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Healthcare

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Deja Vu All Over Again

9/18/2017

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They’re back and this time it’s with a vengeance! After having rejected four different Affordable Care Act (ACA) repeal plans this summer, Senate Republicans are at it again. What makes this most recent iteration so frightening is that their desperation to undo President Obama’s signature accomplishment is almost palpable. The current monster Republicans are trying to unleash on the American people is the eponymous Graham-Cassidy-Heller-Johnson. (It should be noted that former PA Senator Rick Santorum has unofficially attached his name to the bill with extensive lobbying efforts on its behalf.)

Work on the bill began in July. (Didn’t they have over 7 years to come up with a replacement plan? Talk about procrastination!) This last ditch effort is being touted by Lindsey Graham as a compromise that will return power to the states. “Instead of a Washington-knows-best approach like Obamacare, our legislation empowers those closest to the health care needs of their communities to provide solutions,” Graham said in a statement on Wednesday. I wonder if the “those closest to the health care needs of their communities” he’s referring to includes the 16 patient and provider groups, such as the American Heart Association, the American Lung Association, the March of Dimes, to name a few,  who oppose his bill. 
​
Picture
Senators Bill Cassidy (R-LA), Dean Heller (R-NV), Ron Johnson (R-WI), Lindsey Graham (R-SC) and former senator Rick Santorum (R-PA) announcing their plan to repeal the ACA. Andrew Harnik A/P
What's in the bill:
While we could go point by point analyzing the inherent problems in each of these, here's an overview of some of the items the bill purports to address:
  • Repeals Obamacare Individual and Employer Mandates.
  • Repeals the Obamacare Medical Device Tax.
  • Strengthens the ability for states to waive Obamacare regulations.
  • Returns power to the states and patients by equalizing the treatment between Medicaid Expansion and Non-expansion States through an equitable block grant distribution.
  • Protects patients with pre-existing medical conditions.

​On Monday Senator Chris Murphy (D-CT) tweeted this out:

THREAD: A short primer on all the ways the #GrahamCassidyBill is an intellectual and moral garbage truck fire. pic.twitter.com/X8IjLLay56

— Chris Murphy (@ChrisMurphyCT) September 18, 2017

​Here's what Graham-Cassidy will actually do :
  • Cover fewer people than the ACA
  • Gut Medicaid
  • Allow insurers to charge the sick higher premiums and stop covering maternity care and prescription drugs
  • Repeal tax credits for middle-income individuals
  • Eliminate pre-existing conditions protections due to ending the individual mandate
  • Current Medicaid expansion spending from the 30 states that are now participating will be distributed over all 50 states. This will benefit states like Texas which haven't expanded Medicaid and cause states like California which have to see dramatic cuts. States will be forced to slash programs, raise taxes, or both.
  • Increase premiums by 20% in the first year alone
  • Hit seniors, children, and the disabled the hardest 
The list goes on...

Most significantly, the biggest departure from the ACA is that funds will no longer be focused on the lowest-income populations. Funding disparities overall get larger over time, because Graham-Cassidy has set a slower growth rate in costs than is realistically expected. ​
Picture

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One last but important thing to mention. The Congressional Budget Office will only release a preliminary assessment of the bill without analysis of coverage or premiums. A full, complete score will not be available for weeks. There’s a September 30th deadline for enacting the budgetary process of reconciliation that Republicans hope to use to avoid a Democratic filibuster, so Republicans are working overtime to push the bill through. All of this means that our Senate is heading toward a blind vote on a piece of legislation that effects 1/5 of the nation's economy and our most vulnerable citizens. 
​

​I could go on, but this beast is scary enough. It's time to exorcise some demons. Maybe with some prodding from their constituents, Republicans will find their way to "the light". 
 
posted by Amy Levengood
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