GOP’s last-ditch attempt would replace ACA with block grants
Sen. Bill Cassidy, R-La., left, and Sen. Lindsey Graham, R-S.C., second from right, accompanied by Sen. Dean Heller, R-Nev., second from left, and Sen. Ron Johnson, R-Wis., right, fist bump each other during a news conference on Capitol Hill, Sept. 13, to unveil their legislation. | Andrew Harnik / AP

WASHINGTON—Senate Republicans launched a last-ditch attempt to repeal the Affordable Care Act, replacing it with block grants that would put 32 million people out of health care coverage.

They’re relying on racing through the legislative calendar, facing a Sept. 30 deadline, to override the opposition.

The same day Sen. Bernie Sanders, Ind-Vt., unveiled Medicare for All, Sens. Lindsay Graham, R-S.C. and Bill Cassidy, R-La., reintroduced their scheme, which they first floated in mid-July. It would turn almost all federal health care spending into block grants to states—and let states decide whom to serve and how to spend it.

Graham, Cassidy, and co-sponsors Dean Heller, R-Nev., and Ron Johnson, R-Wis., call their plan the latest Republican replacement for the Affordable Care Act (ACA), which they revile. The Center on Budget and Policy Priorities says their scheme would be worse than prior Trumpcare “repeal and replace” bills, or even just repeal with no replacement. GOP President Donald Trump backs it.

By eliminating the ACA’s Medicaid expansion and marketplace subsidies in 2020 and substituting “an inadequate block grant” to the states, the Graham-Cassidy bill “would provide $239 billion less between 2020 and 2026 than projected federal spending for the Medicaid expansion and marketplace subsidies under current law,” the center warns. Then there’s another 17 percent cut in 2027.

“The block grant would not adjust based on changes in states’ funding needs, and it could be spent on virtually any health care purpose, with no requirement to offer low- and moderate-income people coverage or financial assistance. And the block grant would disappear altogether in 2027.”

The Republicans are pushing Graham-Cassidy as they’re running out of time: Senate rules for a fiscal 2017 budget “reconciliation” bill let them jam it through with only 50 GOP votes—plus Vice President Mike Pence as a tie-breaker—but only until the end of September, when the fiscal year ends.

The GOP also counts on passing the bill before Trumpcare foes can mobilize again. But MoveOn.org and Sen. Elizabeth Warren, D-Mass., are blowing the whistle. And American Federation of Teachers (AFT) President Randi Weingarten is alerting her members to GOP attempts to “sabotage” the ACA.

“The fight to save health care isn’t over. Sound the alarm. We need you to fight today & every day until this @SenateGOPbill is dead,” Warren tweeted. “Let me repeat: The Graham Cassidy @SenateGOP ‘health care’ bill IS Trumpcare, & it will rip health care away from millions of Americans.”

Ben Wikler, Washington director for MoveOn, provided a timeline for Senate action, saying the vote could come as late as Sept. 27-29, after closed-door Senate GOP meetings this week and a break for Rosh Hashanah, but before the second Jewish holiday, Yom Kippur.

“White House ‘all hands on deck.’ Rs whipping votes this week, already at 49,” Wikler’s follow-up tweet warned. He urged everyone to call the Capitol at 202-224-3121 and be connected to their senators.

Unions are also trying to quickly mobilize their members.

After announcing AFT endorsed Sanders’ Medicare for All bill, Weingarten added: “At the same time, it’s critical we continue to resist Donald Trump’s attempts to sabotage the Affordable Care Act and return us to a time when families were one illness away from bankruptcy. We must continue to take immediate steps to build upon our current system, including stabilizing the insurance markets, preserv-ing Medicaid expansion for older Americans and protecting patients with pre-existing conditions.”

That’s exactly the opposite of the Graham-Cassidy bill, health care analysts note.

Vanita Gupta, president and CEO of the labor-backed Leadership Conference on Civil and Human Rights, said repealing the ACA, and replacing it with Graham’s legislation—or anything else—would let insurers and states return to making being female a pre-existing condition subject to discrimination.

The ACA, she said, “is the first federal civil rights law to prohibit sex discrimination in health care. Attempts to weaken those protections are a direct assault on all the communities the rule protects, including people of color, women, people with disabilities, seniors, people whose primary language is not English, immigrants, and LGBTQ individuals. All individuals need to be protected from discrimination in health coverage or care.”

The Graham-Cassidy bill isn’t the only health care legislation floating around. Joining it are Sanders’ bill, which now—for the first time—has a majority of U.S. House Democrats on board, too, and a range of ACA “fixes” introduced by the 43-member bipartisan House “Problem Solvers Caucus.” A dozen of them discussed their measure with Trump on Sept. 13.

“Congress needs to act very quickly to prevent health insurance from becoming even less affordable for millions, when ACA premiums lock in for 2018,” explained one Problem Solver, Rep. Dan Lipinski, D-Ill. He said their plan “will prevent a 20 percent increase in premiums for benchmark plans by guaranteeing cost-sharing reduction funding” to the insurers “and help lower rates an additional 10 percent with a stabilization fund.”


CONTRIBUTOR

Mark Gruenberg
Mark Gruenberg

Mark Gruenberg is head of the Washington, D.C., bureau of People's World. He is also the editor of Press Associates Inc. (PAI), a union news service in Washington, D.C. that he has headed since 1999. Previously, he worked as Washington correspondent for the Ottaway News Service, as Port Jervis bureau chief for the Middletown, NY Times Herald Record, and as a researcher and writer for Congressional Quarterly. Mark obtained his BA in public policy from the University of Chicago and worked as the University of Chicago correspondent for the Chicago Daily News.

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