Posted On 22 Sep 2017
Here are the four reasons to support the Graham-Cassidy (GC) bill to “reform” healthcare law in America:
- We have known for most of this year that there is, regretfully, no political will for full repeal in this Congress.
- We know now that bipartisan agreement on healthcare reform (Alexander-Murray in the Senate HELP Committee hearings) is dead, not that we gave it any credibility.
- GC is the last chance for reform. If it fails, the debate is over and Obamacare (OC) remains in place. Americans’ suffering under OC will increase relentlessly, hastening the impoverishment of the country.
- If GC fails, some pundits predict a massive Republican exodus in the Congressional 2018 elections.
Those are pathetic reasons to support a bill, but it’s the hand we are dealt, even after all the years of tireless advocacy for repeal.
- Medicaid expansion ends. No non-expansion state can expand Medicaid after September 1, 2017.
- States that don’t spend all their (Medicaid) block grant funds will receive a bonus. (This type of incentive is key to reducing dependency.)
- Medicaid allocations to states transform from open-ended sums to per-capita caps, equalizing federal expenditures across all 50 states by 2026. Currently, four states—CA, NY, MA, and MD—receive 40% of federal Medicaid funds. States that exceed their caps are penalized.
- GC permits states to add work requirements for childless adult Medicaid recipients.
- HSAs are expanded, as are the types of “qualified expenses.” – Sec. 113 adds the [Direct] Primary Care Enhancement Act.
- GC reduces permissible Medicaid provider taxes from 6% currently to 4% by 2026.
- GC eliminates the “Prevention and Public Health Fund” aka “slush fund.”
- GC eliminates cost-sharing subsidies as of December 21, 2019, and does not appropriate funds for cost-sharing subsidy claims through 2019.
- GC sets up “50 innovation laboratories” to reform the health sector (utilizing waivers, though that process is not without risk. See Jacobs here.)
- GC is far from perfect, much less what was promised or envisioned, but it is a big step away from Washington control. If a future Congress has the political will, perhaps whatever remains of Obamacare by then could be repealed.
- With GC, we open the door to future reforms that will make health freedom a reality. What have we got to lose?