WashPost: The Graham-Cassidy health-care bill puts millions of Americans at risk
At this time, I see the bill as being vindictive--just like Trump-punishing primarily Democratic states who have cared for its peoples health!
https://www.washingtonpost.com/opinions/the-graham-cassidy-health-care-bill-puts-millions-of-americans-at-risk/2017/09/19/517df610-9d67-11e7-9c8d-cf053ff30921_story.html?utm_term=.440e512cc2f5
Opinions
The Graham-Cassidy health-care bill puts millions of Americans at risk
Sen. Lindsey O. Graham (R-S.C.). (Andrew Harrer/Bloomberg)
By Timothy Jost September 19 at 5:46 PM
Timothy Jost is an emeritus professor at Washington and Lee University law school.
The Senate is on the verge of launching a dangerous experiment. Having failed for months to repeal and replace the Affordable Care Act, Republicans hope to dump onto the states the problem of providing low- and moderate-income Americans with access to health care. So long as they are determined to push forward without meaningful Democratic input, they have until Sept. 30 to act under Senate rules. The Graham-Cassidy bill — their last chance to meet this deadline — would simply hand the states block grants and abandon to them millions of Americans whom the ACA now helps.
In doing so, however, Graham-Cassidy would radically redistribute health-care funding. It would effectively strangle the efforts of states — predominantly Democratic — that have been most successful in extending coverage under the ACA’s Medicaid expansion, tax credits and cost-sharing reductions.
Conversely, it would lavish funding on states — predominantly Republican — that have resisted the coverage expansion opportunities the ACA offered. It would also allow states to waive the basic health insurance protections the ACA has given individuals with preexisting conditions. Finally, like previous Republican bills, it would cap federal Medicaid funding growth at levels that would force states to cut back on traditional Medicaid coverage, further increasing the numbers of the uninsured.
If passed, Graham-Cassidy would proceed in three stages. The current ACA premium tax credits and Medicaid expansion would remain in place for 2018 and 2019. But the bill would immediately — indeed retroactively — end the individual- and employer-mandate penalties, while offering nothing in return to encourage healthy enrollees to maintain coverage. The bill would also do nothing to compensate insurers for the reductions they must make in deductibles and other cost-sharing for low-income enrollees, an issue that is currently driving up premiums. The bill includes some funding that could be used to help stabilize insurance markets, but does not specify how the money would be used, and in any event, it provides too little money. Under this law, it is quite possible that the individual insurance markets could collapse in some states before 2020.
In 2020, the second stage of Graham-Cassidy would go into effect. Between 2020 and 2026, funding the states currently receive would be reallocated according to a complex formula that would, subject to several adjustments, base each state’s share on its portion of the U.S. population with incomes between 50 and 138 percent of the federal poverty level. While the sponsors of the bill assert that this is fair, it would create numerous problems.
To begin, it would dramatically cut funding for states that have successfully extended coverage under the ACA. California would effectively receive $28 billion less in 2026 than under currently projected funding, New York $19 billion less. On the other hand, the bill would just as dramatically expand funding for states that have largely ignored their uninsured: Funding for Texas would increase $8 billion over currently projected levels........
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