Cassidy-Graham collapse leaves uncertainty

September 27, 2017 GMT

WASHINGTON — Connecticut Democrats on Capitol Hill expressed hope that Republicans would finally come to the negotiating table after the demise of the latest effort to repeal and replace Obamacare, but they weren’t holding their breath.

“I don’t know that Republicans can quit this,’’ Sen. Chris Murphy said with a laugh shortly before Republicans came out of their weekly policy lunch at the U.S. Capitol and confirmed the obvious: They didn’t have the votes to pass the Cassidy-Graham measure so the vote scheduled for this week was canceled.

“We’re still a little bit in the ‘morning after’ phase,’’ said Sen. Richard Blumenthal. “Some of it will depend on the president and how hospitable he is to a bipartisan effort.’’

The fate of the bill by Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., was sealed late Monday when Sen. Susan Collins, R-Maine, became the third GOP senator to announce opposition. With the Senate in control of Republicans 52-48, Republicans could only afford two defections.

The proposal would have turned $1 trillion in Obamacare spending into block grants controlled by states. Critics, including Connecticut lawmakers, said it would have effectively shifted money away from states like Connecticut that fully embraced the Affordable Care Act — Obamacare — to states like Texas that did not.

An analysis by the Avalere Health consulting firm in Washington, D.C., concluded Connecticut would lose $10 billion in Medicaid benefits between 2020 and 2026 if the bill passed. Gov. Dannel Malloy’s office last week said Cassidy-Graham could shift up to $7 billion in health care costs to the state through 2026.

Cassidy, Graham and other Republicans had argued the measure would put states in charge of health care instead of one-size-fits-all Washington. But groups of hospitals, doctors, insurers and persons with disabilities argued the bill would deprive millions of health care, a claim backed up preliminarily by a Congressional Budget Office analysis released late Monday.

Republicans faced a Sept. 30 deadline to get a repeal-and-replace bill passed by a simple majority. Beyond that date, Senate rules would require 60 votes — a mathematical impossibility.

In announcing the vote cancellation, Senate Majority Leader Mitch McConnell, R-Ky., expressed little interest in a bipartisan solution to the problems plaguing Obamacare, particularly the sharp rise in premiums on the individual market.

“Where we go from here is tax reform,’’ McConnell said. “We haven’t given up on changing the American health care system, (but) we aren’t going to be able to do it this week.’’

But Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor & Pensions Committee, held out hope that a bipartisan effort to stabilize the individual markets could be resuscitated.

Murphy, a member of the committee, said negotiations between Alexander and his Democratic counterpart, Sen. Patty Murray, D-Wash., were “80 percent done’’ before Alexander backed out in support of the now-failed repeal effort.

For Democrats in the long run, “we’ve got to be serious about making concessions,’’ Murphy said. “I think a lot of Republicans don’t believe Democrats are willing to make true concessions.’’

Among the areas where Democrats should make room to negotiate, Murphy said, is on plans with a “lower actuarial value’’ — meaning a wider range of low-cost plans that might draw in younger and healthier individuals who have been resistant to Obamacare’s requirement that all must have insurance.

But in the short run, said Rep. Elizabeth Esty, D-Conn., the focus of negotiations must be on the individual market — the place where individuals without employer health care who earn too much for expanded Medicaid can go for policies.

In Connecticut, 111,524 people have this kind of insurance through Access Health CT, the state’s Obamacare exchange. But the two providers of policies on the individual market, won approval of rate increases between 27 and 31 percent for 2018.

“Is this lion lying down with the lamb?’’ said Esty, D-Conn. “I’m not sure we’re at that Biblical Eden, but I do believe we should start with stabilizing the individual market, which is the one most in trouble.’’