Senate Republicans are at it again with their latest Obamacare repeal bill, known as Graham-Cassidy, which is expected to be voted on before the end of September. Because of the short time frame, the Congressional Budget Office is not expected to have an analysis of how it will affect the number of Americans without coverage, insurance premiums or the deficit until after the Sept. 30 deadline, but early indications are that it isn't much better than previous proposals that were ultimately rejected this summer and, in some ways, might actually be worse.
Gov. Larry Hogan spoke out against the bill on Tuesday, emphasizing that it would be a bad deal for Marylanders, and we couldn't agree more. "Unfortunately, the Graham-Cassidy bill is not a solution that works for Maryland. It will cost our state over $2 billion annually while directly jeopardizing the health care of our citizens," Hogan, a Republican, said in a prepared statement. "We need common sense, bipartisan solutions that will stabilize markets and actually expand affordable coverage."
Hogan notes that he will support any solution "no matter which side of the aisle it comes from" if it keeps intact parts of the Affordable Care Act that work, makes fixes to the parts that led to drastic 50 percent hikes in premiums, and protects coverage for Maryland residents. The proposed repeal sponsored by Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana doesn't seem to do any of that.
Maryland has benefited more than many states with the expansion of Medicaid under Obamacare, providing coverage to more than 260,000 residents. Under Graham-Cassidy, that expansion would be replaced with block grants. The grants would provide money to each state to do as it sees fit regarding health care, but with less money, meaning some people would lose Medicaid coverage unless the state was able to fund subsidies.
The bill would not eliminate an Obamacare protection for people with preexisting conditions — insurers couldn't outright refuse to cover someone because they are already sick — but it would allow insurers to charge premiums that are prohibitive to those individuals getting coverage. Graham-Cassidy would eliminate the wildly unpopular individual mandate and requirements that large employers (those with 50 or more full-time equivalent employees) must offer health care plans.
Without a score from the CBO, including how many would lose coverage, it would be irresponsible for the Senate to approve Graham-Cassidy. Yes, Democrats rushed to pass Obamacare — "We have to pass the bill so that you can find out what's in it" — but did so after the nonpartisan CBO had issued a report on its impact.
Instead, let's see what a bipartisan group of about 40 legislators, put together by Lamar Alexander and Patty Murray, the Republican and Democratic leaders of the Senate health committee, come up with in the next week. The group has been working this month to develop bipartisan solutions to cut premiums and stabilize the individual health insurance market with a deadline of Sept. 27, when insurers sign contracts with the federal government over what plans can be sold on the exchanges to roughly 11 million Americans.
It's small potatoes compared to sweeping efforts to repeal and replace Obamacare, but bipartisan agreement here could be a sign that Congress is ready to put political differences aside and instead work together to focus on — no pun intended — surgical tweaks to repair the ACA without disrupting health care coverage for millions of Americans, including those in Maryland, the way passage of Graham-Cassidy would.