On September 13, 2017, Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) unveiled new proposed legislation to replace the 2010 Patient Protection and Affordable Care Act (ACA). The legislation would substitute a new Senate version for H.R. 1628, the American Health Care Act, that passed the House of Representatives in May. As budget reconciliation legislation, the proposed amendment must be voted on before October 1, 2017, in order to pass with just 51 votes.
The Congressional Budget Office says that it will not be able to release a full analysis for several weeks. A report by Avalere, a health care consultancy firm, however, predicts that the bill would repeal much of the ACA and limit future federal funding for Medicaid (as currently written, it would eliminate Medicaid funding by 2026):
The proposed legislation would repeal the ACA’s Medicaid expansion, premium tax credits, cost sharing reduction (CSR) payments, individual and employer mandates, and the Basic Health Program (BHP). Instead, the bill would provide states with block grants to fund health insurance coverage in their state. The bill would also change the financing structure for the traditional Medicaid population from an open-ended approach to a fixed per capita cap or block grant approach.
A September 18 report by think tank Center on Budget and Policy Priorities forecasts that the legislation would “[e]ventually result in larger coverage losses than under proposals to repeal ACA’s major coverage provisions without replacement.”
A group of Democratic and Republican state governors wrote to U.S. Senate leaders on Sept. 19, urging them to support recent bipartisan efforts by Senators Lamar Alexander (R.-Tenn.) and Patty Murray (D.-Wash) to bring stability and affordability to the existing state health care markets. Senator Alexander said in a statement: “We have worked hard and in good faith, but have not found the necessary consensus among Republicans and Democrats.”
Related Reading:
Elise Viebeck, Why Senate Republicans Are in Such a Rush This Month on Health Care, Washington Post, Sept. 20, 2017.
Robert Pear & Thomas Kaplan, Republican Leaders Defy Bipartisan Opposition to Health Law Repeal, N.Y. Times, Politics, Sept. 19, 2017.
Comedian Jimmy Kimmel’s monologue on Jimmy Kimmel Live! about Senator Cassidy’s “Jimmy Kimmel Test.”