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Monday, September 25, 2017

GOP Graham-Cassidy Health Care Bill Might Be Potentially Dead For Now

The GOP's last-ditch effort to repeal and replace Obamacare received what appeared to be a fatal blow Monday evening when Sen. Susan Collins, R-Maine, announced her decision not to support the bill, becoming the crucial third Republican to oppose it.

nice article by LEIGH ANN CALDWELL for NBC NEWS | Sept 25, 2017                                     
Marilee Adamski-Smith from Brookfield, Wisconsin, left, and Colleen Flanagan of Boston, center, join others outside a hearing room where the Senate Finance Committee will hold a hearing to consider the Graham-Cassidy healthcare proposal, on Capitol Hill in Washington on Sept. 25, 2017. Manuel Balce Ceneta / AP

Collins joins Sens. John McCain, R-Ariz., and Rand Paul, R-Ky., as GOP "no" votes. Unless one of them switches their position, Republicans can't muster the 50 votes needed to pass it.

Momentum for the bill sputtered Monday morning even after a new version was released by authors Sens. Lindsey Graham and Bill Cassidy that included new incentives to appease the concerns of a handful of uncommitted Republican senators.

GOP leaders faced a Saturday deadline to pass Graham-Cassidy with a simple Senate majority and it's still unclear if Republican leaders will put the bill before the Senate for a vote, even without the votes for it to pass.

Leaving a leadership meeting, Sen. Orrin Hatch, R-Utah, said, "I doubt it" when asked if Senate Majority Leader Mitch McConnell would bring the legislation to the floor for a vote. And that was before Collins had solidified her position against it.

Collins' opposition caps off a months long effort to repeal the Affordable Care Act after years of campaign promises to do so. Senate Republicans failed to pass three other version of a repeal to Obamacare in late July when Collins, McCain and Sen. Lisa Murkowski, R-Alaska, all voted against it.

Murkowski has not yet indicated her position on Graham-Cassidy.

"Today, we find out that there is now a fourth version of the Graham-Cassidy proposal, which is as deeply flawed as the previous iterations. The fact that a new version of this bill was released the very week we are supposed to vote compounds the problem," Collins said in a statement announcing her opposition.

Collins announced her position despite changes being made to the bill to get remaining holdouts on board. An analysis of state-by-state health care funding shows that under Graham-Cassidy, Maine would see a 43 percent increase in federal health care funds, Arizona would get an additional 14 percent, Kentucky another 4 percent and Alaska 3 percent. But Collins said despite the positive numbers, Maine would still lose money by dismantling the Affordable Care Act.

"Maine still loses money under whichever version of the Graham-Cassidy bill we consider because the bills use what could be described as a 'give with one hand, take with the other' distribution model. Huge Medicaid cuts down the road more than offset any short-term influx of money," Collins said in her statement.

Collins announced her position after an incomplete analysis of an earlier version of Graham-Cassidy by the Congressional Budget Office found that "millions" would lose their health insurance under the plan.

The rushed process to meet a September 30 deadline before the legislation expires that allows passage with just a simple majority frustrated a handful of senators, including McCain who had more problems with the process than the substance. He came out against the bill on Friday.

In an effort to calm the critics on a closed process, the Senate Finance Committee held the first and only hearing Monday afternoon on legislation. It turned out to be highly attended by passionate activists worried about their health care being stripped from them.

Protestors filled the hallways outside the hearing room that snaked around the corner and down the length of a city block. Hundreds of people chanted "shame" as Graham entered the hearing room to testify before the committee. Voluminous protests inside the hearing room delayed the start of the hearing. Chairman Orrin Hatch, R-Utah, attempted to gavel in the committee but protestors drowned him out. Police dragged them out, many of whom are disabled and in wheelchairs, out one by one.

             NBC News Coverage Sept 25, 2017

Once the committee room was clear of the public, the hearing began. Protestors maintained their chants in the hallway outside; their sound seeping through the doors providing constant background chanting.The Association of Health Insurance Plans and Blue Cross Blue Shield released prepared testimony before the hearing stating that they can't support Graham-Cassidy.

"The bill would have negative consequences on consumers and patients by further destabilizing the individual market; cutting Medicaid; pulling back on protections for pre-existing conditions; not ending taxes on health insurance premiums and benefits; and potentially allowing government-controlled, single-payer health care to grow," a summary of their testimony states.

Graham testified that Obamacare was a “disaster” in his state and boasted that "every major insurance company opposes our bill,” saying it was evidence that his legislation would give states more flexibility in dealing with them.

But Democrats pointed out it wasn’t just insurers upset with Graham-Cassidy: The top industry groups representing doctors and hospitals also publicly opposed the bill along with a parade of patient advocacy groups, from AARP to the American Heart Association. These organizations have argued the bill would cut overall health funding while allowing insurers to treat customers differently based on a pre-existing condition, a practice banned by Obamacare.

Under questioning from Senator Ron Wyden, D-Ore., Cassidy said their assessments were wrong and that it was “not true” that states could charge higher premiums based on their health status under his bill.

But the bill as written allows states to waive Obamacare’s rule preventing insurers from charging sick people more for care as well as its requirements that plans cover certain essential benefits. Outside analysts have consistently said it would weaken protections for pre-existing conditions.

The loosening of the regulations on insurance coverage was seen as an attempt to help conservatives come on board.

Protestors also sat-in the office of Murkowski in protest. Her deputy chief-of-staff came out to address the activists and said that she left Anchorage at 6 a.m. on Monday and is using her flight time back to D.C. “thinking about her decision.”

Marilee Adanski-Smith traveled to D.C. from Wisconsin on Saturday to attend the hearing. She was born without arms and legs and relies on Medicaid.

“We’re here to save Medicaid. Our lives depend on Medicaid,” she said, adding that she’s fearful that the legislation will take away Medicaid recipients' ability to live at home and force people into nursing homes.

“People are going to die in nursing homes if people don’t have the community and home-based services they need,” Adanski-Smith, a small-business owner, added.

Graham-Cassidy would end the Medicaid expansion in 2020 and reduce the money given to Medicaid by changing how it's allocated. It would no longer provide it for whoever is in need — instead, it would cap the number based on population.

The bill would also end the individual mandate to buy insurance and dismantle the structure of the Affordable Care Act, widely known as Obamacare. Instead, it would give money to states to implement their own health care systems. And while it would require that people with pre-existing conditions have access to health insurance, like Obamacare, it wouldn't prohibit insurance companies from charging people with long-term health care needs more money.

The new version of Graham-Cassidy would also provide billions of dollars more for states during the transition from Obamacare and as a contingency fund.


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