Health

Graham And Cassidy May Have Saved Obamacare Repeal

REUTERS/Aaron P. Bernstein

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Robert Donachie Capitol Hill and Health Care Reporter

Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana are set to release a new version of their Obamacare repeal bill Monday that will provide key concessions to moderate and conservative Republicans that have thus far signaled their unwillingness to back the party’s eleventh-hour push to upend the American health care system.

The Republican holdouts thus far, include: Sens. John McCain of Arizona, Lisa Murkowski of Alaska, Susan Collins of Maine, Rand Paul of Kentucky and, most recently, Ted Cruz of Texas and Mike Lee of Utah.

More Money For Murkowski

Murkowski’s home state of Alaska is one of the costliest under Obamacare, as it has a sprawling population with a lot of low-density areas. Under the original version of Graham-Cassidy, Alaska could see as much as a $1 billion cut to the state’s federal health care funding from 2020 to 2026, according to research from consulting firm Avalere. That would work out to roughly a $1,350 cut per resident.

The new version is likely to include funding carve outs for low-density states and an uptick in the federal reimbursement rate for Medicaid, both of which would help states like Alaska. These provisions could help swing Murkowski to a yes, but the verdict is till unclear.

Wrangling The Conservatives Paul, Cruz And Lee

Graham and Cassidy are providing their conservative colleagues with a few concessions that would increase state’s flexibility in implementing health care.

The new bill will reportedly allow for multiple insurance risk pools, although how that would look remains unanswered. If the multiple pools end up bifurcating into ones that consist of mainly healthy individuals and ones that are made up of mostly sick people, the premium problems for those with pre-existing conditions or the elderly could go up substantially. Effectively, if a insurance pool does not have healthy people paying in for sicker, riskier enrollees, the cost sharing is non-existent and insurers have to pad their risk with more buy-in from insurees.

Graham and Cassidy’s new version will also remove a few of Obamacare’s insurance regulations.

McCain Is Likely Voting ‘No’ Unless This Goes Through Regular Order

“I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” he said in a statement Friday.

“Nor could I support it without knowing how much it will cost, how it will effect insurance premiums, and how many people will be helped or hurt by it. Without a full CBO score, which won’t be available by the end of the month, we won’t have reliable answers to any of those questions,” McCain said.

The Arizona senator has been adamant throughout the rollout of Graham-Cassidy that any major health care bill needs to go through regular order, which forces a bill to get 60 “yes” votes and provides Democrats with the opportunity to filibuster.

Republican leadership has until Saturday, Sept. 30 to pass a bill through the Senate’s budget reconciliation process, which allows leadership to pass a bill with only 50 “yes” votes and bypasses filibusters from Democrats.

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