Republicans are struggling to pass what is being labeled a last-ditch attempt to repeal and replace Obamacare. Its chance of success looks iffy, depending once again on a few Republican senators who couldn’t be depended on in the last repeal vote. They are still looking for a better plan instead of taking what could well be their last viable opportunity to repeal imploding Obamacare before elections roll around.
Leading the new effort are four senators: Lindsey Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada and Ron Johnson of Wisconsin. This is how they explained the bill:
It “repeals the structure and architecture of Obamacare and replaces it with a block grant given annually to states to help individuals pay for health care. This proposal removes the decisions from Washington and gives states significant latitude over how the dollars are used to best take care of the unique health care needs of the patients in each state.”
The grants would replace federal funds for Medicaid expansion, Obamacare tax credits, cost-sharing reduction subsidies “and the basic health plan dollars.” States would have “the resources and regulatory flexibility to innovate and create healthcare systems that lower premiums and expand coverage.” A key part of the proposal is to equalize treatment between Medicaid expansion states and non-expansion states “through an equitable block grant distribution.”
The bill would preserve coverage for pre-existing medical conditions and eliminate the medical device tax and the hated Obamacare individual and employer mandates, although states would have latitude to reinstate them. This plan puts the responsibility squarely in the hands of the states.
Why is this not better than Obamacare’s sky-high premiums and deductibles, mandates, taxes and penalties? Yet the proposal faces much the same problem that derailed the last GOP effort to repeal Obamacare. The new bill must get 50 of the 52 Republican votes in the Senate because there will be zero votes from the other 48 senators controlled by the Democrats. If Republicans can achieve a 50-50 tie, then Vice President Pence will cast the 51st vote to pass the bill.
But as usual Republicans are their own worst enemies. One naysayer, Rand Paul, of Kentucky, is flat out opposed and unmovable, objecting to what he calls “Obamacare lite.” Sen. Susan Collins, of Maine, is expected to vote against the bill as she did the previous one. She says she’s concerned that the Congressional Budget Office will not fully score the bill before the end of this month when a super majority of 60 votes will be needed to pass the bill under the Senate rules (which should be ditched). Likewise, the third iffy Republican, Lisa Murkowski of Alaska, wants “hard numbers” on the impact on her state — although she at least has apparently moved from being outright opposed to the last bill to being undecided on the new one.
That leaves John McCain, who is again giving signals he might vote for the bill, same as he did before surprisingly and dramatically casting the final vote to kill the skinny repeal in July. This time around, McCain first said he might “reluctantly” support the new bill if Gov. Doug Ducey of Arizona endorsed it — which Ducey did right away. But then McCain reiterated his concern about Republicans repealing Obamacare without any Democrat votes. “That’s not the way to do it,” he said on CBS. “The way to do this is have a bill, put it through committee.” McCain will get his wish. There will be committee hearings next week.
Then what? Will the committee hearings be enough for McCain? Or will he insist on bipartisan support? Instead, he and the other iffy Republicans should be concerned about whether this bill is better than Obamacare and at least a starting point for more reforms.
If McCain votes against the bill, or if he votes for the bill and Murkowski does not, then the last-ditch attempt to repeal Obamacare will go into the ditch and the sky-high premiums and deductibles, mandates, tax penalties, medical device tax and all the other onerous provisions of Obamacare will remain in place as a lasting memorial to the misguided actions of one or two Republicans and the failure of the Republicans now in Congress to keep their promise to rescue the people from a terrible law.
Columnist Don McKee is the editorial page writer for the Rome News-Tribune.