Back from the Dead: One Last Attempt at ACA Repeal

There they go again. Senate Republicans are trying one last ditch attempt to repeal the Affordable Care Act. The latest version is called the Graham-Cassidy bill, and Senator McConnell is attempting to push it through before September 30th, when their power to pass health care legislation with only 51 votes expires. But the latest version is like an unwanted sequel--more of the same and nothing new. Like the previous repeal attempts, millions of people would lose their health insurance under Graham-Cassidy, and the Senate should reject it.

The bill has four co-sponsors: Senator Lindsey Graham (R-SC), Senator Bill Cassidy (R-LA), Senator Dean Heller (R-NV), and Senator Ron Johnson (R-WI). They claim this legislation is not partisan and will not result in drastic cuts, but that is simply not true. Cassidy-Graham would cause millions of people to lose their health insurance, drastically change Medicaid for the worse, get rid of protections for people with pre-existing conditions, and result in higher health care costs. Moreover the Congressional Budget Office (CBO) will only be able to conduct a bare-bones analysis of the bill before September 30th; a full analysis would require significantly more time, and yet Republicans are trying to pass it as soon as possible.

The Graham-Cassidy bill would eliminate ACA subsidies for health insurance marketplaces and replace them with inadequate block grants. The funding for the block grants would be far below current funding for health coverage, it wouldn't be adjusted based on how much people need the money, and it would be completely eliminated after 2026. The block grants could also be spent on any kind of health care, and would not be required to help low and moderate income people get health insurance.

And that is just the beginning. The bill would also turn Medicaid from a joint program run by the states and federal government into a per capita cap, meaning Medicaid funding for seniors, children, and people with disabilities would be cut. States could also waive the ACA's prohibition on charging higher premiums based on people's health status, meaning people with pre-existing conditions would have to pay more. And under Graham-Cassidy, insurance companies would no longer have to cover benefits like mental health and substance abuse treatment or maternity care, placing further hardships on women and families. Planned Parenthood would be defunded as well.

Finally, the bill would harm the individual insurance market by both getting rid of ACA subsidies to purchase health insurance and getting rid of the requirement that people buy health insurance. CBO previously estimated that simply repealing the ACA without replacing it would result in 32 million people losing their health insurance. This bill would likely result in more people losing their health insurance--over 32 million, largely because its block grant funding would end in 2026 and the rest of Medicaid would undergo severe funding cuts.

Congress should reject this repeal attempt. The Affordable Care Act needs reform, but this bill will make our health care system immensely worse.