The most important thing to understand is if this new “repeal and replace” bill becomes law, it won’t just screw up Obamacare. It will impact how most of us access health care, directly or indirectly. It’s actually worse than the last bill they tried to pass.
The stated motive of its sponsors â€” Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana â€” is to return power and flexibility to the states. But the states â€”Â even those run by Republican governors like Trump ally Chris ChristieÂ in New Jersey â€”Â do not want this. Neither doÂ doctors, nurses, hospital administrators, or anyone else who knows one whit about how health care in America actually works. One particularly harsh critic urged defeat of the Senate bill because it â€œreduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americansâ€™ choice of health plans.â€ What pot-brownie-addled BernieBro said that?Â The association of Blue Cross Blue Shield insurers, thatâ€™s who.
Margot Sanger-Katz writes at the New York TimesÂ that the bill would force states to build entire health care systems from scratch.
The bill, proposed by Bill Cassidy and Lindsey Graham, would eliminate Obamacareâ€™s expansion of state Medicaid programs to cover poor adults and its system of subsidies to help middle-income Americans buy their own insurance in state marketplaces. Instead, it would allow states to apply for big block grants of money once they have developed a plan to use the money to provide health care or health insurance coverage. …
…States could use the money in any number of ways: state insurance programs, subsidies for private insurance, direct payments to health providers, high-risk pools or more. They would be free to preserve the central consumer protections created by Obamacare, or to decide to allow insurers to limit benefits or charge higher prices to sicker customers than healthier ones.
The challenges would fall into two major categories. First, states would need to make political choices about what they want their system to look like. Next, they would need to submit applications, hire contractors and build new systems to run them. Neither would be easy.
Oh, and the states have two years to accomplish this.
The bill would make health care an active, high-stakes political debate in all 50 states. Under Obamacare, states had limited, rather binary policy choices, and even those were hard for state governments to make quickly.
A considerable percentage of state governments are even more dysfunctional and corrupt than the U.S. Congress. People in those states can pretty much kiss their access to health care goodbye. Insurers have come out against it, because the amount of uncertainty this bill would create would pretty much blow their business model out of the water. And, whether people want to admit it or not, what happens with federal funding, including Medicaid, deeply impacts hospitals and sets off ripple effects that impact everyone.
So far, the most effective voice speaking out against this atrocity is Jimmy Kimmel.
â€œOh, I get it. I donâ€™t understand because Iâ€™m a talk-show host, right? Well then, help me out. Which part donâ€™t I understand? Is it the part where you cut $243 billion from federal health care assistance? Am I not understanding the part where states would be allowed to let insurance companies price you out of coverage for having pre-existing conditions? Maybe Iâ€™m not understanding the part of your bill in which federal funding disappears completely after 2026? Or maybe it was the part where the plans are no longer required to pay for essential health benefits, like maternity care or pediatric visits?â€
â€œOr the part where the American Medical Association, The American College of Physicians, The American Academy of Pediatrics, The American Hospital Association, The American Cancer Society, The American Diabetes Association, The American Heart Association, Lung Association, Arthritis Foundation, Cystic Fibrosis, ALS, The National Multiple Sclerosis Society, and The March of Dimes, among many others, all vehemently oppose your bill?â€ he continued. â€œWhich part of that am I not understanding? Or could it be, Senator Cassidy, that the problem is that IÂ doÂ understand, and that you got caught with your G-O-Penis out? Is that possible? Because it feels like it is.â€
I assume Senate Democrats are speaking out against this also, but media are ignoring them. See also Greg Sargent,Â Cassidy-Graham could still blow up in the GOPâ€™s face. Hereâ€™s how.