EDITORIAL: Senate GOP trio offer another Obamacare repeal plan that deserves to fail

Aug. 28--When Republicans in the Senate failed to repeal the Affordable Care Act earlier this summer, the vote unfortunately didn't mark the end of GOP efforts to repeal the Obama-era law that has helped millions of people gain health insurance coverage and lowered the nation's uninsured rate to its lowest level on record.

Now, a repeal plan proposed by GOP Sens. Bill Cassidy of Louisiana, Lindsey Graham of South Carolina and Dean Heller of Nevada is, as Cassidy put it recently, "about the only game left in town" when it comes to the GOP's hackneyed promise to repeal and replace Obamacare, as the law is also known.

Some Senate Republicans took the lesson they should have from their party's Obamacare repeal failure: that their energy is better spent working with Senate Democrats on tweaks to the 2010 health care law.

Cassidy and his colleagues -- who have been working with the White House on this repeal attempt -- apparently didn't. They've managed to assemble an Obamacare repeal package that retains some of the objectionable elements of previous repeal attempts that motivated Maine Sen. Susan Collins' opposition. Plus, their repeal proposal offers a new twist on a strategy to cancel many of the Obamacare's coverage gains.

The plan would take the funding devoted to expanding coverage and gradually eliminate it over the next decade. Those funds today are paying for more than 30 states to extend Medicaid coverage to more low-income adults, and they're helping millions of other Americans who don't have other affordable coverage options to purchase coverage through the individual health insurance market.

Indeed, that money has been key to realizing some of Obamacare's most notable benefits: coverage for more than 16 million adults who didn't previously have it, and profound declines in the uninsured rate in states such as Arkansas, Kentucky and West Virginia. (The percentage of Maine residents lacking health insurance declined because of the Affordable Care Act, but the decline would have been greater if Gov. Paul LePage agreed to expand Medicaid coverage.)

After 2026, under Cassidy, Graham and Heller's proposal, that national investment in expanded coverage would simply disappear. Before it disappears, the legislative proposal would convert that funding into a block grant for states, redistributing much of it to states that haven't expanded Medicaid. According to a Center on Budget and Policy Priorities analysis, only eight states -- none of which expanded Medicaid coverage -- would collect more federal health care funding over the next decade under the Cassidy-Graham-Heller proposal than they otherwise would.

And the trio's legislation also would fundamentally change the nature of Medicaid, similar to previous Republican repeal attempts. It would institute a per-person cap on the amount of Medicaid funding dispensed to the states -- a change from the current Medicaid model under which the federal government contributes at least $1 for every dollar states spend on Medicaid, with no maximum on the amount states can spend.

Under the change, Medicaid would cease to be a reliable source of support that helps states pay for critical care and services for disabled residents and for long-term care for the elderly -- the populations responsible for three-quarters of Maine's Medicaid spending. With diminished federal support, states would have to decide what to do -- cut coverage, spend more of their own money to cover obligations previously covered by federal funds, or some combination of the two.

In addition to the millions of people who would likely lose coverage under the Cassidy-Graham-Heller plan, state budgets would end up losers as well.

And to what end?

There's no compelling rationale for the changes Republicans continue to propose to the nation's health care policies. It's clearly not to extend health coverage to more people or to maintain it for those who currently have it. It's clearly not to make matters easier for the states. And it's clearly not to tackle the genuine health care problems Americans face, such as staggeringly high costs and inferior outcomes.

With clearly no helpful intentions in mind, Cassidy, Graham and Heller ought to let this Obamacare repeal plan fail like its predecessors.

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