Republicans Reveal New Senate Bill, Democrats Tout Medicare-For-All

September 13, 2017

Senate Republicans unveiled the text of the “Graham-Cassidy-Heller-Johnson bill,” the latest effort to repeal and replace the Affordable Care Act (ACA). Meanwhile, at the same time a number of Senate Democrats announced their support for Independent Senator Bernie Sanders’ Medicare-for-all single payer health care bill.

The new republican bill, sponsored by Senators Lindsey Graham (R-South Carolina), Bill Cassidy (R-Lousianna), Dean Heller (R-Nevada), and Ron Johnson (R-Wisconsin), would drastically overhaul how Medicare and Medicaid are funded by giving states block grants, and complete control over funding the programs.

“Instead of a Washington-knows-best approach like Obamacare, our legislation empowers those closest to the health care needs of their communities to provide solutions,” Sen Graham said in a press release. “Our bill takes money and power out of Washington and gives it back to patients and states.”

According to a press release, the block grant dollars would replace the federal spending currently going to Medicaid expansion, ACA tax credits, cost-sharing reduction subsidies, and the basic health plan dollars. The plan would also eliminate the cost-sharing reductions and ACA tax credits.

The Graham-Cassidy-Heller-Johnson bill also eliminates the employer mandates, the individual insurance mandate, and ACA medical device taxes.

There is language that earmarks funding within the bill that aims to continue protections for patients with preexisting conditions.

Experts have argued that the bill would be more disruptive to the health care system that simply fixing current issues with the ACA. Reports indicate that the level of block grant funding would not keep pace with medical inflation, and would likely lead to huge cuts to many federal health care services. The bill would also likely impact maternity care and prescription drug coverage.

Critics have also pointed out that eliminating the individual mandate would eventually create sicker, higher cost risk pools—due to healthy people abandoning the insurance market.

“In July of this year, the Senate failed to garner the necessary votes in the process of moving forward with legislation to repeal and replace the ACA in a budget reconciliation bill,” Jack Ende, MD, MACP, president of ACP, wrote in a letter to the bill’s sponsors.  “Rather than continue with an effort to repeal and replace the ACA, ACP urges you to set aside this legislation and instead, focus on bipartisan efforts to stabilize the health insurance marketplaces, create competition among insurers, and lower the costs of health care for all Americans.”

However, President Trump lauded efforts by republicans to resurrect ACA repeal plans.

“As I have continued to say, inaction is not an option, and I sincerely hope that Senators Graham and Cassidy have found a way to address the Obamacare crisis,” a White House statement read.

The bill currently does not have enough pledged support to get the 51 votes needed under a budget reconciliation. Republicans are under a tight deadline, as any health reform bill presented after September 30th would need a 60-vote supermajority until the next calendar year starts.

Democrats Resurrect Medicare-for-all

Meanwhile, a number of Democratic lawmakers rallied behind a different ACA repeal plan: Senator Bernie Sanders’ (I-Vermont) Medicare for All Act of 2017.

A number of Senators turned out to unveil the bill, including Senator Al Franken (D-Michigan), Senator Cory Booker (D-New Jersey), and Senator Elizabeth Warren (D-Massachusetts). The bill currently only has the support of 18 Democratic senators and is unlikely to pass through the Republican-controlled senate.

The plan would completely overhaul the current United States health care system by replacing it with a single-payer public option. Under the plan, all health services would be provided without any copay or cost sharing. The plan would be funded through higher taxes for both individuals, employers, and corporations.

Americans not currently eligible for Medicare would be phased in to the program over a 4-year period, with all employer-sponsored plans being eliminated entirely. This would result in about 2/3s of Americans who are currently in the insurance market losing their plans and being shifted on to Medicare.

The Democrats hope that by releasing the plan now, they can rally support for a single-payer system ahead of the 2020 election cycle.

“This struggle will ultimately not be won here on Capitol Hill, but through grassroots activism all across this country,” Sen Sanders said at a press conference, “The reality is that when millions of Americans stand up and fight back, when they become engaged politically, there is nothing that will stop us.” —David Costill