With her announcement that she won’t vote for the Graham-Cassidy bill, Sen. Susan Collins (R ME) has ended GOP efforts to kill the ACA.
She also saved her party from the disaster that would befall it if the bill had become law.
- millions of core Republicans would have lost health insurance coverage,
- states that went for Trump in the presidential election would have lost billions in federal funds,
- many of the people covered in the individual market in Trump states have pre-existing conditions; Cassidy-Graham would have allowed insurers to drastically limit their coverage
- Key GOP states such as Arkansas and Kentucky would lose billions in Medicaid dollars over the long term
This doesn’t mean future efforts won’t seek to slash coverage for kids via cutbacks in the Child Health Insurance program (CHIP), limits on Medicaid, or thru budget machinations. But these will be much lower-impact, subtler moves that won’t be as potentially devastating to the Republican brand as Cassidy-Graham. CG would have shown core supporters the GOP’s “solution” to the healthcare mess was far worse than the current one.
So, what now?
Nothing much is going to happen with healthcare in Congress for some time. That’s too bad, as ACA needs fixing – namely:
- enforcement of the mandate;
- guaranteed full funding of the Cost Sharing Reductions that help lower-income Americans pay deductibles and co-pays;
- allow us older folks to buy-in to Medicare, thus reducing insurers’ risks
This would go a long way to giving certainty to insurers, certainty that would lower premiums and stabilize markets.
What does this mean?
While the result may be a failure to deliver on a core campaign promise, what’s really happened is the GOP didn’t do deeper and broader damage to itself.