The Senate Republicans’ latest Obamacare repeal effort collapsed Tuesday, as Majority Leader Mitch McConnell, facing certain defeat, announced that the measure would not be brought to the floor for a vote. The announcement followed statements by three Republicans—Rand Paul of Kentucky, John McCain of Arizona and Susan Collins of Maine—that they would vote against the measure.
With all 48 Democrats set to vote “no,” the Trump administration and Republican leaders could afford no more than two Republican defections to obtain passage in the 100-member chamber.
The so-called “Graham-Cassidy” bill was similar to previous Republican efforts under Trump to repeal the 2010 Affordable Care Act, better known as Obamacare, all of which would strip tens of millions of people of health insurance and end Medicaid, the government health insurance program for the poor, as a guaranteed entitlement program.
Graham-Cassidy, sponsored by South Carolina Senator Lindsey Graham and Louisiana Senator Bill Cassidy, would have imposed a per capita cap on Medicaid spending and shifted to a system in which states received block grants from the federal government. The result would be growing shortfalls between states’ Medicaid funding needs and what the federal government would provide, forcing deep cuts in Medicaid coverage.
The failed proposal would have eliminated the individual mandate, which requires that uninsured individuals buy coverage or pay a penalty, and the employer mandate, which requires that businesses with a certain number of employees provide coverage for their workers or pay a penalty.
States would also have been allowed to obtain waivers from Obamacare rules barring insurance companies from denying coverage or jacking up rates for people with preexisting conditions, as well as from requirements that insurers cover essential benefits such as maternity and newborn care, outpatient care, emergency services and mental and addiction treatment.
The Trump administration and congressional Republicans had an effective deadline of September 30 to pass an Obamacare repeal bill because with the start of the new fiscal year on October 1, they could no longer pass such a bill under the so-called “budget reconciliation” process, which requires a simple majority rather than the filibuster-proof 60-vote super-majority needed under normal procedures.
After McConnell’s announcement, some Republicans, including the right-wing libertarian Rand Paul, voiced support for coupling tax reform with repeal of the ACA. Republican leaders quickly opposed this plan, which could make tax reform (i.e., massive cuts to the corporate tax rate) more difficult.
Senate Majority Whip John Cornyn, the second-ranking Senate Republican, said, “I know the work [on repealing the ACA] is going to continue, but I think we need to turn to tax reform while that work continues.”
Cornyn also noted that senators Lamar Alexander, a Republican, and Patty Murray, a Democrat, are working on a bipartisan effort to “stabilize” insurance markets. He was referring to efforts by the Democrats to work out a bipartisan deal with the Republicans that would retain the basic framework of Obamacare, which is broadly supported by the corporate elite and the insurance industry, and is being used to increase out-of-pocket costs for workers while slashing costs for businesses and the government, while introducing regressive changes being demanded by the insurance monopolies.
The Alexander-Murray negotiations broke off when Republicans were attempting to muster votes for Graham-Cassidy, but will likely be revived in the aftermath of the failure of the Republican bill.
This is the real orientation of the Democratic Party—not the posturing by Senator Bernie Sanders and some Senate Democrats on behalf of a “Medicare-for-all” bill that stands little chance of even being brought up for debate. As the World Socialist Web Site noted when Sanders announced his bill, “The goal of the exercise is to provide a political smokescreen for backroom Democratic Party dealings with the Trump administration, on health care and especially on tax cuts.”