New Graham-Cassidy health care plan stumbles under opposition from governors

WASHINGTON — The suddenly resurgent Republican effort to undo the Affordable Care Act was dealt a blow on Tuesday when a bipartisan group of governors came out against a proposal gaining steam in the Senate.

But it was unclear whether it would ultimately derail the attempt, as key Republican senators including Lisa Murkowski of Alaska said they had yet to make up their minds.

The collective criticism from 10 governors arrived as Vice President Pence and Senate Majority Leader Mitch McConnell tried to rally support for the bill, which is sponsored by GOP Sens. Bill Cassidy, La., Lindsey Graham, S.C., Dean Heller, Nev., and Ron Johnson, Wis.

“We ask you not to consider the Graham-Cassidy-Heller-Johnson amendment and renew support for bipartisan efforts to make health care more available and affordable for all Americans,” the governors said in their letter.

They added that they prefer a bipartisan push to stabilize the insurance marketplaces that Sen. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., have been negotiating.

The governors who signed the bill are particularly notable, since some are from states represented by Republican senators who are weighing whether to back the bill. Among them: Alaska Gov. Bill Walker, I, who holds some sway over Murkowski, a potentially decisive vote who opposed a previous Republican effort to repeal and replace the Affordable Care Act.

Nevertheless, Murkowski said Tuesday afternoon that she was still weighing her options and explained how her position on this bill might ultimately differ from her opposition on an earlier repeal bill that failed dramatically in July.

“If it can be shown that Alaska is not going to be disadvantaged, you gain additional flexibility, then I can go back to Alaskans and I can say, ‘Okay let’s walk through this together.’ That’s where it could be different,” she said.

But Murkowski, who has been in close touch with Walker, said she didn’t yet have the data to make that determination.

Alaska’s other Republican senator, Dan Sullivan, said he was still mulling whether to support the bill.

On Tuesday, Pence traveled from New York, where he was attending the annual U.N. General Assembly, to Washington with Graham, in a sign of the White House’s visible support for the proposal.

“My message today is I want to make sure that members of the Senate know the president and our entire administration supports Graham-Cassidy,” Pence told reporters on the flight down. “We think the American people need this.”

Graham added that President Donald Trump called him at 10:30 Monday night.

“He says, ‘If we can pull this off, it’ll be a real accomplishment for the country,'” he recalled.

Pence attended the weekly Senate Republican policy luncheon, where he said the current health-care system is collapsing and the bill fulfills key GOP promises to return control to states and rein in federal entitlement programs, according to GOP several senators.

Afterward, McConnell declined to ensure a vote on the bill, but said his team is working to secure sufficient support.

“We’re in the process of discussing all of this. Everybody knows that the opportunity expires at the end of the month,” said McConnell, referring to the limited window Republicans have to take advantage of a procedural tactic to pass a broad health-care bill without any Democratic support.

The current bill would give states control over billions in federal health-care spending and enact deep cuts to Medicaid. The Medicaid cuts are a major source of concern to the governors, both in terms of imposing a per-capita cap on what states would receive as well as restrictions on how they could spend any federal aid on their expanded Medicaid populations.

The fact that the bill would also bar states from taxing health-care providers in order the fund their Medicaid programs posed a problem for several governors as well.

The governors who have been most outspoken in their criticism of the bill have been negotiating behind the scenes to bring as many state executives on board, according to aides, tweaking the language over the past couple of days to get the maximum amount of support.

Also among the governors signing the letter: John Kasich, R-Ohio, and Brian Sandoval, R-Nev. Sandoval’s positioning puts him at odds with Heller, who has been touting the bill as a co-sponsor.

Pence said Trump told him to reach out to some Democrats. He spoke to Sen. Joe Manchin, D-W.Va., over the weekend. But after reviewing the bill, Manchin said he told Pence’s aides that he could not support the legislation.

Schumer said he’s confident no Democrat will vote for the legislation because “it hurts people in every state.”

Democrats have been working furiously in the past 24 hours to advance talks between Alexander and Murray on a deal to immediately stabilize insurance marketplaces with federal subsidies. The negotiations rapidly escalated after weeks of slow but consistent talks after it became clear that Senate GOP leaders were serious about holding a health-care vote before the end of the month, according to several Senate aides.

Alexander said Tuesday that the pair was working toward a compromise that would extend federal cost sharing payments for subsidies in exchange for some reforms to the way states are able to implement the ACA. But those talks were stymied last week after a group of 15 Democrats, led by Sen. Bernie Sanders, I-Vt., introduced a “Medicare for all” plan to extend federal benefits to all Americans.

Graham said that the decision for his colleagues on health care is stark: “Socialism or federalism.”

“If you’re a Republican chances are you believe in federalism. … I believe that most Republicans like the idea of state-controlled health care as opposed to Washington-controlled health care,” Graham said.

The Washington Post’s Ed O’Keefe and Ashley Parker contributed to this report.

New Graham-Cassidy health care plan stumbles under opposition from governors 09/19/17

[Last modified: Tuesday, September 19, 2017 6:25pm]


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