The Panic Over Graham-Cassidy The single-payer Democrats won’t budge on health care.
https://www.wsj.com/articles/the-panic-over-graham-cassidy-1506035850
Senate Republicans must be making progress on their latest attempt to reform health care, because the opposition is again reaching jet-aircraft decibel levels of outrage. The debate could use a few facts—not least on the claims that the GOP is engaging in an unfair process.
Republicans are scrambling to pass Lindsey Graham and Bill Cassidy’s health-care bill before Sept. 30, when the clock expires on the budget procedure that allows the Senate to pass legislation with 51 votes. The bill would devolve ObamaCare funding to the states, which could seek waivers from the feds to experiment within certain regulatory boundaries, and it also repeals the individual and employer mandates and medical-device tax.
The left spent weeks declaring this dead on arrival, but now that Republicans appear close to a majority here come the tweets. The Graham-Cassidy proposal “eliminates protections for people who are or ever have been sick. GONE. Insurers back to denying coverage for the sick,” Connecticut Democrat Chris Murphy claimed this week.
In fact, a state that receives a waiver from ObamaCare’s regulations must show plans that retain access to “adequate and affordable” coverage for people with pre-existing conditions. ObamaCare’s rules are not the only way to do this, despite the claims of Jimmy Kimmel. The Affordable Care Act’s price restrictions have in practice degraded the quality of care for the ill and sent insurers shopping for healthy patients who are more profitable. (See “Pre-Existing Confusion,” May 2)
States could set up high-risk pools, for example. These pools subsidize care for those who need costly treatment without concealing the expense across healthy patients, who may drop coverage if they can’t afford it. This can lower premiums for everyone.
Another complaint is that Republicans may vote without a score from the Congressional Budget Office, which has said it will release a preliminary estimate but won’t rule on premiums or coverage effects for several weeks.
CBO forecasts are often wrong, but in this case they’d also be meaningless. The point of Graham-Cassidy is to allow states to experiment and tailor approaches to local populations. Some might try to expand Medicaid’s reach or even go single-payer. Others might tinker with reinsurance. The budget office can’t possibly know what 50 states would do or how that would affect coverage.
The irony is that even as critics say little is known about the bill, progressive groups are pumping out black box estimates of what would happen. A report flying around the internet from the consulting firm Avalere says that states will lose $4 trillion in funding over 20 years.
That sounds bad. Except the study assumes no state block grants past 2026—because Congress would have to reauthorize funding. That’s right: The report equates renewing an appropriation with zeroing out an account, as if Congress doesn’t periodically approve funding for everything from children’s health care to highway spending.
The least credible charge is that Republicans are undercutting bipartisan Senate debate and compromise. Bipartisanship would be nice, but let’s retrace the history this year. Even moderate Democrats refused to cooperate during the first GOP shot at reform, though Minority Leader Chuck Schumer promised that if it failed he’d be ready to compromise.
Tennessee Senator Lamar Alexander then took up that offer and negotiated in good faith with Democrat Patty Murray to make modest repairs to insurance markets for 2018. There were hearings. There were meetings. Yet this week Mr. Alexander pulled the plug because they had “not found the necessary consensus.” Democrats claim Mr. Alexander was coerced by GOP leaders and the White House, but in our experience the Tennessean doesn’t give up easily or on anyone’s orders. Senate Democrats refused in the talks to make more than de minimis changes to ObamaCare’s waiver process to give states more regulatory flexibility.
Mr. Schumer is never going to let Ms. Murray make concessions beyond an insurer bailout because he figures he can blame Republicans for higher premiums going into the 2018 election. He also won’t buck Bernie Sanders or his more than 15 other Members who recently endorsed single-payer health care. Democrats are moving left on health care, not to the center. “Process” is beside the point.
The shame is that many Democrats once liked a federalist solution to health care, and Lindsey Graham was one of those who worked with them. In 2007 he and Wisconsin Democrat Russ Feingold proposed the State-Based Health Reform Act that would have given states even more freedom than Graham-Cassidy. But these days Democrats fear that state laboratories would discredit the command and control approach to health care that they hope will lead to single-payer.
The choice Republicans face isn’t between Graham-Cassidy or some bipartisan beau ideal. Their choice is to pass their own bill, which now means Graham-Cassidy, or fail again and cede the health-care advantage to the single-payer wing of the Democratic Party.
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