Don’t look away on health care

The saga of the Republican Party’s repeated attempts to repeal and replace the Affordable Care Act has a few more days to play out. It is a dreary tale, one not told by an idiot perhaps, but certainly populated by politicians worthy of our disdain. The nation is watching as this drama unfolds. At stake is whether the Graham-Cassidy replacement bill will squeak through before Sept. 30, when the clock must be reset because of Senate rules. On Friday, one big question mark was removed in the fight to find enough votes to push repeal over the top. Arizona GOP Sen. John McCain announced he opposed the measure — striking a blow against the bill from which it might not recover. On Monday, Maine Sen. Susan Collins announced her “no” vote. Time is running out.

With the Senate almost evenly split, the GOP can afford few defections. All 46 Democrats and two independents have opposed several bad repeal bills. That coalition has not budged. To triumph, the Republican-majority Senate can afford to lose two votes (Vice President Mike Pence can break a 50-50 tie), but that’s it. Republicans fell short over the summer, when Sens. Collins, Lisa Murkowski and McCain opposed repeal.

Fast-forward to fall — repeal appeared to be dead, but Senate Majority Leader Mitch McConnell and President Donald Trump have refused to quit. The revival of repeal in the form of the Graham-Cassidy legislation began taking on steam earlier this month. Now, the end is in sight, with GOP leaders frantically tinkering with the bill to try and find a way to sway the skeptics.

Sen. Rand Paul of Kentucky also said Monday he is against it, but Paul has switched positions before. Sen. Ted Cruz of Texas has said the bill doesn’t have his vote “right now,” whatever that means. Sen. Murkowski remains a likely no, and this time, by not waiting until the actual vote, McCain has led the way. His statement Friday that, “In good conscience I cannot vote for this bill,” seems to close the door on repeal — for now, anyway.

But as New Mexico Sen. Tom Udall told us Friday in a meeting with New Mexican staffers, don’t ever take the repeal bill’s death for granted. Citizens have to keep paying attention — calling senators, lobbying relatives in other states, writing letters and otherwise making their feelings known. “One of the things that has happened because of all the hurricanes and earthquakes and news,” Udall said, is that people become distracted. “It’s a pretty shrewd move to bring it up at this time.”

For New Mexico, the Medicaid expansion allowed under the ACA, or “Obamacare,” has provided some 266,000 more people with insurance. The proposed repeal legislation would cost the state billions, money New Mexico simply does not have. That would mean less health care for residents but also financial hits to rural hospitals and clinics. The repeal legislation does not protect people with existing health conditions, meaning that many sick people — think diabetes or cancer or lupus — will have difficulty finding insurance coverage.

Obamacare helped in covering Native people through expansion of Medicaid as well as through Indian Health Services, and the repeal would set back gains. Udall wrote that, “The bill’s massive cuts to the Medicaid program would devastate access to life-saving health care across Indian Country. The Graham-Cassidy TrumpCare legislation is an irresponsible and dangerous abdication of our federal government’s trust responsibilities to tribes.”

It appears — for now — that the repeal effort will die in the Senate once more. Both Udall and Sen. Martin Heinrich have been staunch fighters for improving the ACA rather than scrapping it with no good replacement ready. Reps. Ben Ray Luján and Michelle Lujan Grisham also have been against a repeal that strips health coverage from Americans and does more harm than good.

Should the worst happen, though, and the Graham-Cassidy bill — somehow — is revived and slips through the Senate, New Mexicans should watch GOP Rep. Steve Pearce. He voted for repeal in July, despite the damage that legislation would do to New Mexico. This bill is worse, and as Pearce begins his run for governor, he will have to tell citizens why he voted to strip them of health care.

That may not happen. Sen. Collins is standing against Graham-Cassidy. And John McCain — who announced Sunday that his prognosis in fighting brain cancer is “not good,” did not back down despite the pressure. Once more, the POW has served his country, putting principle above party and even friendship. His decision to oppose repeal could be the final blow. This time.