Latest bill doesn’t have the votes
WASHINGTON — A Maine Republican on Monday effectively killed the latest effort to gut the 2010 health-care law, dimming yet again the likelihood that Republicans will keep what was a central promise of the 2016 presidential campaign.
After reading Congressional Budget Office predictions that a repeal effort by Sens. Bill Cassidy of Louisiana and Lindsey Graham would cost millions of Americans their health-care insurance, Sen. Susan Collins became the third GOP senator to promise that she would vote against the bill.
She did so as, across Capitol Hill, Ohio Sens. Sherrod Brown and Rob Portman sat through hours of questions at a hearing on the proposal, which Graham and Cassidy tweaked over the weekend in hopes of securing more Republican support.
Republicans need 51 votes by Sept. 30 in order to pass the bill under an arcane budget procedure that allows them to pass legislation with a simple majority, rather than the 60-vote threshold that many Senate bills require. The Senate has 52 Republicans and 48 Democrats, and Democrats have unanimously opposed the Graham-Cassidy bill.
Senate Republicans planned to huddle Tuesday to discuss their next steps.
Portman, a Republican, had unsuccessfully pushed to add money for opioid treatment to the bill. On Monday, he insisted he was still undecided but offered praise of the Graham-Cassidy bill, which would provide grants to states to craft their own health-care programs using dollars previously used for Obamacare.
He argued that the flexibility afforded by the bill would allow states to address the opioid epidemic even as Sen. Brown, a Democrat, and other opponents argued that the Graham-Cassidy bill would gut states’ efforts to address the epidemic through Medicaid expansion dollars.
“This is a very different proposal than the proposals we were looking at previously,” Portman said. “It takes the funding in the Affordable Care Act and sends it back to the states and gives states flexibility to be able to do what they think is right for its citizens.”
Portman argued the measure — which has faced intense opposition from health-care groups, including the American Medical Association, the American Hospital Association and the BlueCross BlueShield Association — has been “mischaracterized” and said “the status quo is not working.”
Brown, meanwhile, asked witnesses whether more would die without the Medicaid funding that states have relied on to treat the epidemic.
“I’m concerned they will,” said acting Pennsylvania Human Services Secretary Teresa Miller. “With the reduced funding, governors are going to have to make very difficult decisions, and some of those decisions may be eliminating essential health benefits like substance-abuse treatment.”
Graham suggested the Senate has little choice but to act.
“If somebody doesn’t fix Obamacare soon, a majority of the counties in the country are going to be down to one provider,” he said, adding that Medicare and Medicaid are on track to cost more than the military by 2027 and on track to take up all taxpayer dollars by 2042.
The bill would largely retain the taxes that paid for Obamacare but would have end within three years the Medicaid expansion that states such as Ohio accepted. Instead, the federal government would give states per-capita grants, which critics said would not be enough to pay for the previously expanded programs.
Ohio Gov. John Kasich has earlier pushed for the Senate to pursue a bipartisan effort by Democrat Sen. Patty Murray of Washington and Republican Sen. Lamar Alexander of Tennessee to shore up the insurance markets. But their efforts broke down after Senate GOP leadership indicated they would push the Graham-Cassidy bill last week, and the House GOP leadership has been cool about the idea of taking up any solution hammered out by Murray and Alexander.
Miller said the Graham-Cassidy plan “would create chaos in our health-care system with frightening implications” by stripping funding that states have come to rely upon.
“There are no winners in this bill, but many who will lose, and many who will be at grave risk,” she said.
Collins’ announcement capped a dramatic day on Capitol Hill. Hatch briefly put the hearing into recess while police removed about a dozen protesters, many in wheelchairs, who were chanting “No cuts for Medicaid, save our liberty.”
“If you want a hearing you’d better shut up,” Hatch said, before gaveling the hearing into recess. Capitol police dragged protester after protester out of the hearing room, occasionally grunting from the effort of physically lifting some protesters.
Kasich and Democrats have insisted that the process has been far too rushed, with only one hearing to examine the bill’s provisions. And multiple analyses of the bill indicate that it would cost Ohio anywhere from hundreds of millions to billions in federal dollars.
“Nobody has got to buy a lemon just because it’s the last car on the lot,” said Sen. Ron Wyden of Oregon, the ranking Democrat on the committee. “The fact that it’s the last repeal bill standing doesn’t make it okay.”