After the failure of the Cassidy-Graham healthcare reform bill on September 26, efforts by the GOP to pass healthcare reform alone seems unlikely. However, given recent bipartisan work by Senators Alexander and Murray, plans to amend Obamacare may soon yield results.
Originally introduced by Republican Senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC) on September 25, the Cassidy-Graham plan gives control of many healthcare decisions to individual states. The bill allocates healthcare money in the form of block grants, which state governments can then appropriate to develop whichever healthcare system they want. This gives states some freedom to decide what programs on which to spend their healthcare grant. However, the plan involves a drastic decrease in federal money and a cap on funding, which means that it would be progressively more difficult for states to maintain current levels of spending on healthcare systems.
This proposal has received much criticism, including from the Director of Georgetown’s Mid-Atlantic Center for Children’s Health and the Environment, Professor Laura Anderko, as well as Assistant Vice President for Student Health Vince Winkler Prins. Both considered the Cassidy-Graham bill flawed. Dr. Anderko criticized its removal of preventive care and the reintroduction of discrimination against people with pre-existing conditions, which would dramatically raise healthcare costs for those who need it most.
However, after the Senate failed to secure enough votes to pass the bill, Senate Majority Leader Mitch McConnell (R-KY) declined to bring the bill to the floor, marking yet another defeat in the Republican-controlled Senate’s latest attempt to repeal the Affordable Care Act.
The same day, the Senate unanimously passed a bipartisan bill, originally sponsored by Mark Warner (D-VA) and Johnny Isakson (R-GA), that aims to expand Medicare and make it more cost-efficient by streamlining services. Known as the CHRONIC Care Act, it expands several non-controversial programs, including a program to provide in-home care for seniors. This act enjoyed broad support and was “one of the few bipartisan healthcare bills to pass the Senate,” according to Senator Orrin Hatch (R-UT).
Although most media sources focused on the failure of Cassidy-Graham rather than the passage of this bipartisan bill, it raises hopes that a bipartisan amendment to Obamacare that would be acceptable to both parties is still possible. While Dr. Anderko and Mr. Winkler Prins disapproved of the block grant approach, they both expressed hope that bipartisan cooperation is possible.
With renewed hope of a bipartisan solution, a formerly abandoned bill has reemerged. The Alexander-Murray bill, co-sponsored by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), is once again a viable option. Originally sidelined by Republican leadership in favor of Cassidy-Graham, the latest attempt at healthcare reform suggests that bipartisanship is once again a possibility. The bill restores previously-cut Obamacare programs, but gives states much more freedom in modifying certain provisions of Obamacare. The Congressional Budget Office, which analyzes the potential impact of legislation, estimates that it will lower federal spending by over $3.8 billion throughout the next ten years, which may make it more attractive to fiscally conservative Republicans. In addition, the freedom granted to states resembles the block grant scheme of the previous bill, which will help to further attract Republican support.
As it stands right now, the bill would require support from the White House to pass. However, President Trump has not expressed firm support. While he did initially call it a “very good solution” during a news conference, he later tweeted that he could not support a bill that continues to enrich insurance companies. These mixed messages have left many lawmakers uncertain, but key Republicans like Senator Collins (R-ME) are cautiously positive about the bill so far.