The intensity is rising on Capitol Hill as Republicans mount another attempt to repeal and replace Obamacare.
The new bill, known as “Graham-Cassidy” after sponsoring Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, contains many features of earlier Republican bills.
It would scrap Obamacare, repealing the Affordable Care Act’s mandates for most Americans to have coverage and for larger employers to offer it, and would eliminate the tax on medical devices.
The bill would make deep cuts in Medicaid, putting the entire program on a budget and ending the open-ended entitlement that now exists, according to an analysis by The New York Times.
In its place, the bill utilizes block grants to distribute federal money to states based on a complex formula. States would receive a per-beneficiary allotment of federal money and could set up their own health insurance systems. States would have discretion on how the money was allocated, including coverage for mental health care and people with disabilities.
It makes sense to give states the flexibility to craft their own health care insurance programs based on their specific needs and patient populations.
We agree with Sen. Roy Blunt, who supports the bill, when he says that policy makers in Missouri are more likely to know what is best for our state than those at the Department of Health and Human Services in Washington, D.C.
Giving states more control over health care policy is a good thing.
However, the latest bill hasn’t been analyzed by the Congressional Budget Office so it is unclear how much it will cost or how many people would lose or gain coverage. Some have suggested the bill could result in potentially 30 million people losing coverage over 10 years.
It appears that in the short term, Missouri would receive an increase in federal funding under Graham-Cassidy. But estimates also show Missouri, like all states, would see a reduction in federal spending over time.
What also is concerning is the real possibility the bill would gut protections for people with pre-existing medical conditions, one of the most popular components of Obamacare. States could easily be forced to make that policy determination based on cost pressures as fewer federal dollars are made available.
This aspect of the bill is going to provoke much outcry and could torpedo its passage.
It also is unclear if Graham-Cassidy would reverse skyrocketing health insurance costs. Health insurance premiums and costs were rising rapidly before Obama-care was passed and they’ve continued to increase since.
Experts have expressed doubt this bill would change this dynamic. It would reduce federal government spending in health care and fulfill campaign promises to end Obamacare, along with some of its worthwhile consumer protections.
Republicans may get Graham-Cassidy across the finish line this time. This could be a good thing if the bill bends the cost curve for the majority of Americans and doesn’t substantially disrupt consumers the way Obamacare did.
But if it passes and there are disruptions and costs continue to rise, along with the expected loss of insurance coverage and protections for millions, the Republicans will own a very unpopular issue for years to come.