Oh Good, the Republican Ghouls' Terrible New Healthcare Plan is Gathering Steam

Conservative Sen. Rand Paul of Kentucky has repeatedly railed against the measure, arguing it's "Obamacare lite" and doesn't do enough to repeal key provisions of the ACA.

It is important to understand, however, that Graham-Cassidy has a wrinkle that could divide GOP governors: The new "block grant" it creates out of Obamacare's tax credits and Medicaid expansion money will be distributed to the states without regard to whether they exercised their option to expand Medicaid under the Affordable Care Act. Cassidy says he's certain they have 48 or 49 Republican votes for his bill.

"Graham/Cassidy keeps Obamacare and tells the states to run it", Paul tweeted, referencing the bill's two lead sponsors.

The bill Schumer refers to is a proposal by Sens. That would entail support from Democrats, which they won't get.

This is a welcome return to federalist principles that the GOP had forgotten when crafting their earlier ObamaCare replacement bills. But if states can use their block money more effectively than ObamaCare, less will mean more.

The liberal Center on Budget and Policy Priorities, for example, complains that "Cassidy-Graham would ... allow states to spend their federal block grant on virtually any health care objective, not just for health coverage".

With Graham seeking to sell the bill as a consensus-builder among the Republican Party, Democrats opposed to his measure could seize on McMaster distancing himself as a sign the legislation does not have sufficient support to move ahead. The bill is still on the Senate calendar. Graham-Cassidy, however, wouldn't simply allow waivers of Obamacare's protections for people with preexisting conditions. Dean Heller of Nevada and Ron Johnson of Wisconsin - are backing the measure too.

The CBO won't report back until October, so Republican Senators will have to decide whether to vote for a bill with incomplete information and even less public airing than two earlier attempts this year to kill the ACA. A more recent twist has been the "per capita cap" which adjusts federal funding to the number of people deemed eligible in each state.

The budget agency's evaluations of past GOP repeal plans concluded they would have caused millions of Americans to lose insurance coverage, an outcome many Republicans are unwilling to accept. The group estimates that in 2027 alone, federal health spending would decline by $299 billion compared with current law and all states would be affected by cuts.

In reality, Graham-Cassidy is the opposite of moderate. Senator John Cornyn, the No. 2 Republican leader, said last week that he'll gauge support for the bill, and the topic is expected to be discussed again privately by Senate Republicans on Tuesday.

And the House, which is away next week, would have to swiftly take up and pass another politically perilous bill before October 1- they approved their own Obamacare replacement in May - to clear the way for Mr. Trump's signature.

"There is tremendous flexibility for states under Cassidy-Graham, but also tremendous responsibility".

  • Jon Douglas