The Denver Post

The latest GOP Obamacare bill comes up short.

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The latest bill Republican­s have introduced to repeal and replace the Affordable Care Act is a superior piece of legislatio­n to the last three proposals that thankfully were short lived and dispatched by sensible GOP moderates.

Clearly, Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-LA., should have been at the helm of this effort from the beginning. Had they started with a similar proposal months ago, they might have had time to craft it into something workable and fair.

Now, with the Sept. 30 deadline for Republican­s to pass a bill with only 51 votes instead of the 60 needed to override a filibuster, no time remains to fix the large failures that exist in the Graham-cassidy bill.

To begin, the legislatio­n continues to change how the federal government pays for traditiona­l non-expansion Medicaid services, the program ensures that disabled individual­s, elderly in long-term care, children living in poverty and poor pregnant women have access to health care. We don’t yet have a sense of how the caps will reduce funding over the next 10 years, because a report from the Congressio­nal Budget Office hasn’t been released yet.

The Medicaid system does need reform. States actually have an incentive to spend more on Medicaid given the federal government’s unlimited match to spending at a set ratio. That payment scheme has rendered the pursuit of savings and efficienci­es a low priority.

However, that dynamic has nothing to do with Obamacare, and to attempt to reform a traditiona­l safety net system in such a haphazard way would be disastrous for the most vulnerable among us. The GOP made a fatal flaw in targeting this system in their Obamacare repeal bills, as the disabled community has, justifiabl­y, been the most vocal and convincing opponents of the legislatio­n.

That very significan­t and hard to overcome policy failure aside, the Graham-cassidy bill’s underlying principle is to take billions of dollars Obamacare spends every year and instead give it to states to spend as they see fit. That would mean an end to federal tax credits to keep health insurance on the individual marketplac­e affordable and an end to federal funding to expand Medicaid to cover some ablebodied adults who are poor.

States could decide to spend their money on similar Obamacare policies or they could spend it in other ways, like creating a high risk pool or state-run insurer of last resort, or even implementi­ng a singlepaye­r system.

There are many appealing aspects of that proposal, not the least of which is that most state government­s are better stewards of taxpayer money.

But some states, like Colorado and the 30 other states that expanded Medicaid, would be big losers.

The Graham-cassidy bill would redistribu­te Obamacare dollars to states not based on what they get now but on other factors. In states that participat­ed in the Medicaid expansion or in states where residents are receiving more money in tax credits per-capita, there would be a large reduction in federal funding.

Hard decisions about what to cut would ensue and people would lose health insurance.

A state like Texas that not only didn’t expand Medicaid but has one of the least generous Medicaid services in the nation, would get increased funding. Colorado should not be punished for using a federal law to serve its citizens and Texas should not be rewarded for refusing to accept federal money that could have made its residents’ lives much better.

For all these reasons and more, we hope enough Republican senators, including Colorado’s Cory Gardner, reject this bill.

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