OPINION: Congressional Republican division means Cassidy-Graham healthcare reform bill is dead
Eight months after the inauguration, the Republican Party’s lack of direction and unity has resulted in its inability to complete President Donald Trump’s first legislative goal — repealing former President Barack Obama’s healthcare law. Now, the party has almost run out of time.
On Sept. 30, the current budget reconciliation measures will expire and Senate Republicans will need 60 votes to pass a repeal of “Obamacare” instead of 50. As there are only 52 Republican senators and essentially no Democrats willing to cross over to aid in repeal efforts, the Republicans have to pass a repeal before the end of September or be faced with a massive legislative failure and broken campaign promises.
The last-ditch effort has resulted in the creation of the Cassidy-Graham healthcare reform bill, a proposal that would change the existing “Obamacare” funding from individual subsidies to block grants distributed to states. It would also reform Medicaid and reduce the protections given to individuals with pre-existing conditions.
In total, the Cassidy-Graham bill is the equivalent of a college student attempting to write their entire thesis a week before it is due. The result is a bill that fails to take on the core problems of the Affordable Care Act, including the lack of competition for plans. Instead, it provides minor changes that will slow the bleeding but will not solve the problem.
Meanwhile, Sen. Bernie Sanders introduced his own healthcare reform bill, Medicare for All, with an impressive 14 senators signing on as sponsors. His proposal would expand single-payer healthcare and increase Medicaid spending, effectively the opposite of what Republicans are attempting to achieve.
As the deadline draws closer, it becomes clearer that the bill is likely not to get the needed 50 votes to pass the Senate. Sen. Rand Paul has already spoken out against the bill, stating that he will not be voting for the Cassidy-Graham bill on the grounds that it does not repeal the Affordable Care Act, instead it gives control of the programs over to the state legislatures.
“No consevative (sic) should vote for a rebranded trillion dollar spending program just because it adds some block grants,” Sen. Paul tweeted. “Keeping 90% of Obamacare is not ok and it’s not what we ran on. Conservatives should say no.”
Republican Senate leadership has struggled to assemble the needed votes for healthcare reform since Trump took office in January. The problem is that some Republicans are insisting on a full repeal of the Affordable Care Act while moderates oppose a total repeal for fear of losing their re-election campaigns.
The campaign slogan “repeal and replace” may have been effective for rallying Republican and undecided voters during the election. The failure of party leadership to establish what exactly that plan means in terms of legislation has led to the current inability to pass a healthcare bill and the splintering of party membership.
Over the weekend, Sens. John McCain and Susan Collins also expressed their disapproval of the bill and the fact that they would likely vote no on the proposal. Sen. McCain’s concern is that the bill did not proceed through the typical process of hearings, markups and open-amendments. Instead, the bulk of the bill was written in secret and the text was released only recently.
On State of the Union with Jake Tapper Sunday morning, Sept. 24, Sen. Collins expressed concerns over the changes to insurance costs and coverage under the Cassidy-Graham bill.
“We already have a problem under the Affordable Care Act with the cost of premiums and deductibles, and,
finally, I’m very concerned about the erosion of protections for people with pre-existing conditions,” Sen. Collins said. “It’s very difficult for me to envision a scenario where I would end up voting for this bill.”
With the expressed opposition of these three Republican senators, the Cassidy-Graham bill is effectively dead. If Republican leadership hopes to accomplish any of its legislative goals this term, then they need to start paying more attention to content and addressing the problems facing the country rather than catchy campaign slogans.