To paraphrase W.C. Fields, it seems as if news of the death of the Graham-Cassidy bill is greatly exaggerated.  As veteran Kaiser Health News correspondent Julie Rovner tweeted this morning:

FWIW I will not believe health bill is really dead until I see it with an actual stake through it.

Her caution is well warranted.  Anti-repeal advocates breathed a sigh of relief last Friday when Senator John McCain (R-AZ) announced his opposition to the bill.  But opponents of Graham-Cassidy still need one more GOP vote to kill it before the September 30th deadline, and so far only McCain and Senator Rand Paul (R-KY) have announced as ‘No’s.  Some Hill-watchers are wary of Rand Paul’s position and predict he will flip to ‘Yes’ at the last minute, as he has done previously.  On the other hand, this weekend Sen. Ted Cruz (R-TX) threw cold water on Graham-Cassidy because he says it doesn’t go far enough in undoing Obamacare regulations:

"Right now they don't have my vote, and I don't think they have Mike Lee's either," Cruz said. "I want to be a yes."              –  Senator Ted Cruz

Seeing their Obamacare repeal bill appear to collapse before their eyes, Senators Lindsay Graham (R-SC) and Bill Cassidy (R-LA) have now sweetened the deal to try to buy off two wavering moderate Senators, Lisa Murkowski (R-AK) and Susan Collins (R-ME).   The Graham-Cassidy bill was changed over the weekend to give away tens of millions of dollars to two of America’s least populous states.  Alaska would net $3 million more in federal health spending than under current law from 2020-2026, and Maine $43 million.  Of course, when Graham-Cassidy’s block grants to states expire in 2026, both states will lose funding along with the other 48.   Steven Dennis of Bloomberg handicaps it this way:


These buy-offs may or may not bring Senators Murkowski and Collins over to the ‘Yes’ side.  Nor should they.  Both Senators have expressed deep concerns about other parts of the bill:  Sen. Murkowski for its elimination of protections for pre-existing conditions; Sen. Collins for its deep cuts to Medicaid.  And of course, these bribes for Alaska and Maine do not make the Graham-Cassidy bill any less egregious.  Every major group of stakeholders – insurers, doctors, hospitals, patients, and all 50 state Medicaid directors – have condemned this bill as a reckless assault on America’s health care system.  National Committee president Max Richtman lays out the case in testimony given to the Senate Finance Committee. 

The Republicans supporting Graham-Cassidy don’t seem to care as much about improving healthcare as they do about fulfilling a reckless campaign promise and scoring a legislative “win,” even though the vast majority of the American people would actually lose.  Premium subsidies would be eliminated, pre-existing conditions no longer protected, essential benefits gutted, and Medicaid decimated to the point where crucial services would be cut for seniors, children and the disabled.  One look at this chart from Kaiser Health News showing where most Medicaid spending goes makes it crystal clear who gets hurt if Graham-Cassidy becomes law.

Senators Graham and Cassidy, along with their enablers in the Trump administration, will continue to falsely claim that their bill protects people with pre-existing conditions, when by leaving it to the states to decide, there is no such protection at all.  If states seek waivers to pre-existing conditions, insurers can jack up rates for patients with diabetes, cancer, heart disease and other chronic illnesses to the point of unaffordability.

Instead of believing more pablum, or trusting that the Republican-led Senate will do the right thing, we must keep up the pressure on wavering Senators (especially Collins and Murkwoski) to vote ‘No’ when the bill comes to the floor later this week.  If we are to see a stake through Obamacare repeal, we must make sure to put it there ourselves.