I have spent the bulk of 2017 writing about the different Republican plans to repeal the Affordable Care Act.
Graham-Cassidy, in my view, is the most radical of them all.
While other Republican plans essentially create a poorly funded version of the Affordable Care Act, Graham-Cassidy blows it up. The bill offered by Republican Sens. Lindsey Graham and Bill Cassidy takes money from states that did a good job getting residents covered under Obamacare and gives it to states that did not. It eliminates an expansion of the Medicaid program that covers millions of Americans in favor of block grants. States aren’t required to use the money to get people covered or to help subsidize low- and middle-income earners, as Obamacare does now.
Plus, the bill includes other drastic changes that appeared in some previous bills. Insurers in the private marketplace would be allowed to discriminate against people with preexisting conditions, for example. And it would eliminate the individual mandate as other bills would have, but this time there is no replacement. Most analysts agree that would inject chaos into the individual market.
Taken together, these components add up to a sweeping proposal sure to upend the American health care system. Because the Senate hasn’t seen an independent analysis yet from the Congressional Budget Office, I can’t even say for sure how sweeping, and neither can any of the Republicans who have come out in support of it.
I’m not the only one drawing this conclusion. The credit agency Fitch Ratings recently described Graham-Cassidy as “more disruptive” than the other Republican repeal bills. Edwin Park, a policy analyst at the Center on Budget and Policy Priorities, says that Graham-Cassidy is “more radical in the sense that you’re eliminating wholesale the marketplace subsidies and the Medicaid expansion.”