Senate Republicans will try once again to repeal and replace the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) after unsuccessful attempts to repeal this summer. “It is the leader’s intention to consider Graham-Cassidy on the floor next week,” a spokesman for Senate Majority Leader Mitch McConnell, R-Ky., told Wolters Kluwer on September 20.
The Graham-Cassidy proposal is being called Republicans’ “last effort” at an ACA repeal. The budget resolution needed to pass an ACA repeal with a simple majority will expire on September 30. The GOP’s previous efforts failed to garner the required 51 votes under reconciliation.
Offered as an amendment to the House-approved American Health Care Act (AHCA), the bill repeals the ACA and certain related taxes, and replaces the Medicaid expansion and premium subsidies with an annual block grant. The proposal is championed by Sens. Lindsey Graham, R-S.C., Bill Cassidy, R-La., Dean Heller, R-Nev., and Ron Johnson, R-Wis. The repeal bill would eliminate the individual and employer mandates retroactively to December 31, 2016. It would also repeal the medical device tax. “The grant dollars would replace the federal money currently being spent on Medicaid expansion, tax credits, cost-sharing reduction subsidies and the basic health plan dollars,” Graham said in a press release.
President Trump took to Twitter on September 20 to voice his support for the Graham-Cassidy proposal. “I hope Republican senators will vote for Graham-Cassidy and fulfill their promise to repeal and replace [the ACA ]. Money direct to the states,” Trump said.
Meanwhile, Democrats are criticizing GOP efforts to “rush” the “dangerous” health care overhaul through the Senate. On September 20, Rep. Joe Crowley, D-N.Y., said that the bill “would mean far worse care, far fewer Americans covered and much higher costs.” However, some on Capitol Hill believe that passing it enhances the prospects for enacting tax reform legislation later in 2017.
House Minority Leader Charles E. Schumer, D-N.Y., and House Minority Leader Nancy Pelosi, D-Calif., asked the Congressional Budget Office (CBO) in a September 18 letter how the Graham-Cassidy proposal would impact family coverage. Moreover, the letter asked for estimates of how many people would lose health insurance and if premiums and out-of-pocket health care costs would increase.
In response, the CBO released a statement saying it will try to provide a preliminary assessment of the bill during the week of September 25. “However, CBO will not be able to provide estimates of the effects on the deficit, health insurance coverage, or premiums for at least several weeks,” it added.
Hearing September 25
The Senate Finance Committee (SFC) is scheduled to hold a hearing on the proposal on September 25. “A hearing will allow members on both sides of the aisle to gain a better understanding of what the authors hope to achieve,” Chairman Orrin G. Hatch, R-Utah said in the hearing announcement.
By Jessica Jeane, Wolters Kluwer News Staff
Legislative Text of the Graham-Cassidy Amendment to HR 1628
Graham-Cassidy Section-by-Section Analysis