This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.theguardian.com/us-news/2017/sep/22/john-mccain-says-he-cant-vote-for-republican-plan-to-replace-obamacare

The article has changed 8 times. There is an RSS feed of changes available.

Version 2 Version 3
John McCain says he can't vote for Republican plan to replace Obamacare John McCain says he can't vote for Republican plan to replace Obamacare
(about 2 hours later)
Senator John McCain said on Friday that he could not “in good conscience” vote for the latest Republican proposal to replace the Affordable Care Act, dealing a potentially fatal blow to its path forward. John McCain said on Friday he could not “in good conscience” vote for the latest Republican proposal to replace the Affordable Care Act (ACA), dealing a potentially fatal blow to the plan.
The Arizona senator’s move made it increasingly difficult for Republican party leaders to get the votes they need to eliminate the ACA, widely known as Obamacare, in what is being seen as a last-gasp attempt. The Arizona senator, who in July derailed the last Republican repeal effort with a dramatic “no” vote, said in a statement he disapproved of the fast-track process GOP leaders are seeking to use to pass the reform, the latest draft of which was authored by Bill Cassidy of Louisiana and Lindsey Graham of South Carolina.
Republicans hold a slim majority in the Senate, with 52 of 100 seats. The process Republicans are using to pursue healthcare, known as “reconciliation”, enables them to pass legislation with a simple majority: 51 votes. “I cannot in good conscience vote for the Graham-Cassidy proposal,” McCain said. “I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will effect insurance premiums [sic], and how many people will be helped or hurt by it.”
As a result, Republicans can afford to lose the votes of just two senators, a scenario in which the vice-president, Mike Pence, would cast the tie-breaking vote. In addition to McCain, the Kentucky senator Rand Paul has said he is firmly against the measure because he does not believe it does enough to repeal the existing healthcare law. McCain’s decision makes it increasingly difficult for Republican leaders to get the votes they need to fulfil their biggest promise of the last decade: to repeal the ACA.
Senator Susan Collins, a Republican from Maine, also said Friday she was “leaning against” the proposal. Republicans hold a slim majority in the Senate, with 52 of 100 seats. The process the party is using to pursue healthcare reform, known as “reconciliation”, enables them to pass legislation with a simple majority: 51 votes.
McCain, who would like to repeal the ACA, has taken issue with the fast-track process Republicans are using to rush the bill to the floor and allow them to pass the bill on a party-line vote. If the Senate were split 50-50, Vice-President Mike Pence would break the tie. As a result, Republicans can afford to lose the votes of two senators. The Kentucky senator Rand Paul has said he is firmly against the Graham-Cassidy bill because he does not believe it does enough to repeal the existing healthcare law.
“I cannot in good conscience vote for the Graham-Cassidy proposal,” McCain said in a statement on Friday. “I believe we could do better working together, Republicans and Democrats, and have not yet really tried.” John Thune, from South Dakota and a member of GOP leadership, said McCain’s defection was “certainly not a good development” but added that there was still a chance his party could find enough votes.
“Nor could I support it without knowing how much it will cost, how it will effect insurance premiums [sic], and how many people will be helped or hurt by it. Without a full CBO score, which won’t be available by the end of the month, we won’t have reliable answers to any of those questions.” “There are a couple of uncommitted members and there is an opportunity between now and 30 September, the end of next week, to get … an affirmative vote,” Thune said on Fox News. “We know this issue is not going away.”
Republican leadership had hoped to hold a vote as early as next week, but McCain’s defection makes the math nearly impossible. Susan Collins, a Republican from Maine who also voted against the last attempt at repeal, said on Friday she was “leaning against” the new proposal.
Senator Lisa Murkowski of Alaska, who along with Collins and McCain thwarted the most recent attempt by Senate Republicans to repeal the ACA in July, has also expressed deep skepticism over Graham-Cassidy. Lisa Murkowski of Alaska, another who voted no in July, has also expressed deep skepticism over Graham-Cassidy.
McCain’s decision on Friday was especially notable given his close friendship with Lindsey Graham, the lead co-sponsor of the latest ACA repeal bill. In his statement, McCain alluded to his rapport with Graham to underscore the difficulty he faced in reaching his decision. McCain’s decision was also notable given his close friendship with Graham. “I take no pleasure in announcing my opposition,” he said. “Far from it. The bill’s authors are my dear friends.”
“I take no pleasure in announcing my opposition. Far from it,” McCain said. “The bill’s authors are my dear friends.” In a statement of his own, Graham said McCain’s decision had no bearing on their friendship and defended his legislation as the “best chance to repeal and replace Obamacare”.
The Graham-Cassidy proposal has faced significant backlash in recent weeks from across the healthcare spectrum. Several leading physicians’ associations, as well as the lobbying group that represents the insurance industry, have come out against the bill. “I feel an obligation to fix this disaster and intend to push forward for state-centric healthcare versus Washington-knows-best healthcare,” Graham said, adding: “We press on.”
As crafted, the Graham-Cassidy proposal would eliminate the ACA’s expansion of Medicaid, the federal program that helps provide access to healthcare to low-income individuals. It also guts coverage requirements for pre-existing conditions, enabling insurers to charge higher premiums to sick people or to refuse coverage entirely. Democrats cheered McCain’s decision and urged Republicans to resume negotiations over a bipartisan effort to stabilize insurance markets by providing certainty around ACA payments to insurers. Such talks stalled as Graham-Cassidy gained momentum.
The latter was highlighted in recent days by the comedian Jimmy Kimmel, who dedicated the opening monologues of his late-night talk show this week to attacking the Republican plan and branding Cassidy a “liar”. “John McCain shows the same courage in Congress that he showed when he was a naval aviator,” said Chuck Schumer of New York, the Senate minority leader. “I have assured Senator McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process.”
Cassidy had appeared on Kimmel’s show amid healthcare negotiations in May and created the so-called “Jimmy Kimmel test”, under which no family would be denied healthcare because they could not afford it. The issue has been deeply personal for Kimmel, who shared the story of his newborn son requiring surgery for heart problems that qualify as a pre-existing condition. The Graham-Cassidy proposal has prompted significant backlash across the healthcare sector. Several leading physicians’ associations, the lobbying group that represents the insurance industry, consumer advocacy groups, hospitals, governors and Medicaid officials all came out against the bill.
The bill also allows states to opt out of coverage requirements established under the ACA for “essential health benefits”, which include maternity care and prescription drugs. Graham-Cassidy would eliminate the ACA expansion of Medicaid, the federal program that helps provide access to healthcare to low-income individuals. It would also gut coverage requirements for pre-existing conditions, enabling insurers to charge higher premiums to sick people or to refuse coverage entirely.
The goal of the Republican plan, much like other failed iterations, is to give more control to the states. The latter was highlighted by the comedian Jimmy Kimmel, who dedicated the opening monologues of his late-night talkshow this week to attacking the Republican plan and branding Cassidy a liar.
The Graham-Cassidy proposal would do so by replacing the ACA’s Medicaid expansion and insurance subsidies with a new block grant program for the years 2020 to 2026. (If enacted, the bill would not go into effect until 2020). Federal funding for Medicaid would also be capped. Cassidy, who appeared on Kimmel’s show in May, created the so-called “Jimmy Kimmel test”, under which no family would be denied healthcare because they could not afford it. The issue has been deeply personal for Kimmel, who shared the story of his newborn son requiring surgery for heart problems that qualify as a pre-existing condition.
An analysis released by the Kaiser Family Foundation found that 35 states would lose $160bn in federal funding under the bill. The Trump administration’s own internal data, which was reported by Axios, showed 31 states poised to lose federal funding, with Murkowski’s state incurring a 38% cut in 2026. The bill Cassidy wrote with Graham would also allow states to opt out of coverage requirements established under the ACA for “essential health benefits”, which include maternity care and prescription drugs.
The stated goal of the Republican plan, much like other failed attempts at repeal, is to give more control to the states. Under the bill, states would have more discretion over how to use federal funds to deliver healthcare coverage. However, under the complex formula used to calculate how funds would be distributed, most states – including Arizona – would receive less funding than under the ACA.
Graham-Cassidy would replace the ACA’s Medicaid expansion and insurance subsidies with a new block grant program for the years 2020, when it would go into effect, to 2026. Federal funding for Medicaid would also be capped.
An analysis released by the Kaiser Family Foundation found that 35 states would lose $160bn in federal funding under Graham-Cassidy. The Trump administration’s own data, which was reported by Axios, showed 31 states set to lose federal funding, with Alaska incurring a 38% cut in 2026.