President Donald Trump has had an awful first nine months in office. His scandal plagued White House has been in a continuous state of chaos. He has failed to unite the country, let alone his own party. President Trump's approval ratings are at a historic low for any president, so he is desperate for a legislative win.
Now beleaguered Republicans in Congress are hastily focusing their efforts on passing their latest repeal and replace measure for Obamacare in a effort to fulfill a longstanding political promise. The bill is sponsored by Republican Senators Lindsey Graham and Bill Cassidy. The president, who has not read the measure, is enthusiastically cheering them on.
The Republican's latest version of healthcare legislation will replace Obamacare with a measure that will leave untold millions of Americans without health coverage. The exact impact and cost of their proposed legislation is not known because the GOP is rushing the bill through without an official scoring by the Congressional Budget Office. They are also circumventing regular Senate procedures to take advantage of a short window that allows them to pass the measure with just 50 votes and a tie-breaking vote by Vice President Mike Pence. Senate Majority Leader Mitch McConnell will bring the legislation up for a vote next week, according to his spokesperson.
Under the GOP measure current expanded Medicaid funding for Obamacare recipients will be converted into block grants to the states that will be capped, putting states in the position of having to pay for any future shortfall. Many state governors oppose the measure because they will immediately lose funding they have committed to paying, including Republicans. New Jersey Governor Chris Christie said Wednesday, "I can't support a bill that takes $3.9 billion away from the people of the state of New Jersey." The authors of the bill seek to equalize the base per-person the federal government gives states. But this would penalize those that are wealthier, for instance, Democratic states like New York, California and New Jersey, and benefit poorer Republican states like Mississippi and Alabama.
The Graham-Cassidy bill would end Obamacare's individual mandate that requires everyone to buy health insurance or pay a penalty. A pool including both healthy and unhealthy people was set up to help control insurance costs. However, this bill will provide no incentive for healthy individuals to enroll in the market, which means only those in need of health care are likely to sign up. The cost burden would fall heaviest on seniors, a fact not lost on AARP, which said in a statement on Wednesday, the bill "could increase premiums and out-of-pocket cost by as much as $16,174 a year for a 60-year-old earning $25,000 annually if the wanted to keep their current coverage." The AMA put it more bluntly in a tweet Tuesday, "Graham-Cassidy would result in millions losing coverage, destabilize insurance markets, decrease access to affordable care."
Obamacare had protections for those individuals with pre-existing health conditions, they could not be denied health insurance. Trump, who during his campaign said that insurers should not be able to deny insurance to those with a pre-existing condition, tweeted Wednesday; "I would not sign Graham-Cassidy if it did not include coverage for pre-existing conditions. It does. A great Bill. Repeal & Replace." Technically the bill says it will not repeal Obamacare's rules about pre-existing conditions. However, it does allow states opt out of rules, like a ban on charging higher premiums for sick people, the requirements on prescription drugs, the rules around how much insurers can increase premiums because of a customers age--elderly are more likely to have pre-existing conditions. In a statement, the Blue Cross Blue Shield Association warned, "The bill contains provisions that would allow states to waive key consumer protections, as well as safeguards for those with pre-existing medical conditions."
This last ditch effort by Republicans comes two months after the Senate failed to pass a Republican repeal to Obamacare. Meanwhile, bi-partisan health care negotiations, that had been proceeding in the Senate, came to an abrupt halt as Republican Lamar Alexander announced the talks had reached an impasse. This came as a surprise to Democrats who charge that this is a tactic to get wavering GOP senators to vote for Graham-Cassidy. Nonetheless, a group of 10 bipartisan governors sent a letter Wednesday to the Senate leadership arguing for a bipartisan solution and against Graham-Cassidy. Some observers say that if Graham-Cassidy passes, it will be with a strictly party line vote just like Obamacare was. They say that will add chaos to implementation because the bill does not have broad support.
Clearly, the best alternative is to fix the problems that exist in Obamacare. But that would be anathema for Republicans who are largely focused on getting entitlement spending under control. They are determined to reduce the size of the federal government. They are committed to shifting responsibility to the states. Of course, they need the projected savings Graham-Cassidy would provide to help finance their tax "reform" proposal, which would largely benefit the wealthy. And those wealthy Republican donors have threatened to withhold campaign contributions unless a health care bill signed into law. Furthermore, House Speaker Paul Ryan says he has greased the skids for the bill in his chamber.
So the GOP leadership is intensely focused on fulfilling their campaign promise of repealing Obamacare. Kansas Republican Senator Pat Roberts told Vox, "Restoring decision-making back to the states is always a good idea, but this is not the best possible bill--this is the best bill possible under the circumstances." He added, "If we do nothing, I think it has a tremendous impact on the 2018 elections--and whether Republicans still maintain control and we have to gavel."
In other words, passing and enacting Graham-Cassidy is not about doing what's best for the American people, it's about doing what's best for the Republican Party. It is not about doing the right thing; it is all about fulfilling a political promise.
No wonder nearly 70% of all Americans disapprove of Congress. And it's only going to get worse if Graham-Cassidy passes.
