Health Care

Last Chance to Tackle ObamaCare?

The Graham-Cassidy bill is a long way from repeal, but it has some selling points for the GOP.

Lewis Morris · Sep. 21, 2017

The window of opportunity is rapidly approaching — and closing — for Senate Republicans to pass their latest attempt to repeal replace reform ObamaCare. After Sept. 30, the opportunity for reconciliation goes away, and with it any chance of passing a bill with a simple majority.

The more cynical among us would say, who cares? We have listened for more than seven years as the GOP made one promise after another to repeal and replace ObamaCare. The electorate handed Republicans both chambers of Congress and then the White House on a silver platter. And yet, they have managed to screw up every attempt to follow through on their promise. Why be concerned about having to face a super majority in the Senate when Republicans can’t even get their own simple majority on the same page?

However, if we were to engage in some cautious optimism for a moment, this time might be different.

Senate Republicans Lindsey Graham (SC), Bill Cassidy (LA), Dean Heller (NV), and Ron Johnson (WI) have introduced a modest proposal that could be the beginning of the end of the Un-Affordable Care Act.

Graham-Cassidy, as it is known, hits a lot of the right buttons in terms of trying to correct the ObamaCare horror show. Individual and employer mandates would be eliminated, as would the medical device tax. It offers block grants to states instead of shoring up their ballooning Medicaid plans with what was essentially bribe money that Barack Obama used to buy state support for ObamaCare in the first place. Health Savings Accounts would be expanded and HSA account holders could spend that pre-tax money on insurance premiums, something that was practically unheard of before.

One of the most attractive elements of Graham-Cassidy is that it allows states to chart their own course to some extent. Block grants would give states the flexibility to experiment with new health care options or keep the ObamaCare model, if for some unholy reason they should so choose. In a more reasonable world, it would offer an excuse for some Democrats to support the bill.

Of course, in the bitter, partisan world in which we live, there will be no Democrat support for this bill. They’re too wrapped up in Bernie Sanders’ single-payer proposal. But that’s to be expected. When it comes to health care, Democrats and Republicans really can’t bridge the ideological gap.

Senate Republicans have a two-vote margin of error to get this bill passed, and Rand Paul and Susan Collins can’t be counted on for support. John McCain appears to be on board after shooting down the last attempt to get a bill through. Lisa Murkowski has yet to declare either way. She ran for re-election in 2016 on a promise to repeal ObamaCare, but let down her Alaskan constituents this past summer when she changed her “yes” to a “no” at the last minute.

Things will get interesting next week as the deadline for passage approaches. The Congressional Budget Office assessment of the bill will be announced, for what that’s worth. The CBO has already stated that its score will not include estimates on the bill’s impact on premiums and the deficit. This makes some wonder: If CBO can’t provide that information, then why bother doing a score at all? Well, the score is better for Democrats to use as a bludgeon on the GOP.

Indeed, while Democrats publicly balked at hearing this news — as if they were going to honestly consider voting for the bill — in reality they just want numbers to wave in front of the media in order to have a tangible excuse for their “no” votes. Now they will just have to stick their fingers in their ears and mumble incoherently during the floor debate.

There are a lot of hurdles before Graham-Cassidy will see the light of day. And should it pass the Senate, it will face an even tougher time in the House.

For the bill to have any chance of reaching President Donald Trump’s desk, it will have to sail through the House without any changes. This is highly unlikely. The House’s ObamaCare repeal bill is quite different from Graham-Cassidy. And it barely squeaked by with a 217-213 vote. Any blue-state representatives will have a tough time supporting a bill that will cost their states billions of dollars in subsidies. Rep. Peter King of New York is one such congressman who can’t be counted on to pull in for the big win.

Funny how all these Republicans were so loud and proud about their opposition to ObamaCare when they didn’t have the power to do anything about it. Where did they all go?

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