“That’s garbage,” Senator Lindsey Graham snarled, as NBC News reporter Kasie Hunt asked about experts’ claims that his eponymous health-care bill will hurt Americans with preexisting conditions.
Graham elaborated in a tweet:
— Lindsey Graham (@LindseyGrahamSC) September 21, 2017
Obviously, this bill is on steroids when it comes to its clunky, ever-lengthening name. To widen its reach, Graham and his original co-sponsor, Louisiana Senator Bill Cassidy, reached out to two senators who said they opposed the last bill to “repeal and replace” the Affordable Care Act (but in the end voted for it): vulnerable Nevada Senator Dean Heller and Wisconsin’s Ron Johnson, who accused Senate majority leader Mitch McConnell of telling moderate and conservative senators entirely different things about what the last Senate bill did. Johnson was right, which doesn’t happen very often.
Still, the bill is mainly the work of Cassidy and Graham. We find that Graham, once a never-Trumper and normally a somewhat sensible conservative (if that’s not an oxymoron), has glommed onto #FakeNews, the president’s false claim that the news media routinely manufacture untrue stories. And Trump, once Graham’s tormentor—remember when he gave a rally crowd the South Carolina senator’s private cellphone number?—is now praising him, calling Graham-Cassidy “a great bill,” and urging senators to back this last-chance drive to repeal and replace Obamacare.
But in order to pass a bill before the September 30 deadline, Republicans are relying on an unsteady platform of lies. First of all, that’s not a real deadline; it’s just the deadline for using the reconciliation process, which lets them pass their changes with only Republican votes. Nothing stops them from pushing Graham-Cassidy through the normal Senate process of hearings, debate, and amendments—and then having to win 60 votes, which means convincing some Democrats.
But the entire pitch for the bill—what it does, and why it’s so urgent—is stunning in its dishonesty. Essentially it takes the funds allotted to Medicaid expansion and insurance subsidies and, through a murky formula, block-grants them to the states. The states are then in charge, and may seek waivers to get around the core protections in the ACA. On the point Graham debated with NBC’s Hunt: States probably wouldn’t get a flat-out waiver to let insurers totally exclude folks with preexisting conditions—which lets Graham think he can lie to Hunt without necessarily going to hell. But they would likely, in very red, anti-government states, get waivers that let them cut back on covering essential health benefits, from maternity coverage to drug rehabilitation to chemotherapy. Thus the already sick would either find themselves with useless insurance, or with premiums that could be far beyond what they could afford.
Oh, and remember that $45 billion fund Mitch McConnell carved out for opioid addiction treatment? That’s not even in this bill. Nevertheless, Senators Shelley Moore Capito of West Virginia and Rob Portman of Ohio are expected to support it.
In pretty much every way, this bill is worse than the one that failed this summer. Why is it still given a decent chance of passing? Having covered at least four rounds of these Republican efforts over the last eight months, I can share one piece of good news: The media seem to be getting smarter, and thus the coverage, to Graham’s chagrin, is getting more negative. Writing in The New York Times, columnist David Leonhardt was even allowed to use the term “lie” about the legislation (a three-letter word that is rarely allowed in its pages, at least attached to a politician’s name). “Senator Cassidy, Please Stop Lying about Health Care,” read the headline on Leonhardt’s morning summary of the bill’s policy and political prospects.
Vox reporter Jeff Stein chased down senators who support Graham-Cassidy to ask them to explain what the bill will do, and brought us a cavalcade of stupid: nine GOP senators unable or unwilling to honestly answer what the bill does. At least one was partly honest. “If we do nothing, it has a tremendous impact on the 2018 elections,” Senator Pat Roberts of Kansas told Stein. “And whether or not Republicans still maintain control and we have the gavel.” Roberts then gifted us with the best image of what’s happening yet: “Look, we’re in the back seat of a convertible being driven by Thelma and Louise, and we’re headed toward the canyon. So we have to get out of the car, and you have to have a car to get into, and this is the only car there is.” Graham-Cassidy is the getaway car that lets the GOP flee the consequences for booting an estimated 30 million people from health insurance. I say “estimated,” because these mooks won’t even wait for the Congressional Budget Office to score this mess.
Amazingly, the nation’s most famous truth-teller about Graham-Cassidy has turned out to be ABC’s Jimmy Kimmel, whose infant son endured many rounds of surgery that might have triggered insurance caps without the ACA. The smarmy Cassidy came on Kimmel’s show back in May and solemnly promised that any ACA replacement would have to pass “the Jimmy Kimmel test,” widely understood to mean that no parent would face financial ruin to save a child’s life. “He lied to my face,” Kimmel said Tuesday night, in a blistering monologue that went viral. “Stop using my name,” the late-night host demanded. “There’s a new Jimmy Kimmel test for you. It’s called a lie detector test.”
When Cassidy retorted by insisting “we have a deadline of September 30” and offering vague reassurances that more parents will find care under his bill, Kimmel roasted him again. The senator had made “a total about-face,” Kimmel said, which meant “he either doesn’t understand his own bill, or he lied to me.” And thus, a late-night comedian articulated the central mystery of Trump-era Republicans: Are they lying, or just stupid?
The Nation’s David Dayen notes another dishonest argument they’re using to push the bill—that through some evil blue-state trickery, most federal health-care spending goes to four states: New York, California, Maryland, and Massachusetts. But that’s because those states expanded Medicaid, built their own exchanges, and worked aggressively to advertise and advance coverage to their state’s uninsured (those states are also among the most populated). It was Massachusetts, you’ll recall, that led the way in providing universal health care under Governor Mitt Romney back in the day. Good times.
So one selling point of Graham-Cassidy is that it takes funds from those evil blue states and gives it to red states. On Vox, Alabama Senator Richard Shelby parried Stein’s concern about an overall federal spending cut by saying, “But it wouldn’t cut Alabama, though.” There’s a wee bit of honesty, however self-serving and cynical.
And yet some red states will lose funding. Senator Lisa Murkowski’s Alaska will lose $14 billion in federal funding by 2036, according to health-care consulting firm Alavere, and seniors could see their annual premiums jump as high as $31,000. Alaska Governor Bill Walker opposes the bill, as does Ohio’s Republican Governor John Kasich, because his state would be another big loser. But, as I write, there are reports that Graham is offering a deal in which Alaska will be exempt from the bill’s Medicaid cuts, hoping to secure the votes of Murkowski and Alaska’s other GOP senator, Dan Sullivan.
Opponents need the three GOP senators who defeated the last bill—Maine’s Susan Collins (who seems stalwart), Murkowski, and Arizona’s John McCain—to be sure of killing this one. (Kentucky’s Rand Paul makes noises about opposing it on the ground that it’s not a simple Obamacare repeal, but he fell in line the last time around, along with two or three other senators who played undecided until the end.) Another blow to the “no” side came when Arizona Governor Doug Ducey announced his support of the bill this week (he’d opposed the last version). That’s because John McCain said Ducey’s position would be an important factor as he made his decision about Graham-Cassidy.
Graham-Cassidy contains everything McCain hated about the last Republican Senate bill, which he ultimately opposed with a dramatic after-midnight thumbs-down down that left McConnell livid, and beaten. McCain continues to say he wants to see a health-care-reform bill passed with “bipartisan support” via “regular order,” which this is absolutely not accomplishing. Yet he hasn’t firmly opposed it. Though Graham-Cassidy has everything bad about the old bill, and then some, it has one thing McCain values: the aggressive promotion of his closest Senate friend and ally, Lindsey Graham. If defeating the bill comes down to McCain, it’s hard to be confident that can be accomplished. Opponents need to keep calling and visiting Senate offices, and then it might be up to Democrats to use every procedural maneuver to try to extend debate beyond that (phony) September 30 deadline. Are they up to it? They better be.