Desperate to Uninsure Someone: The latest Obamacare repeal bill reeks of sick, sad political desperation

By Pat Garofalo

Like some horror movie villain that screenwriters just can't quit, the GOP's effort to "repeal and replace" Obamacare is once again back from the dead.

But this sequel looks a whole lot like the movies that came before it: At this point, it seems Republicans are just desperate to ensure they take health insurance away from someone, somewhere. Anyone will do.

The latest iteration of the repeal effort is spearheaded by Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C. Republicans reportedly intend to make a push for their legislation this week; the White House may pile in, and there's even been a perfunctory committee hearing scheduled.

For procedural reasons, Republicans have a deadline of Sept. 30 to pass a health care bill with just 50 votes – as opposed to the 60 that would be needed to circumvent an inevitable Democratic filibuster – and they might just put the pedal to the metal in order to scoot in before the deadline.

On policy, Cassidy-Graham, as it's known, would dump much of the structure of Obamacare, turning that law's Medicaid expansion and subsidy system into a block grant to states to administer as they please. The catch is that the funding sent to the states would be ratcheted down over time, likely causing deep cuts in health care coverage as states deal with smaller pots of money. (For the record, block granting rarely works as a policy strategy if you care about anything other than bean counting.)

According to the Center on Budget and Policy Priorities, a left-leaning budget-crunching organization, millions of people would be rendered uninsured were the bill to become law. Meanwhile, individual insurance markets would be destabilized, as "many insurers would likely respond [to the bill] by withdrawing from the market, leaving a large share of the population living in states with no insurers"; protections for those with pre-existing medical conditions would be weakened, if not outright eliminated, depending on where folks live.
Oh, and more specific numbers are harder to come by because the bill's proponents haven't managed to secure a score from the nonpartisan counters at the Congressional Budget Office.

That stink you sense in the air is desperation. This bill reeks of it. None of the political or policy problems that earlier, failed efforts to repeal Obamacare suffered from are solved by this new piece of legislation. The GOP is just throwing one last Hail Mary in the hopes a miracle occurs.

For instance, the key hang-ups with earlier repeal efforts were that they would leave millions more people uninsured than would current law and included politically untenable cuts to Medicaid. Cassidy-Graham would, you guessed it, leave millions more uninsured than would current law and includes politically untenable cuts to Medicaid.

Compounding its issues, Cassidy-Graham would transfer a whole lot of money to southern, non-Medicaid expansion states from their northern brethren, including from states represented by key Republican senators. (See: Maine and Alaska.) It's hard to see how stiffing those states makes it more likely that their previously reluctant-to-repeal senators – Susan Collins and Lisa Murkowski, respectively – help the GOP's cause.

In fact, it's hard to see what meaningfully positive progress toward untangling the GOP's repeal knot the bill makes at all.

But that hasn't stopped the Cassidy-Graham chatter from noticeably increasing over the last week or so. Republicans are making noise about having 40-something votes in the bag already.

The problem for repeal has never been that first 40 or so votes, though. It's been the last few that could actually advance a bill out of the upper chamber. It's unclear whether the GOP leadership at this point is just posturing, hoping to create momentum where none really exists, or actually has a real plan to breathe life into Cassidy-Graham, to scrape up those final few yeas and get something across the finish line.

If this weren't so deadly serious – if the consequences of each successive piece of GOP legislation weren't so grave – it would all be a little bit sad. Senate Republicans are seemingly so desperate to attach themselves to something that looks like Obamacare repeal that any old thing will do; Cassidy-Graham is one last flavor of the week.

However, don't let that overshadow the very real harm this bill would cause, and the fact that a majority of the Senate GOP caucus is surely in favor of it. There's a whole host of lawmakers who really, really want to cast a vote to leave a lot of people without health insurance. And that's not sad, it's downright scary.