Republican Sens. Lindsey Graham and Bill Cassidy on Monday were
set to roll out a last ditch effort repeal and replace the
Affordable Care Act in the near-term.
The Graham-Cassidy bill would maintain a significant
portion of the structure of previous GOP attempts at a
healthcare overhaul in the first half of the year. But it
contains some notable differences in an attempt to appeal
to more moderate members of the party.
The bill, however, faces an uphill battle and a short window in
which it could be passed.
ruling by the Senate parliamentarian earlier this
month said Republicans can’t continue after
September 30 to use the process of reconciliation, which allows
bills to be passed with a simple majority in the Senate if they
decrease the deficit.
That leaves a little under three weeks for Republicans to
attempt to push the bill through
Congress. President Donald Trump has
reportedly urged a vote on the
bill before the option for budget
reconciliation runs out. But given the minuscule
window and competing healthcare-related pushes, there is
little hope for the effort on Capitol Hill.
With that in mind, here’s a breakdown of what’s expected in the
- Shift Medicaid funding and insurance subsidies to a
block-grant system: Instead of determining
the federal government’s share of funding for
Obamacare’s Medicaid expansion and individual insurance
subsidies through a formula, states would receive large
chunks of money up front — and then determine what to do with
it. About $1.2 trillion would be allocated for this purpose
from 2020 through 2026. Funding would be cut off by 2027.
- Eliminate the individual and employer mandate:
People who do not sign up for insurance would not face a tax
under the plan, and companies would not be compelled to offer
coverage. States could pass their own mandates, however.
- State reinsurance fund: A certain amount
will likely be allocated to insurers to offset greater
losses from insuring a sicker pool of people.
- Adjust the essential health
benefits: States could determine what qualifies
as an essential health benefit. Currently, the federal
government mandates that all plans sold on the Obamacare
exchanges cover 10 basic types of care, including
emergency-room visits and prescription drugs.
The legislation still needs to be evaluated by lawmakers and
scored by the Congressional Budget Office, complicating the
already tight window for potential passage.
Additionally, the Senate Health, Education, Labor, and Pensions
(HELP) Committee has already been moving forward with hearings
focused on bipartisan healthcare fixes that would be
smaller in scope but possibly garner more support.
Sen. John McCain — who cast a deciding vote that killed the
previous round of Obamacare repeal efforts — has indicated that
he would possibly vote for the package.