HomeWashington Letter2017 ▶ Senate Set to Vote Next Week on Graham-Cassidy ACA Repeal Bill
Senate Set to Vote Next Week on Graham-Cassidy ACA Repeal Bill

September 2017

Next week, the U.S. Senate is set to begin consideration of another proposal to repeal and weaken major portions of the Affordable Care Act (ACA). The bill, known as the Graham-Cassidy bill would eliminate the ACA's health insurance subsidies and Medicaid expansion and replace them with state block grants, causing millions to lose their health insurance.

Congressional Republicans have one week left, with a hard deadline of Sept. 30, to use the budget reconciliation mechanism to pass an ACA repeal and replace bill with a simple majority of 51 votes (including Vice President Pence), so although it is not yet clear if they have the required votes, they are moving ahead with planned votes and limited debate before the end of next week. If the Cassidy-Graham bill passes the Senate by Sept. 30, it could be quickly passed by the House and President Trump would sign it into law.

Although the Graham-Cassidy bill preserves ACA rules requiring insurers to offer coverage to people with pre-existing conditions, it would allow states to permit insurers to base insurance premiums on health status. This would result in some people with chronic life-threatening conditions being priced out of the insurance market. The Cassidy-Graham bill would also allow states to waive essential health benefits such as maternity care and chronic disease management, which will result in reduced coverage and higher costs in some states.

The bill has not yet been "scored" by the nonpartisan Congressional Budget Office on how many might lose health insurance if it is enacted. Some estimates indicate that at least 15 million would lose health insurance within the first year due to the elimination of the ACA individual insurance mandate, but this number would rise as a result of the bill's funding reductions to Medicaid. The Kaiser Family Foundation has estimated that the bill would cut up to $180 billion between 2020 and 2026 to states that have expanded Medicaid because the bill would redistribute funds to non-Medicaid expansion states, and additionally, impose a per-person cap on all state Medicaid funding. Medicaid expansion states would lose an average of 11 percent in Medicaid funding, but states such as California and New York could lose 35 percent of their Medicaid funding between 2020 and 2026.

The bottom line is that the Graham-Cassidy bill is bad for the health of Americans. The ATS urges members to contact their senators by September 27 and tell them to vote "NO" on the Graham-Cassidy bill.

Phone calls are the most effective form of communicationclick here to call your senators.

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Last Reviewed: October 2017