State funding changes in spotlight in
Republican healthcare bill
Send a link to a friend
[September 22, 2017]
By Susan Heavey and Yasmeen Abutaleb
WASHINGTON (Reuters) - Republican leaders
sought to nail down the final votes needed to pass what U.S. Vice
President Mike Pence on Thursday called their "last best chance" to
repeal Obamacare while a new analysis underscored how Democratic-leaning
states stand to lose large amounts of federal funding under the
legislation.
Senate Majority Leader Mitch McConnell plans to bring the bill
introduced by fellow Republican Senators Lindsey Graham and Bill Cassidy
to a vote next week, as his party seeks to make good on seven years of
promises to erase Democratic former President Barack Obama's signature
legislative achievement.
With no Democratic support for the bill, Republicans remain a handful of
votes short in the Senate, needing 50 votes in a 100-seat chamber they
control 52-48, with Pence casting a potential tie-breaking vote. Senator
Rand Paul opposes it and at least six others are undecided: John McCain,
Susan Collins, Lisa Murkowski, Dan Sullivan, Rob Portman and Jerry
Moran.
Asked whether the legislation will pass, Pence said, "We'll see. We're
close."
Republicans, still reeling from their failure in July to win Senate
passage of previous legislation to repeal and replace Obamacare, have
set a Sept. 30 deadline for passage of this bill.
"This may well be our last best chance to stop and turn around and head
America back in the direction of the kind of healthcare reform that's
based on individual-choice, state-based innovations," Pence told Fox New
Channel.
President Donald Trump has been pushing Congress to repeal and replace
Obamacare, which would fulfill one of his top campaign promises from
last year.
The current bill would take money that the federal government now spends
on healthcare through the Medicaid insurance program for the poor and
subsidies to help Americans buy private insurance and distribute it to
the states in block grants.
The non-partisan Congressional Budget Office has not yet assessed the
bill's effects but independent analyses indicate it would fundamentally
redistribute federal healthcare money, generally with Republican-leaning
states benefiting and Democratic-leaning states losing.
The nonprofit Kaiser Family Foundation, a healthcare research group,
estimated on Thursday that states that expanded Medicaid under Obamacare
would lose $180 billion under the bill from 2020 to 2026, while
non-expansion states would gain $73 billion in the same time period.
The Graham-Cassidy bill in 2020 would end the Obamacare Medicaid
expansion, which many Democratic-governed states had carried out while
many Republican-governed states did not, and limit overall federal
spending on the five-decade-old program regardless of how many Americans
qualify for its benefits.
Republicans have called Obamacare, formally known as the Affordable Care
Act, a federal overreach, and say block grants would give states
discretion on how to provide healthcare coverage.
WINNERS AND LOSERS
According to the Kaiser Family Foundation analysis, five states would
stand to lose more than 30 percent of their federal healthcare money
from 2020-2026: New York (down 35 percent), Oregon (down 32 percent),
Connecticut (down 31 percent), Vermont (down 31 percent) and Minnesota
(down 30 percent). All are Democratic leaning.
[to top of second column] |
Vice President Mike Pence prepares to speak during a meeting of the
Security Council to discuss peacekeeping operations during the 72nd
United Nations General Assembly at U.N. headquarters in New York,
U.S., September 20, 2017. REUTERS/Lucas Jackson
The analysis found that six Republican-leaning states would get at
least 40 percent more in federal funds: Mississippi (up 148
percent), Texas (up 75 percent), Kansas (up 61 percent), Georgia (up
46 percent), South Dakota (up 45 percent) and Tennessee (up 44
percent).
In total dollars, the state with the largest forecast loss of funds
is California, losing $56 billion. The biggest gainer would be
Texas, with a $34 billion increase. California, the most populous
U.S. state, is Democratic leaning. Texas is the second most populous
state and the largest Republican-leaning one.
"It's absolutely true to say the Graham-Cassidy bill over time
levels out on a per-person basis the way we distribute money on
healthcare, which I think resonates with most Americans," Pence
said.
McCain, Collins and Murkowski were the three Republicans who voted
against the last Republican healthcare legislation brought up in the
Senate, which failed 51-49 in July. Paul, who voted in favor of that
bill after previously expressing misgivings, on Thursday went to
Twitter to underscore his criticism that the Graham-Cassidy bill
does not go far enough to erase Obamacare.
The insurance industry, hospitals, medical advocacy groups such as
the American Medical Association, American Heart Association and
American Cancer Society, the AARP advocacy group for the elderly and
consumer activists have come out against the bill, urging a
bipartisan fix to the current law that was abandoned this week.
More medical and civil rights advocacy groups lined up against the
Graham-Cassidy bill on Thursday, including the American
Psychological Association, the American Congress of Obstetricians
and Gynecologists and the NAACP.
The Center on Budget and Policy Priorities, a liberal think tank,
estimated that the bill would cause more than 30 million people to
lose insurance.
The Graham-Cassidy proposal would let states opt out of the
requirement that insurers charge sick and healthy people the same
rates, causing a furor among advocacy groups that say it could make
health insurance unaffordable for those with pre-existing
conditions.
(Reporting by Susan Heavey and Yasmeen Abutaleb; Additional
reporting by Doina Chiacu; Editing by Bill Trott)
[© 2017 Thomson Reuters. All rights
reserved.]
Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
|