The coming push in Washington, D.C., to take yet another run at repealing the Affordable Care Act puts a cringeworthy spotlight on the staggering innovation gap between policymakers and the nation’s world-class medical providers, researchers, device and drug manufacturers.
While the American health care community is perpetually at the leading edge when it comes to treatment and technology, congressional Republicans are reportedly poised to serve up health reform leftovers — a stew of already stale proposals thrown together last summer in a sprawling bill that proved too unappetizing to pass last fall. The legislation remains known as Graham-Cassidy after its Senate champions: Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana.
The unhealthy obsession with extinguishing former President Barack Obama’s landmark health reform law unfortunately did not die last summer after Republican majorities failed to enact Graham-Cassidy or other comprehensive repeal-and-replace bills. According to a May 25 Wall Street Journal story, “a group of Republicans and advocacy groups will soon release a proposal intended to spark another push to repeal the Affordable Care Act ... .”
Leading this push is failed presidential candidate and former Pennsylvania Republican Sen. Rick Santorum, who is at the helm of a conservative work group that reportedly has White House support for its campaign.
The group has also been working for eight months on its reform package, which is hard to believe given what’s known about the coming proposal. Reports suggest strongly that it will be nothing more than a Graham-Cassidy retread — a suspicion reinforced by a health care white paper that Cassidy released last week to highlight his plan again.
The strategy to pass it is also a summer rerun. It will reportedly rely on a procedural shortcut — one wielded unsuccessfully last year — to pass the plan with 50 Republican votes in the Senate.
The original Graham-Cassidy proposal, like other Republican repeal-and-replace plans, would have taken a wrecking ball to health care access, resulting in an estimated 32 million fewer Americans having adequate health insurance in 2027. Among the core components driving this damage: weakened protections for those with pre-existing conditions, reduced aid to help people buy health insurance, and a shift to block granting the Medicaid program resulting in fewer dollars to cover care for the poor, disabled and elderly. It also would have had a block grant financial formula that punished health care innovators like Minnesota in favor of states that did little to improve coverage.
The updated Graham-Cassidy would still undermine Medicaid and destabilize the private individual health insurance market by weakening consumer protections, targeting subsidies to discount consumer premiums and creating incentives for “junk insurance” — coverage that often doesn’t cover serious medical issues. The main difference appears to be limiting the Medicaid block grant approach to dollars provided under the Affordable Care Act to expand the program. Proponents also contend the update addresses concerns about the block grant funding formula punishing states that embraced coverage expansion.
Momentum to pass reform-and-replace measures stalled last summer when the Congressional Budget Office detailed the staggering coverage losses caused by various Republican proposals. It’s unclear how anyone could conclude the result would be different with a low-energy reworking of Graham-Cassidy. Or, why the public would be less alarmed.
Midterm elections loom this fall. Congress is certainly free to devote the summer to a bill that would blow up the private individual insurance market and result in millions more uninsured, but it’s a risk-filled move in a campaign year.