Latest Republican Healthcare Overhaul Dies Before Crucial Deadline

Then-Congressman Bill Cassidy speaking at the Republican Leadership Conference in 2011. (Unmodified Creative Commons photo by Gage Skidmore. http://bit.ly/1jxQJMa)

On September 25, Sen. Susan Collins, R-Maine, announced her opposition to the Graham-Cassidy bill, effectively killing the Republicans’ latest attempt at repealing the Affordable Care Act.

She joined senators Rand Paul, R-Ky., and John McCain, R-Ariz., in opposition to the party leadership’s attempt to fulfill the GOP’s longstanding campaign promise to repeal President Obama’s signature health care law.

President Trump expressed his disappointment by Tweeting a video compilation of McCain criticizing Obamacare, followed by the statement “A few of the many clips of John McCain talking about Repealing & Replacing O’Care. My oh my has he changed-complete turn from years of talk.”

Despite having control of the House of Representatives, Senate, and presidency, Republicans have struggled to find consensus on repealing the ACA. Graham-Cassidy unsuccessfully attempted to bridge the gap between libertarians like Rand Paul and moderates like Susan Collins by combining the money spent on the Medicaid expansion and ACA exchange subsidies, cutting it, allocating it to states as block grants set by population, and phasing out the funding over a period of ten years.

Collins and Senate Democrats opposed the block grant plan on the basis that states would have far too much leeway as to how the grants would be spent.

Additionally, by determining the size of the grant by population and not increasing it as more people enrolled, Collins and Senate Democrats believed the plan would essentially punish states for trying to expand access to health care.

Outside of the content of the bill, the three dissenting senators took issue with the procedure being used to rush the bill through the Senate.

Republican leadership skipped the full committee review process and only got a preliminary CBO score in the hopes of passing it before September 30, the deadline for passing a reconciliation bill.

John McCain took a particularly hard stance against the unorthodox procedures, saying that “health care reform legislation ought to be the product of regular order in the Senate… That is the only way we might achieve bipartisan consensus on lasting reform, without which a policy that affects one-fifth of our economy and every single American family will be subject to reversal with every change of administration and congressional majority.”

By passing the bill using the reconciliation process, Republican leadership would’ve only needed majority support in the Senate, rather than the standard three-fifths, to pass the bill. The drive to repeal and replace the ACA as soon as possible stems from the fears of GOP Congressmen that they’ll be punished in 2018 with primary challengers and low Republican turnout if they don’t deliver on what has been their core campaign promise for the better part of a decade.

Despite his bill failing, Graham remained positive about the prospects of repeal happening eventually, saying that “it took 18 months for [Democrats] to pass Obamacare” and that “it’s gonna take us a while to replace it.”

However, the discussion in Congress has largely shifted towards tax reform with the Senate Budget Committee’s unveiling of an 89-page plan that sets up the budget reconciliation process that will allow Republicans to pass tax reform with just 50 votes.

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