Last week progressives led a growing call for a single-payer health care system, with independent Vermont Senator Bernie Sanders officially announcing the Medicare for All Act of 2017. The Sanders bill would expand health care coverage from those over-65 to all Americans, effectively ending the need for private insurance.
Sanders made his case via the New York Times last week, writing, “All over this country, I have heard from Americans who have shared heartbreaking stories about our dysfunctional system. Doctors have told me about patients who died because they put off their medical visits until it was too late. These people who had no insurance or could not afford out-of-pocket costs imposed by their insurance plans.”
Now the GOP has responded, resurrecting their battle to repeal the Affordable Care Act via a new bill introduced by Republican Senators Bill Cassidy and Lindsey Graham. If passed, key components of Obamacare would be stripped, including the individual mandate and the federal health exchange. The Republican bill also would slow the growth rate of Medicaid, effectively ending the ACA expansion that extended health care coverage to millions of low-income Americans in states that opted into the program.
Speaking on the Senate floor, Republican Senate Majority Leader Mitch McConnell of Kentucky praised the new bill earlier this week: “The men and women we represent have suffered a lot under Obamacare. Skyrocketing costs. Plummeting choices. Collapsing markets. Many of us thought our constituents deserved better. That’s why we did as we promised and voted to repeal this failed law so we could replace it with something better.
“Governors and state legislators of both parties would have both the opportunity and the responsibility to help make quality and affordable health care available to their citizens in a way that works for their own particular states,” he added.
Under the Graham-Cassidy bill, states that had previously opted out of expanding Medicaid — a partisan move that restricted millions from accessing more affordable care — would be rewarded with generous funding. Meanwhile, states that had originally expanded, including the left-leaning California and New York, would see their funding decreased.
On September 14 South Carolina Senator Graham defended the bill on the floor, insisting, “Four states get 40 percent of the money under Obamacare: New York, California, Massachusetts and Maryland. Our goal is by 2026 to make sure every patient in every state gets the same contribution, roughly, from the federal government.”
What Graham failed to mention, however, was that many right-leaning states had voluntarily removed themselves from a portion of the Obamacare exchange, a maneuver made possible by a 2012 Supreme Court ruling that allowed states to opt out of Medicaid expansion.
Not every GOP-leaning states would see their funding increase however, states like Arizona, Arkansas, Kentucky, Louisiana and Nevada who expanded Medicare under Obama-Care would see decreases. In Nevada, where GOP Senator Dean Heller is a co-sponsor of Graham-Cassidy, Republican Governor Brian Sandoval firmly opposes the bill. “I will not pit seniors, children, families, the mentally ill, the critically ill, hospitals, care providers, or any other Nevadan against each other because of cuts to Nevada’s healthcare delivery system proposed by the Graham-Cassidy amendment,” Sandoval said Thursday.
While Louisiana Senator Cassidy helped pen the measure, his state’s Democratic Governor John Bel Edwards has opposed it, announcing “My primary objection relates to the elimination of the Medicaid expansion program in 2020.”
Edwards added, “We’re saving lives, money and investing in our people to ensure they are able to receive quality health care. Importantly, Louisiana’s uninsured rate has dropped to nearly 10 percent. Undoing this progress would negatively impact our citizens and our economy.”
And Edwards is not alone, joining nine other governors in a letter to McConnell and Minority Leader Chuck Schumer that advised “As you continue to consider changes to the American health care system, we ask you not to consider the Graham-Cassidy-Heller-Johnson amendment and renew support for bipartisan efforts to make healthcare more available and affordable for all Americans. Only open, bipartisan approaches can achieve true, lasting reforms.”
But in today’s political climate, it’s become yet another partisan debate, with very real consequences. While the measure would remove the individual mandate, an unpopular feature for some, it would also put those with pre-existing conditions at risk, a point President Trump denied, tweeting, “I would not sign Graham-Cassidy if it did not include coverage of preexisting conditions. It does! A great bill. Repeal and replace.”
It’s a strong assertion, but one not fully based in fact, thanks to a Graham-Cassidy loophole that would allow individual states to let insurance companies revert to pre-ACA practices by saying the magic words that the state “intends to maintain access to adequate and affordable health insurance coverage for individuals with pre-existing conditions.”
Unlike Obamacare, which guarantees that individuals with pre-existing conditions cannot be denied insurance or charged more than healthy people, Graham-Cassidy would use waivers to allow states to come up with their own alternatives but won’t force them to outline just what those alternatives are.
Even celebrities are lending their voices to the debate, including comedian Jimmy Kimmel, who made his own headlines earlier this week after claiming that Cassidy had “lied to his face” about the lack of protections for those with pre-existing conditions. It’s become a personal issue for Kimmel, whose infant son was born this year with a heart defect. Although he, of course, has the means to ensure the best care for his child, he’s since advocated for families that do not.
The late-night host addressed the issue by explaining, “I don’t know what happened to Bill Cassidy. But when he was on this publicity tour, he listed his demands for a health-care bill very clearly. These were his words. He said he wants coverage for all, no discrimination based on pre-existing conditions, lower premiums for middle-class families and no lifetime caps. Guess what? The new bill does none of those things.”
Republican Arizona Senator John McCain must agree with Kimmel, as he recently came out against the Grahm-Cassidy act, diminishing its chances of getting out the Senate. The Senator has now twice effectively stopped Republican efforts to repeal Obama-care over the last few months. Saying he could not “in good conscience” vote for the bill. Republican lawmakers have not yet withdrawn their efforts, hoping still to coax one Senator to change their vote.
And while lawmakers continue to bicker on Capitol Hill, in the background everyday Americans continue to suffer. According to Georges Benjamin, Executive of the American Public Health Association, “The Graham-Cassidy plan would take health insurance coverage away from millions of people, eliminate critical public health funding, devastate the Medicaid program, increase out-of-pocket costs and weaken or eliminate protections for people living with pre-existing conditions.”
But for those whose sole mission is to simply “repeal and replace,” it’s all in a day’s work.
First published via Atlanta Black Star, September 2017