The August recess gave members of Congress a much-needed opportunity to step back from the failed, partisan effort to repeal the Affordable Care Act and develop workable solutions to the real problems in our healthcare system. Many lawmakers used their annual break to listen to the needs of their constituents, talk with experts, and working across the aisle to find a new path forward when they return in September.
Unfortunately, a group of three Republican senators, including Louisiana’s Bill Cassidy, continues to push another hyper-partisan health-care bill that includes many of the same components of the legislation voted down in July.
In the Senate, Republican Lamar Alexander of Tennessee is teaming with Democrat Patty Murray of Washington to host hearings in early September on a health care package that, according to Alexander, will be “small, bipartisan, and balanced” and “should include funding for the cost-sharing reductions.” Unlike the fast-track approach of the failed repeal effort, the policy details would be fleshed out using the Senate’s regular order. That means hearings, public debate and amendments – and a 60-vote threshold to pass a bill. Already, the committee has invited five governors – three Republicans and two Democrats – and several state insurance commissioners to testify.
Similarly, 43 House members have come together as the bipartisan “Problem Solvers Caucus,” which recently issued a set of proposals aimed at increasing stability in the marketplaces while decreasing premiums and out-of-pocket costs. The caucus supports the mandatory funding of cost-sharing reduction payments and the creation of a “dedicated stability fund” that states could use in a variety of ways to bring down the costs of insurance. They also would loosen the employer mandate and tweak the ACA’s insurance regulation waivers to encourage more innovation in states. No hearing dates have been set.
Perhaps most importantly, neither the House or Senate bipartisan efforts call for changes or cuts to Medicaid. The Cassidy-Graham proposal, on the other hand, would cap and cut the traditional Medicaid program and eliminate funding for Medicaid expansion. The Cassidy-Graham bill also eliminates the ACA’s premium tax credits that help moderate-income consumers buy private insurance. In the place of funding for expansion and the premium tax credits, states would be given a block grant that would not adjust for population growth or medical inflation, so would grow increasingly inadequate over time.
An analysis of the Cassidy-Graham bill by the Center on Budget and Policy Priorities found that in 2026, Louisiana would receive $2.3 billion less in health care funding – a 38 percent cut compared to current law. The bill also would redistribute funding in a way that gives extra money to Mississippi and Alabama, while punishing Louisiana for taking up the Medicaid expansion in 2016. Certainly, residents of Mississippi and Alabama deserve additional health care funding, but it shouldn’t have to come at the expense of low and moderate-income Louisianans. And these states could reap additional funds under current law – by following Louisiana’s lead and expanding the Medicaid program.
Sen. Cassidy is a member of the Senate Health, Education, Labor and Pensions Committee that will hold four hearings in early September, with the goal of crafting bipartisan health care legislation. Rather than continuing to push an unpopular bill, Cassidy should direct his expertise and energy to these bipartisan discussions.