Through a combination of bribery and even more savage cuts and deregulation, Republicans are ensuring that the repeal bill that goes to the Senate floor is even worse than the one originally proposed.
From the outset, the latest Republican health care repeal bill was the worst of all the Obamacare repeal proposals introduced this year in the Senate.
The so-called Graham-Cassidy bill is now less popular than Vladimir Putin, with only 20 percent support from voters and all major doctor, patient, and insurer groups opposed. Less than half of Republican voters want it passed. Meanwhile, Sen. John McCain’s refusal to support the bill has put its future in doubt.
But the bill is not dead.
Republicans are frantically trying to negotiate with their own caucus to get to 50 votes, and in the process, every change they are proposing to appease GOP holdouts makes the bill even worse.
To start, the new draft Republicans are releasing much more explicitly does away with coverage for pre-existing conditions by letting states set the rules for insurers — likely a concession to Sens. Ted Cruz and Mike Lee, who threatened to withhold their votes without a total repeal of federal standards.
Nominally, states would still have the choice to keep Obamacare protections, but without the federal individual mandate and tax credits, those protections are unaffordable. This change obliterates the repeated lies from Republicans who insisted Graham-Cassidy would protect coverage for pre-existing conditions.
Meanwhile, Sen. Rand Paul of Kentucky, who acted as if he was a hard “no” last week, is now saying he would change his vote if the block grants replacing Medicaid are cut in half. Already, these block grants would cut nearly $4 trillion in funding to states over the next 20 years. Cutting the block grants in half would give some states essentially no money for health coverage as we know it.
And as all of this continues, Republicans are doubling down on their attempts to bribe Alaska Sen. Lisa Murkowski, who sunk previous Senate repeal bills. Last week, the GOP essentially offered to let Alaska keep Obamacare in return for her vote to repeal it in the other 49 states, which is likely unconstitutional. Now, they are further increasing health care funding to her state.
It is worth remembering that the one thing Senate Republicans haven’t even considered is trying to court Democratic votes.
In August, Democratic Sen. Patty Murray and Republican Sen. Lamar Alexander crafted a genuine bipartisan compromise, allowing states to offer lower-tier plans and waive some Obamacare regulations in return for fully funded reinsurance and cost sharing reductions. Republican leaders summarily killed these talks and are instead ramming through yet another bill with zero Democratic input or independent budget analysis. This partisan push is eating up so much time that the Senate might not even get around to reauthorizing children’s health insurance.
Nothing further demonstrates Republicans’ inability to govern than the fact that they are including nobody but themselves in health care negotiations — and with every deal they strike, their bill becomes more dangerous.