In an effort to fulfill an 8-year promise and erase the bad taste from the previous two failures to repeal and replace the Affordable Care Act, Senate Republicans have devised a bold new strategy for American healthcare: make it worse.
A brave route for legislators whose health coverage will see no changes should such a bill pass, the new bill spearheaded by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana hopes to avoid the fate of party’s previous two healthcare-related legislative failures. So courageous an effort, the Republican Senate is hoping to jam the bill through Congress before Sept. 30 in hopes of avoiding public scrutiny for a bill that could reshape a sixth of the American economy.
So what exactly is in this bill? How could they possibly make it worse than the last one, which would have increased the number of uninsured by 22 million and enjoyed around 12 percent support nationally in June, according to a USA TODAY/Suffolk University Poll? Oh, they could and they did.
Let’s start with significant cuts to Medicaid. According to healthcare consulting firm Avalere Health, under Graham-Cassidy, Medicaid and private insurance policy subsidies would see $215 million in cuts between 2020 and 2026. The idea is to take money from the states who took advantage of the Affordable Care Act’s Medicaid expansion — a group West Virginia and a number of red-states are among — and give it to the states that didn’t in the form of block grants. In the distribution of these block grants, The Washington Post says 34 states would see a decrease in funding, with West Virginia seeing a billion in cuts by 2026.
The last Republican healthcare bill, the Better Care Reconciliation Act, wasn’t even this radical. It decreased federal funding, but kept the core concept of the Medicaid expansion, with states receiving between 50 to 70 percent of the funding they’re granted under the Affordable Care Act, according to The Henry J. Kaiser Family Foundation. Graham-Cassidy does no such thing.
Cuts in Medicaid could be catastrophic for states like West Virginia. In this state alone, the uninsured rate dropped from 14 percent before the Affordable Care Act’s Medicaid expansion to 8.6 percent in 2015, according to The West Virginia Center on Budget and Policy. The nonpartisan policy research organization reported the same year that 91.4 percent of West Virginians now have health insurance as a result of the Obama era legislation.
Right now it’s too early to measure the overall impact the Graham-Cassidy legislation could have. The Congressional Budget Office has yet to score the bill, and it’s unlikely they’ll have time to before the Sept. 30 deadline, after which point the special budget rules allowing the Senate to pass the bill with a simple majority will expire.
But early projections from the Commonwealth Fund, a private healthcare-related foundation, estimates that 32 million people could lose coverage after 2026, with 15 to 18 million becoming uninsured in just 2019, the first full year of the plan’s enactment. This projection uses previous CBO numbers estimating the effects of doing away with the Affordable Care Act’s individual mandate, which requires individuals to purchase healthcare coverage or face a tax penalty. With Graham-Cassidy doing away with the individual mandate and doing little to manage the consequences of jettisoning it (reconciling the decrease in tax dollars, mainly) this projection may not be too far off.
Medicaid cuts and dips in federal healthcare funding are only the surface level blemishes on a fundamentally ugly bill. Women’s healthcare certainly isn’t a prerogative, with federal funding for Planned Parenthood getting slashed alongside any federal subsidies for private insurance policies that provide access to abortion
Health groups like the American Medical Association, AARP, Blue Cross Blue Shield Association, American Heart Association and the American Cancer Society have already voiced their opposition to the bill. Most famously, Jimmy Kimmel has used the opening monologue of his late night show Tuesday and Wednesday to attack the bill and its co-drafter, Cassidy, for what he sees as a dishonest approach to solve the country’s healthcare problem.
Public animosity contributed to the downfall of the previous two bills, which means it can do the same for this one. You’re probably tired of hearing this by now, but if you want better healthcare in America, give your senator a call and let them know that Graham-Cassidy isn’t the solution we’re looking for.
Jared Casto can be contacted at [email protected]