The last Affordable Care Act (ACA) repeal bill left standing had a dubious chance of passing the Senate. But now, Senators John McCain (R-AZ) and Lisa Murkowski (R-AK) are reportedly weighing whether they could support the Cassidy-Graham bill, which would repeal ACA subsidies and the Medicaid expansion and instead give states a temporary block grant.
McCain tells @GarrettHaake he wants bipartisan bill with wks of hearings. BUT may "reluctantly" back Graham-Cassidy if AZ Gov approves
— Benjy Sarlin (@BenjySarlin) September 18, 2017
Murkowski undecided on Graham-Cassidy plan, per @tedbarrettcnn
— Manu Raju (@mkraju) September 18, 2017
Additionally, the bill caps funding to the Medicaid program overall. The Center on Budget and Policy Priorities has characterized this bill as likely the worst iteration of GOP repeal-and-replace because of its grave hits to consumer protections and funding cuts to states.
Sens. Murkowski, McCain, and Susan Collins (R-ME) killed the last iteration of ACA replace-and-replace just two months ago. Pressure is mounting on the senators to vote yes.
Murkowski and Collins largely voted no to previous GOP health bills because of the extreme cuts to the Medicaid program. Additionally, the two senators have been vocal supporters of the bipartisan health care negotiations run by the Senate’s Health, Education, Labor and Pensions (HELP) Committee; the senators have attended all four hearings.
On the other hand, McCain has not attended any of the ACA bipartisan health hearings. Additionally, he’s said that he would largely decide his vote based on whether his governor supports the bill. Arizona Governor Doug Ducey took to Twitter Monday afternoon to throw his support behind the Cassidy-Graham bill. The Arizona governor did throw his support behind the repeal-only bill last time-around, and McCain voted against it.
— Doug Ducey (@dougducey) September 18, 2017
McCain has also cited lack of Senate “regular order” as reason to vote against the Cassidy-Graham bill — rather than the text of the legislation itself. The Committee on Homeland Security and Government Affairs announced it would hold a hearing on health care block grants Monday morning, signalling an attempt to appease regular order calls. Senator Ron Johnson (R-WI), who has been a staunch supporter of the bill, said last week the committee he chairs would hold a hearing on the Cassidy-Graham bill if committees with typical health jurisdiction do not.
Meanwhile, the Senate HELP committee has held four committee hearings looking to stabilize the ACA individual marketplace in time for September 30, the last day insurance companies can decide whether they’ll participate. HELP committee ranking member Patty Murray (D-WA) said Monday she and chairman Lamar Alexander (R-TN) are hopeful and optimistic about the deal.
Senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC) have until September 30 to pass their repeal-and-replacement bill with just a simple majority, per the Senate parliamentarian’s rules.
Democratic congressional leaders are doing all they can to stall the legislation ahead of the critical deadline. Senate Minority Leader Chuck Schumer (D-NY) and House Minority Leader Nancy Pelosi (D-CA) asked the Congressional Budget Office (CBO) for a full analysis of the GOP proposal Monday, a tall request to accomplish by the end-of-the-month.
The Cassidy-Graham bill has not been scored by the CBO. The office announced it would provide a preliminary assessment of the bill early next week. CBO will not be able to provide point estimates on the deficit, health insurance coverage, or premiums given the short time frame. Additionally, the bill’s language has not been cleared by the Senate parliamentarian, who approves whether provisions meet budget rules. The office of Senator Bernie Sanders (D-VT) said that once the CBO releases its score next week, they will meet with parliamentarian Elizabeth MacDonough to see which provisions adhere to reconciliation; Sanders is the ranking member of the Senate Committee on the Budget.
Senate Majority Leader Mitch McConnell (R-KY) shelved the GOP health bill when it failed 49 to 51. Picking up from where it last was, the Senate has exhausted most of its debate time, leaving little time to debate the Cassidy-Graham bill.
This post has been updated to reflect new information from both the CBO and Sanders’ office.