Graham- Cassidy bill too reasonable to support
Will the real moderate party please stand up? On the same day that socialist Sen. Bernie Sanders, I-Vermont, introduced his “Medicare for All” health-care plan, Sens. Lindsey Graham, R-South Carolina, and Bill Cassidy, R-Louisiana, introduced a last-ditch effort to sortakinda repeal and replace Obamacare. Despite having zero chance of being passed any time soon, Sanders’ bill grabbed the limelight for two reasons.
First, it’s a beacon of hope for the demoralized base. As a Rolling Stone headline put it, “Single-Payer Movement Shows: Life After Trump May Not Suck.” Second, Sanders got 15 cosponsors — including some Democratic senators with presidential ambitions. The fact that so many contenders signed on to a bill that, if enacted, would throw 100 million Americans off their employer-provided health care and cost taxpayers an estimated $32 trillion over a decade revealed just how far to the left the Democratic Party has moved.
And yet, to listen to Democrats and many of the journalists who love them, you’d think it was the Republican proposal that’s extreme. “It contains, in exaggerated and almost caricature form, all the elements that made previous Republican proposals so cruel and destructive,” said New York Times columnist Paul Krugman.
The news section of the Times was more evenhanded: “Medicare for All or State Control: Health Care Plans Go to Extremes.”
Are they really both “extreme”? Graham-Cassidy’s chief goal is to pare back the federalization of healthcare policy by getting rid of the individual and employer insurance mandates and letting governors waive out of some regulations. More important, it block-grants Medicaid — a long-sought dream for those wanting to get a handle on out-of-control spending and debt.
A main driver of exploding health-care costs has been the way the federal reimbursement system discourages thrift. Obamacare made that problem much worse. Under Obamacare, Medicaid rolls were vastly expanded, adding millions to a faltering program. And in order to seduce states into signing up, the Feds promised to cover 100 percent of the additional costs for the first three years and no less than 90 percent in later years. If you had an expense account where someone else covered most of the tab, how eager would you be to control costs?
By giving states a lump sum via block grants, the hope is that they would experiment with cost-saving reforms that improve healthcare results.
Graham-Cassidy is by no means perfect, and odds are it won’t pass. Democrats are locked into the position that health-care reforms can only involve more government spending and regulation. With 52 GOP senators, Graham-Cassidy can pass only if at least 50 of them vote for it, and they must do so before Sept. 30, when the arcane budget window known as “reconciliation” closes. It would be smart to emulate Obamacare (and welfare reform) and be overly generous up front with the block grants, to essentially bribe politicians into voting for it.
Meanwhile, Kentucky Sen. Rand Paul, who has mastered the art of supporting the status quo by voting against piecemeal improvements in the name of purity, has already indicated he will continue to play that game.
The choice for Republicans is between this or letting Obamacare continue intact, violating all of those repeal-and-replace promises entirely.
That’s what’s so silly about the claim that GrahamCassidy is as “extreme” as Sanders’ radical and shoddily written proposal (the bill is totally silent on how to pay for any of it). Graham-Cassidy is very close to the kind of legislation we would have ended up with if Republicans had an idea of what they wanted from the get-go and the Democrats were interested in compromise. But we live in a time when extremism is defined as not getting everything you want.