Lack of support sinks Senate’s latest healthcare bill
Wednesday, September 27, 2017
Sen. Susan Collins (R-Maine) dealt a fatal blow Monday evening to the Graham-Cassidy healthcare bill to repeal the Affordable Care Act, aka Obamacare. She joined fellow Sens. John McCain (R-Ariz.) and Rand Paul (R-Ky.) in opposing the measure, leaving the Republicans' 52-48 majority over the Democrats short of the required 50 votes for passage under procedures from the fiscal year 2017 budget resolution.
"Healthcare is a deeply personal, complex issue that affects every single one of us and one-sixth of the American economy," Collins said in a Sept. 25 statement. "Sweeping reforms to our healthcare system and to Medicaid can't be done well in a compressed time frame, especially when the actual bill is a moving target."
Her decision against Graham-Cassidy came after the nonpartisan Congressional Budget Office and the staff of the Joint Committee on Taxation released a preliminary analysis of the bill on Sept. 25: "Over the 2017-2026 period, CBO and JCT estimate, the legislation would reduce the on-budget deficit by at least $133 billion and result in millions fewer people with comprehensive health insurance that covers high-cost medical events."
"One thing is clear," said Robert E. Moffit, a senior fellow in The Heritage Foundation's Center for Health Policy Studies in Washington, D.C. "Overturning Obamacare turned out to be a monumental policy failure."
The Republican effort to undo the Affordable Care Act (ACA) began in 2010, and President Donald Trump made repealing and replacing it a cornerstone of his successful election campaign.
Currently, the Trump administration is funding ACA insurance subsidies (cost sharing for low-income people) on a month-to-month basis. He has not committed to ongoing spending for ACA cost sharing.
All things equal, insurers' lack of certainty about a steady federal revenue stream for 2018's ACA marketplace policies opens the door to steep price spikes.
"We must stop the attempts to sabotage our health system by the Trump administration, from the possibility of unilaterally defunding already budgeted cost-sharing reductions to undoing key consumer protections through regulation," said Anthony Wright, head of Health Access California, a consumer advocacy coalition.
Bloomberg reports that Trump, and Senate Majority Leader Mitch McConnell (R-Ky.) are keeping hope of overturning the ACA alive, despite Graham-Cassidy failing to get a simple majority vote by the Sept. 30 budget reconciliation deadline.
We will have the votes for Healthcare but not for the reconciliation deadline of Friday, after which we need 60. Get rid of Filibuster Rule!— Donald J. Trump (@realDonaldTrump) September 27, 2017
Is it time for senators to reach out across the aisle to improve the ACA?
Senate GOP Health Chairman Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) had been working together on a plan to strengthen the stability of ACA cost sharing. However, they shelved their bipartisan effort when Graham-Cassidy took center stage in its bid to get 50 votes with Vice President Mike Pence ready to cast the tiebreaking vote.
"I will consult with Sen. Murray and with other senators, both Republicans and Democrats," Alexander said in a Sept. 26 statement, "to see if senators can find consensus on a limited bipartisan plan that could be enacted into law to help lower premiums and make insurance available to the 18 million Americans in the individual market in 2018 and 2019."
Even Trump indicated today that he may be willing to reach across the aisle for a new healthcare bill.
"I'm also going to meet with Democrats, and I will see if I can get a healthcare plan that's even better," he said at the White House.
Could Democrats and Republicans improve the ACA through compromise? Time will tell, as the federal funding of cost sharing for healthcare policies that millions of people buy remains uncertain.
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