The Bastards Are At It Again

It’s been 51 days since Republican Senator John McCain cast the dramatic “No” vote that sunk the bill that would have sunk the Affordable Care Act. Most of us assumed that was the end of the story. Even Sen. McConnell, the evil Majority Leader, said it was time for the Republicans to “move on”.

But we were wrong. They’re making one more attempt to repeal the Affordable Care Act. They have until September 30th, because the Senate rules say that’s the last day they can pass a bill with only 50 senators, plus the Vice President, voting “Yes”.

Sarah Kliff of Vox calls the latest bill, released by Sens. Bill Cassidy and Lindsey Graham on Wednesday, “the most radical” repeal effort yet:

Work on Cassidy-Graham began in the midst of the chaotic Obamacare repeal effort in July….

The senators are selling this idea as a compromise plan and say it is a way to return power to states, giving local governments more control over how they spend federal dollars….

But the plan does much more than that. The proposal would eliminate the health care law’s subsidies for private insurance and end the Medicaid expansion. States could allow for waivers that let insurers charge sick patients higher premiums and stop covering certain benefits required under the Affordable Care Act, like maternity care or prescription drugs. The health insurance marketplaces would no longer exist as they are envisioned to continue under other Republican proposals.

The federal government would convert some (but not all) of that spending into a lump-sum payment to states. States could choose to spend this money on providing insurance — or they could use it to fund high-risk pools, or do other activities to pay the bills of patients with high medical needs….

The plan hasn’t been scored by the Congressional Budget Office yet, but analysts who have studied Cassidy-Graham estimate it would cut deeply into federal funding for the health law programs, likely resulting in millions losing coverage.

Cassidy-Graham would arguably be more disruptive, not less, to the current health care system than the plans that came before it. It would let money currently spent on health insurance go toward other programs, providing no guarantee that the Affordable Care Act programs individuals rely on today would continue into the future.

Jonathan Cohn of the Huffington Post quotes Aviva Aron-Dine of the Center on Budget and Policy Priorities:

“This bill is far more radical [than previous repeal bills] in that it envisions going back to the pre-ACA world, where the federal government wasn’t in the business of helping low-income adults or moderate-income people without employer coverage get health insurance at all… Compared to pre-ACA, there would be some extra state grant money floating around ― but it would have virtually no requirements attached to it at all and, since the funding wouldn’t adjust based on enrollment or costs, it would be hard for even well-intentioned states to use it to create an individual entitlement to coverage or help.”

Cohn continues:

Oh, and the bill would repeal the Affordable Care Act’s individual mandate, and do so right away ― destabilizing insurance markets and causing premiums to rise right away, according to official projections….

It’s difficult to say where this is all going. After all, the idea that repeal could get another look now, despite its unpopularity, in the form of a proposal that in some respects is more radical than its predecessors, is difficult to fathom. And yet here we are, fathoming it.

So it looks like we need to speak up again. Republican senators need to hear from their angry constituents again. Facebook and Twitter need to heat up again. Activists need to get arrested again, because this is a matter of life and death for many of our fellow citizens and nobody knows if three Republicans will still vote “No”. McCain, who provided the crucial third “No” in July, has changed his tune from day to day (he’s 81 and has a brain tumor). People are saying he might vote “Yes” this time because he and Sen. Graham are very good friends. 

In November 1932, the German government was in disarray. Hitler was demanding to be made chancellor. He had many supporters, but others feared he would immediately institute a murderous dictatorship if given the chance:

Yet it was entirely unclear who would succeed [Franz von Papen] as chancellor or whether a way out of the political crisis could be found. The only thing that was clear, [a German count named Harry Kessler] noted … was the absolute impenetrability and uncertainty of the situation: “Everything more or less depends on chance and the good or bad moods of four or five individuals”.

Hitler became chancellor two months later.