Washington – In a fiery speech this week in Phoenix, Ariz., President Donald Trump faulted GOP congressional leaders for failing to repeal the Affordable Care Act and urged them to try again.
One option available to the GOP is a bill being written by Sens. Lindsey Graham, R-S.C. and Bill Cassidy, R-La., that aims to give states full authority to craft their own health care systems – with some financial aid from the federal government.
But that repeal and replace plan would increase the number of uninsured nationwide, restructure Medicaid and have an especially harmful impact on Connecticut and a handful of other states, a liberal-leaning Washington D.C.-based think tank said.
“It would cause many millions of people to lose coverage, radically restructure and deeply cut Medicaid, increase out-of-pocket costs for individual market consumers, and weaken or eliminate protections for people with pre-existing conditions,” says an analysis released Thursday by the Center on Budget and Policy Priorities.
The legislation aims to appeal to both conservatives and moderates alike.
Bill supporters say the Graham-Cassidy plan would give Republican states the flexibility to draft alternative, more conservative, health care plans that work better for their states.
“We need to let states take care of themselves and give power back to the patient,” said Cassidy, a former medical doctor, in a Washington Post op-ed. “ Let a blue state do a blue thing and a red state such as mine take a different, conservative approach.”
The plan would eliminate the ACA’s marketplace subsidies and the increased federal Medicaid funds states like Connecticut received to expand that health care program for the poor to more people – including single adults who did not earn more than 138 percent of the federal poverty rate.
That federal money, which helped states cut the number of uninsured, would be replaced by block grants that would grow at the annual inflation rate — not the higher medical inflation rate.
The Graham-Cassidy bill would also turn the regular Medicaid program, which in Connecticut is funded 50-50 by the state and federal government, into a program in which federal payments are capped based on a per-capita formula. That means that if demand for the program increases, services would likely be cut and/or eligibility restricted.
The Center for Budget and Policy Priorities estimated Connecticut could lose almost $2.5 billion a year in federal health care funds by 2026 under the Graham-Cassidy plan.
The plan would also allow states to waive Obamacare regulations on the amount of coverage an insurer must provide and eliminate bans on annual or lifetime limits on coverage.
The Center of Budget and Policy Priorities report said the Graham-Cassidy plan “would effectively punish states that have been especially successful at enrolling low- and moderate-income people in the Medicaid expansion or in marketplace coverage under the ACA, while imposing less damaging cuts, or even initially increasing funding, for states that have rejected the Medicaid expansion, enrolled fewer people in marketplace coverage, and have lower population density and lower per-capita income.”
“The cuts would be especially severe in nine states — California, Connecticut, Delaware, Florida, Massachusetts, New Jersey, New York, North Carolina, and Virginia, plus the District of Columbia,” the center said. “By 2026, block grant funding amounts in these states would be 50 percent or less of the federal Medicaid expansion and/or marketplace subsidy funding these states would otherwise receive.”
When Congress returns from its summer break in early September, the Senate Health, Education, Labor and Pensions Committee plans to hold hearings in the hopes of coming up with a bipartisan health care overhaul. Cassidy is a member of the committee, as is Sen. Chris Murphy, D-Conn. The Graham-Cassidy bill is likely to be discussed.