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Senate’s bad medicine gets worse with new health care bill

Sen. Lindsey Graham speaks to reporters in Washington

Sen. Lindsey Graham speaks to reporters in Washington on Sept. 19, 2017. Credit: Ron Sachs

The latest version of the Senate health care bill, now clinging to life by a thread, would decimate the care of many Americans from the cradle to the grave, robbing children and mothers of healthy futures and the elderly of the care and dignity they deserve.

It’s no exaggeration. The bill sponsored by Louisiana Sen. Bill Cassidy and South Carolina Sen. Lindsey Graham would cause that much damage.

In New York, the costs of 51 percent of births are paid by Medicaid, as are the bills of 67 percent of nursing home patients. But the legislation features devastating cuts to both the expansion of Medicaid that came with the Affordable Care Act and the traditional Medicaid program that’s been in place since 1965.

And it would specifically plunder New York’s funding by funneling huge sums of federal money away from urban, Democrat-dominated states with higher costs and sending the money to GOP-friendly states that cover far fewer of their people and have far lower costs.

Cassidy-Graham is, in a year of punitive health care bills, the most inhumane and cynical one yet. It includes many of the same mistakes as earlier attempts, but would implement them in a harsher manner. And it features several new and devastating wrinkles.

If Cassidy-Graham becomes law, states could easily seek waivers that would allow insurers to:

  • Deny coverage to people with pre-existing conditions or charge them far more than healthy customers.
  • Reinstate lifetime coverage caps. Before the Affordable Care Act, such rules drove many ill Americans who did have health insurance into bankruptcy.
  • Sell policies that do not cover essential needs, as they could before the Affordable Care Act, when 75 percent of individual plans excluded maternity coverage, 45 percent excluded substance-abuse treatment, and 38 percent did not cover mental health care. Such policies are often described as providing choice. In fact, they help insurance companies winnow out customers who may have future health care needs and charge them astronomical rates.
  • Charge older customers five times as much for coverage as younger customers, when the maximum is three times as much under the Affordable Care Act.

The bill also would:

  • Cost New York $45 billion in Medicaid funding over the next 10 years by shifting the money to states like Texas that never expanded Medicaid coverage. And it would disburse Medicaid funding via one large sum, or block grant, to each state rather than as a percentage of each Medicaid patient’s costs. After the block grants end in 2026, every state would suffer huge cuts. New York would lose $19 billion a year.
  • End the mandate that large employers must provide health insurance.
  • End the rule that individuals must buy insurance, making the insured pool much older and sicker than it is now.
  • End the subsidies in the Affordable Care Act that help people afford coverage.

The earlier bills to replace Obamacare failed because they would have cost an estimated 23 million people their coverage. Now the nation is staring down the barrel of a plan that would leave an estimated 32 million people uninsured, according to independent analysts. There is no Congressional Budget Office score of the bill’s costs yet. That’s one of the main reasons Sen. John McCain of Arizona cited Friday in refusing to support the bill, dealing it a potentially fatal blow.

The nation is getting the bum’s rush to have this bill voted on by Sept. 30. Before that deadline, the bill needs only 50 votes in the Senate, plus Vice President Mike Pence’s tiebreaker. After that, the bill needs an impossible 60 votes to pass, ending the latest GOP drama of “repeal and replace.”

Until recently, Democratic Sen. Patty Murray of Washington and GOP Sen. Lamar Alexander of Tennessee were working on a bipartisan solution to give states more of the freedoms that conservatives want, and to shore up the health care exchanges and subsidies so many Americans depend on. That effort has been shut down for the moment. Meanwhile, the more liberal arm of the Democratic Party insists on a single-payer plan for all that’s anathema to many moderate voters. And conservatives dominating the GOP caucus are standing by Cassidy-Graham, which is ill-conceived and punitive to states that are actually trying to address the health needs of their residents.

The odds of the GOP passing Cassidy-Graham dropped dramatically with McCain’s departure. That’s good news, because Cassidy-Graham clearly isn’t what the nation wants or needs right now. Neither is single-payer.

What the nation does need, immediately, is an agreement to shore up the insurance exchanges and provide the subsidies customers count on before the individual market collapses and Americans lose coverage. After that, we need exactly the things McCain is holding out for — a bipartisan bill reached via the regular, orderly operation of Congress, with floor debate and amendments offered — to correct the mistakes of the Affordable Care Act and capitalize on its successes.