As the 40th President of the United States used to mutter, well, there they go again.
The Republicans in the 115th Congress apparently will make another go at repealing and replacing the Affordable Care Act, what may be their 70-something such try. It may come in the form of legislation advanced by GOP Senators Lindsay Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada, and Ron Johnson of Wisconsin.
The so-called Graham-Cassidy bill, which analysts say would slash tens of millions of Americans from health coverage, cut tens of billions of dollars in federal aid for health care, and convert the ACA into state-controlled block grant funding, must overcome major obstacles to advance.
Because Republicans hope to pass it under arcane and rigorous budget reconciliation rules to avert a possible Democratic filibuster, they must act in both the House and Senate by September’s end.
That leaves them paltry few working days in the Senate, but especially in the House.
And Graham-Cassidy—which foes already have roundly denounced as Draconian and unworkable, especially because it, among other things, will eliminate protections against insurers denying patients coverage due to pre-existing conditions—likely before lawmakers will vote on it, will not get any hearings, will barely be printed and shared, and may not be scored for its costs and effects by the independent Congressional Budget Office.
Congress has tried this kind of slap-dash lawmaking before, leading to the dramatic, late-night failure earlier this summer of Obamacare repeal and replacement via the House-backed American Health Care Act and the Senate’s version, the Better Care Reconciliation Act.
In my practice, I see not only the huge harms that patients suffer while seeking medical services but also their heart-breaking struggles to afford unaffordable medical care, with or without insurance coverage and especially if they have long and major health needs.
The ACA is imperfect, and lawmakers have every right to fix it, or even if they wish, to repeal and replace it. But they owe it to the American people to do so in the right and proper ways—with ample consultation with experts, public discussion in extensive hearings, and more. Graham-Cassidy’s fate is murky, considering that GOP leaders again must find the narrow way to get 50 votes in the Senate.
Still, it would be an outrage if Congress, with so little time and public consideration, makes a monumental move with this bill, which affects a sector of the economy that comprises 17 percent of the nation’s GDP and on which we Americans spend $3 trillion annually.
It hasn’t helped Americans’ health or finances, by the way, that the Trump Administration has campaigned in administrative fashion to undercut the ACA by slashing at efforts to get qualified people to sign up for it and by shilly shalling as to whether it will pay cost-sharing subsidies.
It’s also worth noting, meantime, that the incessant Obamacare attacks, as carried out by the GOP, prevent Congress from its work on other issues, including priorities like the health of poor kids. Lawmakers reportedly have struck a deal for a long-term renewal of the Children’s Health Insurance Program or CHIPs. But the program, which provides health coverage and critically important medical services for nine million poor youngsters, will exhaust its funding and mandate at September’s end without congressional action.
Congress also needs to reconcile and make final House and Senate budget allocations for important support for medical and scientific research, particularly for the National Institutes of Health, a major funder of such efforts nationwide. To their credit, lawmakers have rejected the Trump Administration’s push to whack NIH funding and instead aim to increase it.
