Republican Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana are trying to get the Senate to vote on a bill to radically cut healthcare funding before the Congressional Budget Office can tell us how the legislation will actually impact people.
In a head-long effort to beat a September 30 deadline that would prevent Senate Republicans from ramming through an epic healthcare disaster, they have thrown together legislation that could leave tens of millions without insurance.
After the CBO advised Congress last Monday that it will not be able able to estimate of the Graham-Cassidy bill “for at least several weeks”, the senators pushed to get their bill to the Senate floor anyway. Even if the bill did reach the Senate floor, there would be virtually no time for debating it. Senators would vote on the bill, and amendments to it, without discussion.
So, without a CBO report, what do we know about the Graham-Cassidy bill?
The Center for Budget & Policy Priorities estimates that at least 32 million people would lose health insurance. The centers’ analysts note that the “new” bill contains the the same measures as last July’s “repeal-without-replace” effort, which CBO found would take away insurance from 32 million. The center also points out that the new bill could cut Medicaid even more than the July one, meaning its toll of uninsured would be even higher.
Regarding the impact of Graham-Cassidy on premiums, the Center for American Progress found that for those who did not lose coverage, premiums would increase significantly, by as much as 20 percent in the first year. For people with pre-existing conditions, such as alcoholism, diabetes, or arthritis, the rate hikes could be even higher. The bill would allow insurers in the individual market to charge a premium markup based on health status and history.
Graham-Cassidy would cut access to services for millions of women and men by eliminating federal funds for Planned Parenthood, which provides people with preventive care, including birth control, cancer screenings, and STD testing and treatment.
The previous attempt by Republicans to repeal the Affordable Care Act included an appropriation to treat Americans with opioid addiction, but the Graham-Cassidy bill doesn’t even include that. This is even more startling in the context of the latest Centers for Disease Control report revealing that opioid overdose deaths increased 52 percent from January 2016 to January 2017. Steve Bannon, unsurprisingly, has called Graham-Cassidy, “the best idea I've heard in years.”
Political developments are driving Graham and Cassidy to compound their recklessness by making last-minute unanalyzed deals that would endanger even more Americans. The senators need 50 votes to get their bill through with Republican votes only. As of this writing, John McCain of Arizona and Rand Paul of Kentucky have announced they won't support the measure, leaving Graham-Cassidy at 50. If one more Republican defects, the the bill would be dead. Susan Collins of Maine is already leaning “no” and several other senators are sitting on the fence.
In response, Graham and Cassidy are making two kinds of backroom deals. The first are aimed at senators like Collins and one of the fence-sitters, Alaska’s Lisa Murkowski. Those deals are supposed to would skew federal healthcare spending toward those senators’ states. The second set of deals are aimed at hard-core right-wingers like Texas senator Ted Cruz. They would make it even easier than the original bill for insurers to deny coverage to people with pre-existing conditions.
This is in spite of the fact that Americans prefer the existing federal health care law to the latest Republican alternative by a twenty point margin. What happens to our health care next depends on what else the Republican leadership has up their sleeves, and how well Republican senators listen to the voters in their states.