child Health Insurance Program (CHIP), which covers 1 in 10 US kids. Its authorization is due to expire on September 30. While there is bipartisan agreement about how to reauthorize it, the Congressional Budget Office has been told to suspend work on scoring it and focus on Graham-Cassidy. This could end up being a critical piece of leverage.

Senate Majority Leader Mitch McConnell will only schedule a vote if he knows he has enough Republicans to pass it.  If he does, the vote will be between Wednesday, Sept. 27 and  Friday, Sept. 29. Saturday, Sept. 30 is likely out of the question because of Yom Kippur.

Dylan Scott at Vox and many other pundits are skeptical about Graham-Cassidy’s chances.

On its face, this new legislation would encounter many of the same problems that earlier Republican health care bills did: Medicaid cuts and coverage losses. No other plan could get 50 Republican votes. Is this really the one that will?

But nothing motivates lawmakers like a deadline. That’s the best hope that Cassidy-Graham has.

“If you believe repealing Obamacare is a good idea, this is your best and only chance to make it happen because everything else has failed,” Graham said Wednesday.

Any chance of this bill’s passage mandates a response. Here’s the Indivisible tool kit making it easy to respond, no matter where you live.

Looking for some action? Check out the Weekly Progressive Calendar, published every Friday in this space, featuring Demonstrations, Rallies, Teach-ins, Meet Ups and other opportunities to get your activism on.

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Doug Porter

Doug Porter

Doug Porter was active in the early days of the alternative press in San Diego, contributing to the OB Liberator, the print version of the OB Rag, the San Diego Door, and the San Diego Street Journal. He went on to have a 35-year career in the Hospitality business and decided to go back into raising hell when he retired. He won numerous awards for his columns from the Society of Professional Journalists in 2012, 2013, 2014, 2015, 2016 and 2017. Doug is a cancer survivor (sans vocal chords) and lives in North Park.

Comments

  1. This isn’t a last stand. They will keep trying to undo the ACA until they succeed or die trying.

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