The Graham-Cassidy-Heller-Johnson bill has been called “a zombie” by the New York Times because the Republican healthcare policy it contains seems to keep coming back from the dead over and over again. It’s hard to say at this point if there are at least 50 votes in the Senate to pass this measure, but observers believe Sen. John McCain (R-Ariz.) might be swayed to give a thumbs up this time.
In general, the bill covers the same familiar territory that Republican lawmakers have traveled:
- Restructuring of Medicaid into block grants with per-person spending caps;
- Elimination of the Medicaid expansion;
- Options for states to eliminate essential benefits;
- Elimination of the coverage mandate;
- Wider range of premium cost levels, including for those with pre-existing conditions; and
- Elimination of subsidies for coverage and out-of-pocket costs.
There is no Congressional Budget Office score yet, and there might not be one prepared in time for the vote, which has been forecasted for as early as Monday morning, Sept. 25. Meanwhile, AARP—which is arguably the biggest lobbying outfit in the country—and almost 500 healthcare organizations have spoken out against the Senate bill, including the National Council for Behavioral Healthcare, the National Association of Addiction Treatment Providers, the American Society of Addiction Medicine, the National Alliance on Mental Illness and plenty others.
According to AARP projections, the bill could cut between $1.2 trillion and $3.2 trillion from total Medicaid spending over the 20-year period between 2017 and 2036. The Center on Budget and Policy Priorities released a report showing in 2027, every state in the nation would see federal funding cuts totaling nearly $300 billion.
Proponents are looking to increase health plan choices for consumers, reduce federal spending and drive efficiencies in Medicaid programs. Critics are concerned about how the policy would shift costs to states and ultimately lead to coverage and eligibility cuts in Medicaid programs—just as they were with the previous bills.
However, there’s also a new twist, in that a separate bipartisan effort is currently underway to fix up the existing healthcare infrastructure, and that effort could be stymied if the Graham-Cassidy bill passes in the meantime.
“The Senate Health, Education, Labor and Pension Committee has spent the past month working on bipartisan legislation that would stabilize the health insurance market and create a better healthcare system,” said Linda Rosenberg, president and CEO of the National Council, in a statement. “With legislation from these efforts expected soon, now is not the time to renew the failed partisan effort that slashes billions of Medicaid dollars from state budgets, costing hundreds of thousands of lives. ”
Editor's Update: On Tuesday evening, the Senate committee ended its discussions.