Republicans have until September 30th to pass a repeal of Obamacare with 51 votes, instead of the filibuster proof 60. This is because the reconciliation process, which Republicans have been using (in vain) to try to repeal Obamacare expires on September 30th. Reconciliation allows bills that impact the budget to be passed with only 51 votes, and it was used to pass certain sections of the Obamacare we know today.
Never one to let an opportunity pass them by, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) introduced an amendment to repeal key sections of Obamacare. As with past measures to repeal Obamacare, this bill would harm low-income Americans, and make healthcare more expensive for all of us.
In his recent book, Senator Al Franken (D-MN) compares Obamacare to a three-legged stool. One leg allows people with pre-existing conditions to buy health insurance. Another leg requires everyone to have health insurance. A third leg provides subsidies so it is possible for everyone to have health insurance. Without any one of those legs, the system sort of falls apart. If you want to provide coverage for everyone, even people with pre-existing conditions, you need healthy people to buy insurance to subsidize sick people. And if they're so subsidy, people can't afford to buy insurance, which means they are subject to the penalty, and it means there are no healthy people subsidizing sick people. So you kind of need all three facets of Obamacare.
One of the main things Graham-Cassidy would do is end the individual and employer mandate. That means there would be no punishment for not having insurance. Which means people won't buy insurance if they don't have to. Which means a leg of the stool falls off.
But the Senators weren't done! They would remove another leg of the stool by eliminating the subsidies that make insurance affordable for everyone and remove the federal funding for the Medicaid expansion. For those keeping track, our three legged stool is now a rod with a circle on top, which is less a stable place to sit and more a circus act.
Senators Graham and Cassidy may argue that they are not totally removing a leg of the stool because they are not eliminating the money for the subsidies, they would turn the funding into block grants. I've written a little about the problems with block grants, but if you don't want to dive in to federal reports, take my word for it that they often perpetuate inequality.
The bill causes problems outside of its block grants. It would loosen regulations for pre-existing conditions, and individual states could make it legal for insurance companies to charge people more based on their medical history. It would also allow states to have "work requirements" for people who receiving Medicaid and defund Planned Parenthood. Proving once again that Republicans love states rights until it's about reproductive health.
Of course, this bill sounds like a bad idea to me, but I'm a Democrat. Maybe I'm just blinded by my love for President Obama and my interest in providing affordable healthcare for as many people as possible.
In this case, however, I find myself with allies such as John Kasich, Republican Governor of Ohio and Chris Christie, Republican Governor of New Jersey. The experts have also spoken out against the bill. The National Association of Medicaid Directors released a statement against the Graham-Cassidy amendment, and many Medicaid Directors in red states have expressed concerns and outright opposition to the new bill.
Unfortunately, there is a real possibility that Graham-Cassidy will pass. Senators are going overboard to court Senator Lisa Murkowski (R-AK). Murkowski is very much a swing vote, and one of three Republicans who voted against the past repeal to Obamacare. The governor of Alaska doesn't support the bill so it will be an uphill battle to have the Senator's support.
At this point, it's unclear if Alaska will be given something special in the bill. Allowing Alaska to keep the tax credits and subsidies may encourage Murkowski to sign on, in an effort to help her state, but will look like special treatment for Alaska which other Senators may find unfair.
Graham-Cassidy has a fighting chance, which means it's important to call your Senator and let them know that you oppose it. Call Them In has scripts and information to help you oppose this amendment, and protect healthcare for all Americans. The Republicans have one last chance to ignore the filibuster. Don't let them win.