Graham-Cassidy bill would keep much of the Obamacare tax structure in place, but it would give the money back to states in the form of block grants.
WASHINGTON — Senate Republicans are pinning their final hopes for an Obamacare overhaul on legislation introduced by Sens. Lindsey Graham, R-S. C., and Bill Cassidy, R-La., and co-sponsored by Sens. Dean Heller, R-Nev., and Ron Johnson, R-Wis.
The Graham-Cassidy bill would keep much of the Obamacare tax structure in place, but it would give the money back to the states in the form of block grants and would allow states to design their own health care systems.
Aided by the support of the White House and GOP leadership, the group is searching for the last few Republican votes to bring them to the required 50 to pass the bill. Democrats will all vote “no.” Cassidy believes they are close — “we’ve probably got 48,49,” he said last week.
Senate Majority Leader Mitch McConnell, R-Ky., praised the legislation in a floor speech Tuesday by saying it would allow “states and governors to actually implement better health care ideas by taking more decision-making power out of Washington.”
Many Democrats say the bill is similar to previous repeal attempts by Republicans. Senate Minority Leader Chuck Schumer, D-N.Y., said Tuesday on the Senate floor that the bill “is worse in many ways than the previous versions of Trumpcare.” The House passed repeal-and-replace legislation in May, and the Senate failed to pass a watered-down repeal bill of their own in July.
Much of what Graham-Cassidy does will depend on what state you live in, because states will receive different amounts of money and will use the block grants differently. But the bill has some major changes that will affect everyone:
The Affordable Care Act put in place a mandate to buy insurance, with a tax penalty if you are uninsured. Graham-Cassidy would get rid of that mandate and the penalty.
The bill would repeal the penalties for large employers that fail to offer affordable insurance to workers.
Insurance companies still won’t be able to deny coverage based on pre-existing conditions, but states can waive the provision that caps what they can charge. They can also waive certain mandated coverage under Obamacare, such as maternity care, mental health services and hospitalization.
Thirty-two states including Washington, D. C., expanded Medicaid under Obamacare to people earning up to 138% of poverty. The Graham-Cassidy legislation would immediately block more states from expanding Medicaid and would stop the existing expansions in 2020. Instead, states would receive per capita block grants to address the needs of low-income residents.
The legislation would change the way Medicaid funding goes to the states to a per capita allotment. It would also limit the growth of the program. States could also elect to have a Medicaid work requirement, though disabled or pregnant people would be exempt.
The plan would leave in place the provision that allows people under age 26 to stay on their parents’ health care plans.
It’s already illegal for the federal government to pay for abortion services. However, the government currently reimburses Planned Parenthood for non-abortion services that are covered by Medicaid. The Graham-Cassidy bill would end that practice for a period of one year. The bill would provide money for community health centers in an attempt to supplement the coverage that will be lost from Planned Parenthood.