Way, way down at the very bottom of the list of things the Trump administration is ruining, at least for me, is my childhood favorite movie The Princess Bride, because I can no longer think of Billy Crystal saying "mostly dead is slightly alive" without also thinking of Trumpcare. Nearly two months after failing to pass an ACA repeal that was simultaneously cruel and incoherent, the GOP has introduced a new health care proposal to the Senate.
Sponsoring the bill are senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC). It's officially the Graham-Cassidy-Heller-Johnson bill, but for the sake of expediency it's being referred to variously as the Graham-Cassidy bill, Cassidy-Graham, etc -- all permutations refer to the same thing.
If you are asking yourself, "What fresh healthcare is this," the answer is nothing. It's not fresh. It's essentially the same as the last round of Trumpcare, except for some parts that are worse.
If pushed through, the bill would mean that beginning in 2020, the federal government would stop granting subsidies included in the ACA. This would be the end of Medicaid expansion. That method of funding would be replaced by an annual "block grant," a term you're going to be hearing a lot in the coming weeks. Distributing health care funds via block grants basically means giving each state a chunk of money directly.
If Graham's press release about the proposal is to be believed, this "gives states the resources and regulatory flexibility to innovate and create healthcare systems that lower premiums and expand coverage."
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What it actually means is the government gives patients way, way less money. The CBO has estimated that as many as 32 million people could lose their insurance. That same press release declared that the repeal would protect people with pre-existing conditions, which is an extremely creative way of saying it would end all federal protections that currently prevent insurance companies from hiking premiums when they feel like it.
The same goes for other superficial luxuries like maternity leave, and rest assured that the bill attacks all the expected parts of sexual and reproductive health, like defunding Planned Parenthood and penalizing health care plans that cover abortions. The cuts also get worse over the course of the next decade as Medicaid is phased out.
The Center on Budget and Policy Priorities estimated that, once the dust has settled, the bill would slash health care funding by -- sit down -- $299 billion.
At its core, this bill does what basically all decipherable GOP legislation seems to do these days, which is to give to the rich by taking from the poor. Capping Medicaid and ending cost-sharing payments will be most devastating to veterans, to the elderly, to low-income kids. It would mean that many of those who need life-saving treatment but can't afford it out of pocket will die, or spend some time buried under a mountain of debt and then die.
The bill's cosponsors will likely try to bring it to the floor by the end of the month, since September 30 is the senate's deadline for passing an Obamacare repeal. The bill needs 50 votes to pass, and like a lot of legislation these days it's probably just a few votes shy of that, since most GOP senators are voting along party lines. But being a few more 'yes' votes from passing also means it only takes a few more 'no' votes to sink it, all of which is to say it's once again time to call your representatives.
Lawmakers to watch are Senator Lisa Murkowski (R-AK), who voted against the first attempted repeal and may do so again. The same goes for Senator Susan Collins (R-ME), Rand Paul has RSVP'd 'no' to the bill on Twitter, but since that's not exactly binding certainly one to watch too.