We need one final push to bury Trumpcare 4.0
Just like the zombies tromping out of the graveyard in Michael Jackson’s Thriller, Senate Republicans have returned in a last-ditch effort to repeal the Affordable Care Act.
The big difference is that Sens. Mitch McConnell, Lindsey Graham, Bill Cassidy, et al don’t dance as well as the undead. But the Graham-Cassidy bill could leave just as many people fighting for their lives.
Senate Republicans face a deadline of Sept. 30 to pass the bill with only 50 votes (Vice President Mike Pence would be the 51st vote and tie-breaker), using a process called reconciliation. After that, because Oct. 1 is the start of a new budget year, the Senate goes back to its regular order of requiring 60 votes to achieve cloture and move a bill forward. Since that will never happen with this bill or any of the other monstrosities that congressional Republicans have tried to foist on the American public, this is their last chance to undo President Obama’s signature achievement of moving the country toward universal health coverage.
GOP senators know the bill is awful; they’ve admitted as much. Iowa’s Chuck Grassley was quoted in The Des Moines Register, on a conference call with Iowa reporters:
“You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Grassley said. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”
In other words, yeah, we know it totally sucks, but we’re going to fulfill our campaign promise, even if it kills a good chunk of the U.S. population.
Graham-Cassidy would cut health spending by 34 percent and give states block grants to spend money however they want. That’s not an abstract; that means people won’t be able to get insurance and needed care. It would eliminate all insurance subsidies and end Medicaid expansion. It would let health insurers jack up rates on those with preexisting conditions and even deny coverage for some needed services altogether. States could drop requirements for what the ACA deemed “essential health benefits,” such as maternity care. A baby born prematurely with a serious medical condition could reach his or her lifetime cap before even leaving the neonatal intensive care unit.
Republicans are scrambling to pass the bill before the Congressional Budget Office can deliver a comprehensive score. Because a CBO score would be as catastrophic as the scores for Trumpcare 1.0, 2.0, and 3.0, which said that up to 32 million people would lose insurance and premiums would shoot up. In the absence of a CBO score, health industry analysts have done their own estimates, concluding that tens of millions would lose coverage and that federal funding to states for health coverage would fall by $299 billion by 2027.
Vox asked nine Republican senators exactly what the bill does. The answers the reporters got were … underwhelming, as they all but admitted they didn’t know how finances would work out. There was a lot of mumbling about returning power to the states, even though “details are still being developed”; how the bill would save money and create efficiencies (how is creating 50 insurance systems more efficient and less bureaucratic?); how the bill wouldn’t hurt their own home states (while taking money away from blue states that expanded Medicaid); and how it gave them a chance to institute a Medicaid work requirement (think those seniors on Medicaid in nursing homes will be lining up for jobs?). As long as it repeals Obamacare, it suits them just fine.
Of course, it all comes down to politics. “If we do nothing, I think it has a tremendous impact on the 2018 elections,” said Sen. Pat Roberts of Kansas. Actually, here’s his best quote:
Look, we’re in the back seat of a convertible being driven by Thelma and Louise, and we’re headed toward the canyon. … So we have to get out of the car, and you have to have a car to get into, and this is the only car there is.
But don’t just take my word for it. Vox also has a list of many health care and related groups opposing Graham-Cassidy:
- American Academy of Pediatrics
- American Cancer Society
- American Heart Association
- American Medical Association
- America’s Health Insurance Plans
- Association of American Medical Colleges
- Blue Cross Blue Shield
- HIV Medicine Association
- Kaiser Permanente
- Planned Parenthood
Also strongly not on board, according to a story in The Atlantic:
- American College of Obstetricians and Gynecologists
- American Hospital Association
- American Psychiatric Association
- American Public Health Association
- Children’s Hospital Association
- Federation of American Hospitals
- National Institute for Reproductive Health
The AMA, hardly a bastion of liberalism, gave a basic reason to reject Graham-Cassidy. “Doctors cannot support the bill, as it violates the precept of ‘first do no harm’—a guiding tenet of the profession.”
Is it too much to hope that the Senate also do the same and not harm America?