Graham should drop his healthcare proposal, support Alexander’s efforts

Graham pushing his proposal recently in Columbia.

Graham pushing his proposal recently in Columbia.

I’ve already written dismissively of Lindsey Graham’s approach to healthcare “reform.”

Today, with it getting so much more attention, I share with you this view of it, headlined “New Trumpcare Deserves a Quick Death.” An excerpt:

On Wednesday, a group of Republican senators plan to release a bill to repeal the Affordable Care Act. It comes from Bill Cassidy of Louisiana and Lindsey Graham of South Carolina, and they will market it as a bill that gives states the flexibility to create the system that they want.

But that’s deeply misleading. While it would theoretically give states more flexibility, the bill would mostly rob states of money to pay for health insurance — and millions of Americans would lose coverage as a result. Think of it this way: Every reader of this newsletter has the theoretical flexibility to buy a private jet.

Cassidy-Graham, as the bill is known, ends up looking remarkably similar to previous repeal attempts. It would likely result in 15 million Americans losing their insurance next year and more than 30 million losing it a decade from now (based on analyses of an early version of the bill, which was similar to previous Republican health bills). “The similarities are more striking than the differences,” Aviva AronDine of the Center on Budget and Policy Priorities told me.

The same column hints at a far better way for our senior senator to direct his energies:

There is also good reason to hope that Cassidy-Graham dies quickly. Members of both parties — like Lamar Alexander, the Tennessee Republican — now seem open to a bipartisan bill to fix some of Obamacare’s problems. A Senate committee held a hearing on the subject yesterday. But it was clear at the hearing that Republicans have a hard time talking publicly about bipartisan compromise so long as the fantasy of a beneficial repeal bill remains alive….

Indeed. Y’all know I’m a Lindsey Graham fan (most of the time), but I was a Lamar Alexander fan long before that. And this time, Lamar is clearly in the right of it. And what Graham is doing is actually an impediment to wise policy.

It amazes me that anyone from South Carolina could think that turning it all over to the states could be a good idea, given that our solons utterly refused a Medicaid expansion underwritten by the Feds simply because it was associated with “Obamacare.”

Lindsey should drop his bad idea like a hot potato and get behind Alexander’s effort. Or better yet, support Bernie Sanders’ single-payer approach. But somehow I’m thinking the Alexander option would be less of a strain for him.

It’s time to get past this “Repeal Obamacare” mania that afflicts Republicans, and get on to serious matters of governance…

7 thoughts on “Graham should drop his healthcare proposal, support Alexander’s efforts

  1. Brad Warthen Post author

    Here’s Graham’s release about the proposal:


    September 13, 2017


    Senators Introduce Graham-Cassidy-Heller-Johnson
    Legislation block grants Obamacare funding to states for health care

    WASHINGTON — U.S. Senators Lindsey Graham (R-South Carolina), Bill Cassidy (R-Louisiana), Dean Heller (R-Nevada), Ron Johnson (R-Wisconsin) and former U.S. Senator Rick Santorum (R-Pennsylvania) today unveiled legislation to reform health care.

    The Graham-Cassidy-Heller-Johnson (GCHJ) proposal 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 block grant is run through CHIP and is subject to a mandatory appropriation.

    The grant dollars would replace the federal money currently being spent on Medicaid Expansion, Obamacare tax credits, cost-sharing reduction subsidies and the basic health plan dollars.

    The proposal gives states the resources and regulatory flexibility to innovate and create healthcare systems that lower premiums and expand coverage.

    More specifically, GCHJ:

    • Repeals Obamacare Individual and Employer Mandates.
    • Repeals the Obamacare Medical Device Tax.
    • Strengthens the ability for states to waive Obamacare regulations.
    • Returns power to the states and patients by equalizing the treatment between Medicaid Expansion and Non-expansion States through an equitable block grant distribution.
    • Protects patients with pre-existing medical conditions.

    GCHJ also eliminates the inequity of three states receiving 37 percent of Obamacare funds and brings all states to funding parity by 2026. As an example, Pennsylvania has nearly double the population of Massachusetts, but receives 58 percent less Obamacare money than Massachusetts.

    Graham-Cassidy-Heller-Johnson treats all Americans the same no matter where they live.

    “Instead of a Washington-knows-best approach like Obamacare, our legislation empowers those closest to the health care needs of their communities to provide solutions,” said Graham.  “Our bill takes money and power out of Washington and gives it back to patients and states. It takes us off the path to single payer health care – which would be a disaster – and puts us on a path toward local control.  Our approach will have better health care outcomes, transparency, and sustainability than Obamacare.  This bill fundamentally transforms health care in the United States.”

    “This past week, we heard testimony from Democrat and Republican governors and Medicaid directors who believe that, with increased flexibility and freedom from Washington, DC regulations, they can do a better job of providing coverage for the people of their state. We agree,” said Dr. Cassidy. “This amendment gives that flexibility to states while protecting patients and the federal taxpayer.”

    “Doing nothing to try to solve Obamacare’s failures isn’t an option. Up until last month, Nevadans living in 14 of our 17 counties were not going to be able to buy insurance on the exchange next year. On top of that, the most disadvantaged Nevadans are forced to pay a fine for a product that they cannot afford,” said Heller. “The Graham-Cassidy-Heller-Johnson plan is the most viable solution to achieving our health care reform goals by recognizing Obamacare’s failed one-size-fits-all approach and returning power to the states. I thank Senators Graham and Cassidy for their leadership, and I urge my colleagues to join us in supporting a plan that allows our governors and legislatures the flexibility to support programs that are currently working in our states and to explore new options to address coverage and cost.”

    “Obamacare continues to collapse, and we have no choice but to address this problem head on,”Sen. Johnson said. “Returning more health care decisions to the states and ensuring equal treatment for states like Wisconsin that spend taxpayer dollars wisely will allow local leaders to tailor their health care system to the needs of its citizens while maintaining protections for those with high cost and pre-existing conditions.”





    1. Brad Warthen Post author

      Anything in the lede of that release make you go, “Huh?”

      That was my reaction to Rick Santorum, who is not a current member of the Senate, being one of the “senators” making this proposal.

      It prompted two thoughts:

      1. Could you not get any more actual senators behind the plan?

      2. Is reaching outside the Senate to pull in Rick Santorum supposed to make me feel better about this plan, or worse?

  2. Brad Warthen Post author

    Graham just sent out another release headlined, “Graham: GOP “Can’t Quit on Repealing and Replacing Obamacare.”

    Yeah, you can. And you need to, for the good of the country. McConnell’s given up. Why can’t you?

  3. Brad Warthen Post author

    Dear Friend,

    Today I introduced legislation to replace Obamacare with health care reform that puts patients first and returns power to the states.

    From the start, Obamacare has been a disaster. 

    Two of its biggest problems are that it was never designed to be patient-friendly and it rewards states that favor big government.

    Instead of a Washington-knows-best attitude, my legislation – cosponsored by Senators Bill Cassidy (R-Louisiana), Dean Heller (R-Nevada) and Ron Johnson (R-Wisconsin) – sets out to change that dynamic by empowering those closest to the health care needs of their communities to provide solutions.

    Our bill is already under attack by some of the chief architects of Obamacare. In fact, one of them called our legislation “the most significant threat” to repeal Obamacare.

    They are worried and for good reason.  It was crafted hand-in-hand with our nation’s governors – who understand the unique health care needs of their states.  It also moves power out of Washington unlike Obamacare which aims to consolidate power in Washington.

    More specifically our bill:

    • Repeals Obamacare Individual and Employer Mandates.
    • Repeals the Obamacare Medical Device Tax.
    • Strengthens the ability for states to waive Obamacare regulations.
    • Returns power to the states and patients by equalizing the treatment between Medicaid expansion and non-expansion states through an equitable block grant distribution.
    • Protects patients with pre-existing medical conditions.
    • States deserve the flexibility – and the funding – they need to make the best health care decisions for their citizens.

    I’m working hard to get this done for the people of South Carolina who have suffered long enough under Obamacare.

    I’ll keep you updated as this proposal moves forward.


    Lindsey O. Graham
    United States Senator

    1. Brad Warthen Post author

      It starts, of course, with a couple of lies that increasingly are accepted as truth in the alternative universe that too many Republicans — and Trump supporters as well — inhabit:

      “From the start, Obamacare has been a disaster.” That is simply not the case. You don’t make a statement like that without backing it up — unless you are talking only to people who believe it without evidence.

      “Two of its biggest problems are that it was never designed to be patient-friendly and it rewards states that favor big government.” What he means there, of course, is “states that actually want to extend health benefits to people who currently lack coverage.”

      1. Brad Warthen Post author

        And “patient-friendly?”

        What plan IS patient-friendly? One of the problems with the twisted wilderness of private insurance AND the ACA is that they are almost impossible for a layperson to navigate.

        Which is why single-payer is the way to go…

  4. Bob Amundson

    Sander’s idea is half right (the universal coverage part), but his plan will “break the bank.” California just looked into a similar program for their state, but an appropriations committee estimated it would cost $400 billion, over twice the state’s annual budget.

    Universal catastrophic coverage has elements from both progressive and conservative playbooks; it combines the federal guarantee of insurance for all with the cost-controlling benefits of insurers competing for that business. For more details, search “universal catastrophic coverage.”


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