Don't do it, Sen. Rubio

Just when it seemed safe to fear only hurricanes and other natural threats to the lives of millions of Americans, here come the Obamacare wreckers in the U.S. Senate once again.

Working against a September 30 deadline to secure passage by just 50 senators, they're in a frenzy to pass a bill that could do even more harm than the rush job three courageous Republicans blocked two months ago, which would have left 32 million people without insurance. As they say, it's never over until it's over.

How much damage? They can’t even say because the Congressional Budget Office says it needs several weeks to calculate anything more than the immediate savings to the treasury.

Those savings, though, would come at enormous cost to an estimated 34 states, 31 of which chose to expand Medicaid, temporarily benefiting those — like Florida — that didn't. Democrats govern most of the states that would lose.

The political cynicism and hypocrisy of this bill are remarkable even in a profession well known for them. Sen. Charles Grassley, R-Iowa, confessed as much in an interview with the Des Moines Register:

“You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Grassley said. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”

In other words, keeping a bad promise to right-wing Republican voters is more important than protecting the health of a far larger majority of Americans.

The bill concocted by Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana seems to appeal to Florida's junior senator, Marco Rubio, who has supported every partisan attempt to unravel the Affordable Care Act.

But in the longer term, Rubio's yes vote would be a dagger to the heart of millions of Floridians, young and old, who depend on traditional Medicaid for everything from maternal and infant health, to long-term care in nursing homes.

Medicaid, which now specifies minimum coverage expectations and sets a federalstate funding formula, would be converted to block grants to the states, along with some of the money now spent on Medicaid expansion and Obamacare marketplace subsidies. But the grants would be capped at an arbitrary limit, rather than allowed to grow according to inflation. The formula would be based on personal income among the states, but — critically — not on the wide variations in health care costs.

Poor and near-poor people covered under Obamacare’s Medicaid expansion would be kicked off. Childless adults would be barred. The entire program would expire in 2026, potentially allowing the GOP to fulfill its ambition to repeal Medicaid entirely. And the bill would end funding for Planned Parenthood, a particularly senseless act of political spite.

Nationwide, Graham-Cassidy would imperil an estimated 60 million low-income children, parents, people with disabilities and the elderly, according to the Kaiser Family Foundation. This is a significant danger to Florida, with its large populations of the elderly and working poor. Nationwide, Medicaid pays for 49 percent of all births and 64 percent of all nursing home bills, according to the New York Times. Rubio would also be voting to erase Obamacare's requirements that people have insurance or pay a tax, that large employers insure their workers and that insurance plans cover pre-existing conditions, pregnancy, and other essentials. The bill would leave those decisions to the states. It would keep almost nothing except the popular provision that allows children to remain on their parents' insurance until they are 26.

Once again, the Republican leadership is demanding all this be done without any of the regular order — committee hearings, public testimony, opportunity for amendments — by which all legislation is supposed to be considered. This bill affects a sixth of the entire U.S. economy, not to mention millions of citizens.

In the Senate committee responsible for health, there is a bipartisan effort to write a bill to shore up the Obamacare marketplaces and make other improvements.

Graham and Cassidy intend to get to the floor first, but their bill is markedly worse than anything the Senate has previously considered. Every major health entity is against it, along with five Republican governors.

The sponsors seem to want people to think their proposal is a reasonable alternative to Sen. Bernie Sanders's single-payer campaign. That's a false equivalency. Graham-Cassidy is no option at all, except as an opportunity for ruthless cruelty and massive economic devastation.

This bill would end access to care for millions of low-income people. It would cause people of little means to die early. It would force low-income elderly people to face long waits for nursing home beds, if they get them at all.

Marco Rubio should consider the lives that will be lost as he considers casting yet another vote in partisan lockstep.

The political cynicism and hypocrisy of this bill are remarkable