Senators John Thune and Mike Rounds will vote for Cassidy-Graham, the worst Republican Affordable Care Act repealer yet, even though they have no report from the Congressional Budget Office telling them what impacts the bill will have. But they do have this report from Avalere Health, which says Cassidy-Graham will cut federal funding to states by $489 billion from 2020 to 2027 and $4.15 trillion by 2036. South Dakota will gain $1 billion by 2027 but give that back and experience a net loss of $4 billion in federal health funding by 2037.
Senators Thune and Rounds also have this report from AARP saying that Cassidy-Graham could cause crushing premium increases for older Americans:
The Graham-Cassidy (GC) bill, as proposed on September 13, 2017, threatens to make health care unaffordable and inaccessible for millions of older Americans. The bill eliminates two sources of financial assistance—premium tax credits and cost-sharing reductions—critical to ensuring that low- to moderate-income older adults are able to afford the coverage they need. For a 60-year-old earning $25,000 a year, premiums and out-of-pocket costs could increase by as much as $16,174 a year if they wanted to keep their current coverage. The bill may also allow states to charge older adults age 50–64 significantly higher premiums than under current law on the basis of their age by waiving federal protections that limit the practice known as age rating [Lina Walker et al., “Graham-Cassidy Legislation Threatens Affordable Coverage for Older Americans,” AARP, September 2017].
The Affordable Care Act’s tax credits and premium subsidies help 60-year-olds making $25K pay just $1,608 for health insurance. Yanking those credits and subsidies in South Dakota could drive that premium up to $13,768, a 750% increase.
But who cares about making South Dakotans pay more than half their income for worse health insurance? Thune and Rounds have a score to settle with that darned Barack Obama!