The House and Senate intend to vote on a repeal and replace of the Affordable Care Act before the end of September, renewing the fight to defend Medicaid and affordable, comprehensive healthcare access for people across the country.
The Graham-Cassidy-Heller proposal would kick at least 32 million people off of health insurance, bar Planned Parenthood from receiving Medicaid reimbursements, gut the Essential Health Benefits that protect women’s access to reproductive healthcare and prescription drugs, and once again allow insurance companies to discriminate against people with pre-existing conditions.
The bill would also end Medicaid as we know it by block granting funding instead of guaranteeing it while cutting hundreds of billions from the program. This proposal would kick millions of poor, disabled, and elderly people off of health insurance and leave millions more with inadequate coverage.
While the bill is almost identical to the other version of “Trumpcare” previously proposed in the House and Senate, it contains one major change: an all-encompassing block grant for each state. Between 2020 and 2026 each state would receive a fixed amount of money that they could spend as they saw fit on the Medicaid-expansion, premium tax credits or tax subsidies. The goal of this provision is to lay the groundwork for an eventual full repeal of the Affordable Care Act, including the Medicaid expansion and the private insurance marketplace, by slowly draining both initiatives of necessary funding.
Advocates argue that demolishing Medicaid piece by piece is a dangerous and deadly proposition that disproportionately impacts women. One-in-five women of reproductive age rely on Medicaid and half of all births in the United States are paid for with Medicaid. Medicaid also pays for two-thirds of all nursing home patients, a vast majority of whom are women. In addition, 42 percent of all Medicaid spending benefits children and adults with disabilities.
If Senate Republicans want to force through a healthcare bill with only 50 votes they will need to pass it by the end of September, when the procedural rule that allows for budget reconciliation expires. However, in order for the bill to comply with budget reconciliation rules it will need to be scored by the Congressional Budget Office (CBO) before it is brought up for a vote. If the bill is not passed by October 1, the Senate will be forced to reach 60 votes in order to pass a healthcare bill, which would require Republicans to earn at least eight Democratic votes.
The CBO is reporting that it will not be able to provide more than a “preliminary assessment” by next week, meaning they will be able to report Graham-Cassidy plan’s impact on the budget, but not exactly how many people will lose health insurance or how much the bill would raise insurance premiums.
After Senate Republicans failed to pass any version of their healthcare bills in July, Senate Majority Leader Mitch McConnell promised to move on to other business and to work with Democrats to come up with a bi-partisan solution to the problems within the healthcare system, especially stabilizing the insurance market. As of now, Republicans have abandoned that initiative.
The bill will be the subject of a hearing in the Senate Finance Committee on September 25.
Media Resources: Feminist Majority Foundation 7/28/17; The Hill 9/18/17; Feminists Fight Back 06/2017; Washington Post 9/18/17; New York Times 9/18/17