Latest Bad ACA Repeal Teases with More Cash for Medicaid Expansion Holdouts

Beware the Graham-Cassidy Affordable Care Act repeal currently floating in the Senate. Seen as the last possible ACA repeal this year, Graham-Cassidy has the same old opt-outs from community rating and pre-existing condition protections that we saw in the earlier GOP proposals that would price older and ailing patients out of the market. Graham-Cassidy would end the tax credits and subsidies that make individual coverage affordable for thousands of South Dakotans and are particularly valuable to rural folks, who have a higher proportion of self-employed (read, farmers and ranchers!) people who don’t have access to employer-based coverage.

But watch out: Graham-Cassidy includes a trick that might look good to ACA-recalcitrant states like ours. The Republican bill keeps some of the Affordable Care Act’s taxes but robs from smart states that expanded Medicaid and redistributes cash to us laggards in less effective block grants:

The plan centers around block-granting billions of dollars in Obamacare taxes that currently fund states’ Medicaid expansions and individual health insurance subsidies. The money would be funneled through the popular Children’s Health Insurance Program, a long-standing block grant to provide care for low- and moderate-income children.

The block-grant formula would generally redistribute money away from states that expanded Medicaid under Obamacare and spread them across the country, boosting the amount of federal money headed to states — largely controlled by Republicans — that refused to expand Medicaid.

Cassidy, in rejecting criticism of the proposal as “partisan,” said Democratic senators from purple states where Republican governors or legislatures blocked Medicaid expansion — a list that includes Virginia, Wisconsin and Indiana — should back the plan because of the increased money [Bryn Stole, “Cassidy, Graham Unveil Last-Ditch Obamacare Repeal Bill,” Tribune News Service via Governing, 2017.09.15].

CBO says it won’t be able to fully score Graham-Cassidy before the September 30 deadline for passing measures with 51 votes. But given that the bill removes requirements that states spend those block grants on getting people health insurance, Graham-Cassidy likely produces the same result as the Republicans’ last three swings: millions of Americans go uninsured.

Senator John Thune said last week that passage of Graham-Cassidy is unlikely. Senator Mike Rounds shares that pessimism but says he likes the original concept. Don’t let them get fooled by any promises of more money and freedom for South Dakota. Get back on the phone and fax and tell your Senators that they still haven’t come up with a health care plan that improves on the status quo.

7 Responses to Latest Bad ACA Repeal Teases with More Cash for Medicaid Expansion Holdouts

  1. mike from iowa
  2. Mr. Lansing

    Rand Paul – NO! Susan Collins – NO! John McCain has another chance to bury one of Don the Con’s campaign promises and side with the vast majority of voters who don’t buy into the “Obamacare is a disaster.” mythical rhetoric. Who thinks he won’t?

  3. The GOP Party won’t rest until it kicks at least 10 million people off of health insurance. In addition to kicking people off of health insurance, this scheme manages to milk more money from blue states that already pay more taxes to the federal government than they get back, and hands that California taxpayer money to states like South Dakota that already don’t pay their own way. South Dakota’s senators should have a little respect and say, “We don’t need any more California taxpayer money than we’re already getting.”

    Besides that, South Dakota government simply can’t be trusted with a block grant. South Dakota managed to funnel most of the money intended to prepare Native Americans for college to GOP Party cronies acting as “consultants.” The kids didn’t get much. Enough already.

  4. Mr. Lansing

    Hear, hear Ror!! “Can’t Be Trusted!!”

  5. How does one write to our stellar congressional contingent to ask if they are “OUT OF THEIR G*D DAMN MIND” without getting one of those, “Thank you for contacting our office,” notes in return?Even Smilin’ Mike ought to realize that this is NOT the way things work in D.C. After constantly complaining of the way Democrats enacted the ACA without Republican support, this is the way they now figure things should be done, everything thru reconciliation, no consultation, even with their own members, written by deep thinkers like Big John and da boiz? SD, be proud… or not!

  6. mike from iowa

    Wingnuts were given an opportunity to provide insight on Obamacare and they chose not to do so. There were several months of hearings as well.

    Now wingnuts are trying to foist bad medicine on everyone and doing it w/o allowing Dems a vote on it. Pass or fail, this is all on wingnuts and Drumpf and Dems must make sure Americans realize who took their healthcare away from them to make the rich richer.

    Block grants allotted to red states means wingnuts can spend it on whatever they want and most likely won’t be healthcare.

  7. Loren, you’ll always get one of those empty notes. Call or write—call and write anyway. No matter how vacuous their response to you personally, they still have to face the mountain of calls and letters that your contact makes higher and recognize that they don’t dare vote to repeal the best general health coverage policy America has come up with yet.