What You Need to Know About the Graham-Cassidy (Aka Zombie Trumpcare) Health Care Bill
The fight to end Obamacare only with a Republican vote will end in September, thanks to a budget deadline. As with any good drama, it makes us nervous right up to its grand finale. The current villain (or hero?), The Graham-Cassidy Bill, is gaining traction and may have a chance to pass. That’s what’s in it.
How Many People Would Lose Insurance?
It is unofficially estimated that the bill will affect fewer people than the ACA, and also fewer people than previous Republican health care proposals. The Commonwealth Fund estimates that 32 million people could lose coverage by 2027 .
What about the official score? Well it won’t. Previous bills were accompanied by reports from the Congressional Budget Office detailing their cost, the number of people who lost coverage, and what would happen to the price of premiums. But there is no time for that in this round, so the vote will continue with the CBO estimate, which is just throwing in a few numbers regarding government spending. The CBO released a statement saying it “will not be able to provide point estimates of the impact on deficits, health insurance or premiums for at least a few weeks.”
What’s going on with Medicaid?
According to the ACA, states have been able to expand Medicaid using the program to reach low-income people who would not otherwise be eligible. 30 states did so and received money from the federal government to pay for the expansion.
Under the Graham-Cassidy bill, the federal money currently going to expand Medicaid will be slashed and split into “block grants” for all 50 states. (By the way, “block grant” is always the code word for reductions.) They will also be unevenly distributed: more rural states – mostly red states that have not expanded Medicaid – will receive a larger share.
But this money is not for expanding Medicaid; states can use it for any of a variety of health care programs , including those that do not improve coverage or access to health care. Blue states lose mostly in this scenario, while red states win a little. (Still, red states might want to, you know, expand Medicaid and get even more benefits.)
Here is the output from Vox :
The bill is being proposed by Republican senators. Lindsay Graham and Bill Cassidy take money from states that did a good job of getting a resident covered by Obamacare and gives it to states that didn’t. This rules out the expansion of Medicaid, which reaches millions of Americans, in favor of block grants. Governments are not obligated to spend money on insuring people or subsidizing low- and middle-income people, as Obamacare is doing now.
Yes, and block grants will disappear in 2027 , along with any Medicaid extensions or other programs they paid for. Gone. The Kaiser Family Foundation will tell you more about this .
What happens to people with pre-existing conditions?
If your state requests a waiver, insurance companies may have the right to charge you any premiums they like, depending on your health condition . The state would say that they are still trying to “maintain adequate and affordable health coverage,” but there is no specifics about what is considered adequate or affordable, and no consequences if your coverage ends are not adequate or affordable.
Do insurance plans still cover everything?
Again, this depends on whether your state is requesting a waiver. If it does, it could eliminate any or all of the significant health benefits required for ACA. (As a reminder, these are: outpatient care, emergency care, hospitalization, pregnancy / pregnancy / newborn care, mental health and drug addiction treatment, prescription drugs, rehabilitation services and devices, laboratory tests, preventive care, and children’s dentistry and vision. )
Will my insurance cost more?
If you get it on the exchanges, then yes – the law excludes premium subsidies and cost-sharing.
If you get it anywhere else, then it all depends on the circumstances. Without the minimum payouts for insurance plans, you could get cheap insurance that is useless in most cases . But with higher premiums for pre-existing conditions, your insurance may be more expensive. There is no indication that you will get better coverage for the same price or cheaper premiums for the same coverage.
Even if this law does not pass, and the ACA remains in force, premiums will still grow. Health care costs are on the rise because they are always on the rise , and insurers are already planning to charge additional fees due to all the uncertainty our government is creating about the future of the health insurance industry.
What are the funniest surprises in this bill?
Because every big bill has funny surprises! It states that qualified health plans may not cover abortion services . Due to overlapping deadlines and the fact that many states, including California, require all comprehensive health insurance plans to cover abortion, thousands of policies will become illegal this January.
I have an opinion on this. Who should I call?
First, your senators , because the bill is in the Senate right now. (After you have done this, you can also call your House representative just because.)
If your senators include John McCain, Lisa Murkowski, Susan Collins, Rob Portman, Shelley Moore Capito or Lamar Alexander, call them additionally and ask your friends to call too. These are senators who now look like wavering votes.
If your senators don’t include these people, don’t call them . This is not only a waste of your time, it prevents their actual constituents from penetrating. Someone in Arizona will get a full voicemail box because of you and your message will still be deleted. The best strategy is to find out who you know in Arizona (or another state) and convince them to call.
If you don’t make phones, that’s okay. Your next best option is to send an email via the senator’s website, or send a properly formatted fax (with your address) via Resistbot. Good luck!