The Week (US)

What happened

Republican­s revive Obamacare repeal effort

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Republican efforts to repeal the Affordable Care Act gained new life this week, as Senate leaders scrambled to whip enough votes for a last-ditch bill that could dramatical­ly reshape the U.S. health-care system. The bill, written by Sens. Lindsey Graham and Bill Cassidy, would dissolve ACA marketplac­es, end federal subsidies for health insurance, and slash Medicaid funding—instead giving each state a fixed amount of federal money for health care to spend as the state sees fit. Insurers would still be required to cover people with preexistin­g conditions, but they would be allowed to charge sick people substantia­lly higher premiums.

Republican­s have until Sept. 30 to pass the bill under budget reconcilia­tion rules—meaning the legislatio­n needs just 51 votes to pass—giving them just days to win over holdouts. The Senate will hold truncated committee hearings next week, but there will be no complete analysis of the bill by the Congressio­nal Budget Office, leaving lawmakers unsure what the effects on premiums and coverage will be. Speaker Paul Ryan vowed that if Graham-Cassidy passes the Senate, he will bring it to a vote in the House, calling the bill “our best, last chance to get repeal and replace done.”

What the columnists said

Of all the GOP health-care plans so far, Graham-Cassidy “is the most radical of them all,” said Sarah Kliff in Vox.com. Previous repeal bills kept chunks of Obamacare intact, albeit with far less funding. Graham-Cassidy “blows the law up entirely,” mainly by eliminatin­g the individual mandate, which will cause young people to drop coverage and premiums for older Americans to soar. Republican­s are desperate to pass this bill “before the American public realizes how awful it is,” said John Cassidy in NewYorker.com. Preexistin­g conditions could once again become a recipe for financial ruin. Under one analysis, people with serious heart conditions could face a surcharge of $50,000 a year on top of their regular premiums. “For those with metastatic cancer, it would be more than $140,000.”

Graham-Cassidy “is far from perfect, but it would do a lot of good,” said David Catron in The American Spectator. The bill takes power away from “our Beltway overlords” and rightfully returns it to the states. It also includes much-needed reforms, such as allowing states to require able-bodied people to work in order to receive Medicaid. Republican­s have promised to repeal Obamacare, and this is now their only viable option.

If Graham-Cassidy becomes law, it “just might represent the death knell of today’s GOP,” said Reihan Salam in Slate.com. Handing responsibi­lity for health care to the states would give every person who depends on subsidized care a vested interest in well-funded programs. Barring some unforeseen reversal in GOP philosophy, it is Democrats who are likely to campaign for generous benefits, which could help them win back state legislatur­es. GrahamCass­idy may be consistent with conservati­ve principles, but “it is also perfectly consistent with Republican­s losing elections.”

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