Many Americans sat on the edges of their seats as Republican-led efforts to repeal and replace, or just straight up repeal, the Affordable Care Act—the suddenly much more popular healthcare law—failed in Congress earlier this summer.
However, the issue is far from settled: A new effort by Senate Republicans appears to have a chance of being pushed through in the next two weeks.
The proposal, unveiled last week, was spearheaded by Sen. Lindsey Graham (R-S.C.) and Sen. Bill Cassidy (R-La.).
As opponents of the Republicans efforts have been cheering for the “Medicare for all” bill Sen. Bernie Sanders (I-Vt.) proposed last week, Republicans have been working on a plan that would make-good on their seven-year pledge to repeal President Barack Obama’s signature healthcare law, also known as Obamacare.
Here’s what you need to know about the so-called Graham-Cassidy bill:
The bill would repeal the Affordable Care Act’s individual and employer mandates for health insurance. It would also keep most of the law’s tax increases but shift them into block grants for individual states that could choose how they wished the use the money. It would also decrease funding for Medicaid in the future.
The Center on Budget and Policy Priorities, a left-leaning think tank, asserts that the Graham-Cassidy bill would also “gut” pre-existing conditions coverage.
Congressional rules could play a large role in whether the Graham-Cassidy bill passes. After Sept. 30, the Senate would need 60 votes to pass any proposal; before that, Senate Republicans can continue using the practice known as budget reconciliation whereby they only need 51 votes to pass it. By using budget reconciliation to pass the bill, the Republicans avoid the possibility of Democrats filibustering the bill.
Politico reports that McConnell said if the Graham-Cassidy bill has support from 50 of the 52 Republican senators he would bring it to the floor for a vote.
It’s unclear just how many Republican senators are in favor of the bill, but at least one Sen. Rand Paul (R-Ky.) has said he would vote against it, arguing that it does not go far enough in repealing the Affordable Care Act.
Graham/Cassidy keeps Obamacare and tells the states to run it. No thanks.— Senator Rand Paul (@RandPaul) September 18, 2017
Keeping 90% of Obamacare is not ok and it's not what we ran on. Conservatives should say no.— Senator Rand Paul (@RandPaul) September 18, 2017
Two Republicans who did not support earlier efforts to repeal and replace the Affordable Care Act, Sen. Susan Collins (R-M.E.) and Sen. Lisa Murkowski (R-Alaska), have also not said where they stand on the bill. Sen. John McCain (R-Ariz.), who was instrumental in stopping the Senate’s efforts to repeal the Affordable Care Act in late July, said he may “reluctantly” back Graham-Cassidy.
The Graham-Cassidy bill has not been scored by the Congressional Budget Office (CBO), a nonpartisan group that “scores” bills to give lawmakers an idea of the impact they might have. For instance, the last Senate version of a healthcare bill would have left an estimated 22 million fewer Americans without health insurance, just one million people fewer than the House’s version of the bill.
Democrats asked for the CBO to conduct an analysis of the bill–including coverage losses, how premiums and out-of-pocket costs may change, and how it would impact Medicare. However, it does not appear likely that they will get their wish before the bill comes up for a vote.
On Monday, the CBO said it would not be able to provide “point estimates of the effects on the deficit, health insurance coverage, or premiums for at least several weeks.”
Several healthcare groups have come out against the Graham-Cassidy bill, including the American Heart Association, the American Diabetes Association, and the March of Dimes, among others, the New York Times reports.
Essentially, the time Republicans have to realistically repeal and replace the Affordable Care Act in 2017 is running out, and Republicans are not going down without swinging for the fences one last time.