As the Cassidy-Graham health care repeal bill gains momentum on Capitol Hill, opposition to the measure is mounting as well. A bipartisan coalition of 10 governors, including Louisiana Gov. John Bel Edwards, and several powerful health industry and patient advocacy groups came out opposed to the measure. The group includes governors, along with the American Medical Association, the AARP, the American Academy of Family Physicians, the American Hospital Association and a group of 16 patient and provider groups. In a separate statement, Edwards explained the bill’s devastating effects on Louisiana.
My primary objection relates to the elimination of the Medicaid expansion program in 2020. Right now, more than 430,000 working poor people in Louisiana have access to health insurance because we chose to bring our federal tax dollars back home. We’re saving lives, money, and investing in our people to ensure they are able to receive quality healthcare. Importantly, Louisiana’s uninsured rate has dropped to nearly 10 percent. Undoing this progress would negatively impact our citizens and our economy.
The opposition to Cassidy’s health care bill was evident on late night TV as comedian Jimmy Kimmel said the senator “lied right to my face.” However, The Huffington Post’s Jonathan Cohn explains that Kimmel is not the only one that Cassidy is misleading.
The story Graham and Cassidy are telling the public is a vast over-simplification, one that leaves out the bill’s most important elements. And the story they are peddling to colleagues? That’s even more misleading. The bottom line is that the Graham-Cassidy bill is like every other repeal proposal that’s come before Congress this year. It would mean millions more people struggling to get care or being exposed to financial hardship. And it’d most certainly hit some Republican-leaning states hard.
Winners and Losers in Cassidy-Graham
The core of the Cassidy-Graham bill involves replacing the existing Medicaid program with large federal block grants that states could spend on health care needs as they see fit. The AP’s Ricardo Alonso-Zaldivar breaks down the winners and losers in this scenario. The losers include people with pre-existing medical conditions and states, like Louisiana, that expanded Medicaid. Medical device manufacturers would come out ahead.
“Every state has to start from scratch creating its own health insurance program, in some cases with reduced federal funding and in some cases with increased federal funding,” [Larry] Levitt said. “I don’t think at this point anybody knows what states are going to do.”“The bottom line is most states will experience a reduction in federal funding under the bill,” said Caroline Pearson of the consulting firm Avalere Health. “States that expanded Medicaid are likely to see some of the biggest cuts.”
According to the Center on Budget and Policy Priorities, all states would be losers by 2027, when the federal block grant expires.
Election-year politics already?
The calendar says it’s 2017, but for many state legislators the 2018 political year is already underway. That’s because a July 1 deadline looms for lawmakers to agree on tax changes that will avoid the $1.5 billion fiscal cliff. But passing new taxes requires a two-thirds majorities in the House and Senate. As The Advocate’s Lanny Keller breaks down the debate:
However much legislators talk among themselves, they continue to face several interlocking problems: Jindal’s cuts to the personal income tax kicked out one leg of the three-legged stool of state finances, also including sales and energy-related business taxes. It takes 70 votes in the House and 26 votes in the Senate to achieve the two-thirds necessary to pass “new” taxes, even if they are replacements for other taxes that are to be reduced as part of a budget deal. Revising the personal income tax, to that before 2007-2008 when tax cuts blew up the system, remains politically difficult. But the tax system is also made worse by hefty state subsidies to local government. Taking those benefits away is difficult, too, even if the taxes are swapped for other sources of revenue.
Uncertainty on tax plan
While President Donald Trump has yet to reveal the details of his tax plan – beyond a bare outline – it appears that U.S. Senate leaders are giving up on reforming America’s tax system and instead just want to cut taxes. The Washington Post reports that Sens. Pat Toomey of Pennsylvania and Bob Corker of Tennessee have agreed to the broad outlines of a plan that would cut taxes by $1.5 trillion over the next decade, adding that amount to the federal deficit.
The agreement would represent an about-face for Capitol Hill GOP leaders such as Senate Majority Leader Mitch McConnell, R-Ky., and House Speaker Paul Ryan, R-Wis., who for months have promised that the GOP tax overhaul would not add to the budget deficit, currently estimated to hit about $700 billion this year. Deficits over the coming decade were already projected to add $10 trillion to the debt. … Republicans preached a hard line on the deficit while Barack Obama was president but are taking a more lenient approach now that Trump is occupying the Oval Office, promising a huge budget boost for the military and signaling an openness to working with Democrats to increase domestic agency budgets, too. Unlike the House, Senate Republicans aren’t planning to pair the tax measure with spending cuts.
Number of the Day
8.1 percent – Gross Domestic Product growth in Lake Charles metropolitan area in 2016, making it the fastest-growing in the country (Source: Bureau of Economic Analysis).