Repeal Obamacare - The Graham-Cracker Plan

Graham-Cracker Bill

This one was cooked up by Senators Bill Cassidy (R-La.), Lindsey O. Graham (R-S.C.) and Dean Heller (R-Nev.).

♦ They are claiming it will turn control of the healthcare markets over to the states. The Graham-Cassidy bill isn't tasty and has nothing in the middle.

The BCRA was bad because it cut not just the Medicaid expansion under the ACA, but it also cut deeply into pre-ACA Medicaid. It intended to shift the burden of paying for healthcare onto states and poor households. At the same time close to 22 million people would have lost health insurance.  Senator McCain helped save America from this debacle.

Senator McCain may have saved American once again. He came out in opposite to the bill on Friday. Saying,

I believe we could do better working together, Republicans and Democrats, and have not yet really tried.

Nor could I support it without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it.

Update:

Monday, September 25^th

Senator Susan Collins of Maine put this bill out of its misery today when she finally got off the fence and said "no."  She went on to say,

Maine still loses money under whichever version of the Graham-Cassidy bill we consider because the bills use what could be described as a 'give with one hand, take with the other' distribution model.

This new GOP healthcare offering is even more horrible than then two previous attempts to get rid of Obamacare.  This new bill is downright destructive.   If enacted it would repeal the ACA without any viable replacement.  It would throw the American healthcare system back to pre-ACA status and at the same time make deep cuts in Medicaid funding.  What little analysis is available shows this bill would leave America’s healthcare system in shambles.

♦ It would kill protections for those with expensive pre-existing conditions.  It would essentially destroy the individual marketplaces by getting rid of premium subsidies, cost-sharing reduction subsidies and the individual mandate.  Older folks could be charged up to five times as much as younger people.

This bill is the worst of the worst the GOP could have cooked up.  All done behind closed doors again.   Again, they want a rush to vote before everyone can read the bill.  And most importantly they don’t want anyone to know the CBO score on this before they vote.

The bill is also written to try to trick the CBO score into looking better than it should.  The CBO looks ten years out.  This bill structures its major cuts to Medicaid to occur in 2027 when funding to states is severely cut.  They don’t want the CBO to estimate loss of coverage after their major cuts kick in.  Most people would consider this a dirty trick.  News organizations picked up on this quickly.

♦ This bill will cause a massive loss of health insurance for millions of American.  The CBO had earlier estimated close to 30 million people would lose coverage if the ACA was repealed and not replaced.  Since the GOP does not want to wait for the CBO score we can assume they believe this new bill will lead to at least 30 million people loosing coverage plus additional millions who will loss Medicaid coverage.  After 2027, even more Medicaid people will lose coverage unless states foot the bill.  We all know states will be hesitant to raise taxes to pay for the old and the poor.

There is no way the GOP can spin this up as good.  But the authors of this bill are trying to do just that.  The say they are giving more control back to states.  Individual states could decide about pre-existing conditions and how much more to charge older people.  As if health insurance wasn't confusing enough already.  It is just putting lipstick on a pig.  It still looks and smells like a pig.

♦ This bill is rigged to use Medicaid funding in a purely partisan fashion.  It would create block grants to pass to states.  This may sound good but it is far from fair.  What it does is redistributes money from an ever shrinking pie.  It is setup to take money from blue states like California and New York and a few other states that decided to go along with the ACA’s Medicaid expansion.  It in affect penalizes states for going along with Obamacare.  It takes money from these states and sends it to red states that refused to expand Medicaid under Obamacare.  It reeks of partisanship.

Many people ask, why is the GOP so intent on killing Obamacare and gutting Medicaid ?  One analyst put it this way, “just follow the money.”  The GOP wants to enact large tax breaks for the wealthiest Americans and their corporate friends.  They will be hard pressed to do that if they cannot cut federal spending. They cannot openly cut entitlements and government funded social programs without risking a public outcry.  That leaves the backdoor approach like this bill.

The Republicans risk a lot pushing one-sided approaches.  If they fail in their latest scheme they will be ridiculed and remain divided.  The Democrats will undoubtedly use this to fire up their base for the 2018 elections.  This scheme may even add wind to the sails of a single-payer concept.