Obamacare Repeal: Understanding the Graham-Cassidy Bill


The Senate parliamentarian has ruled that Republicans can only repeal ObamaCare with a 51-vote majority until September 30. After that, the reconciliation vehicle that allows them to avoid a Democrat filibuster will expire.

Consequently, some Republican Senators – led by Lindsey Graham and Bill Cassidy – are pushing very hard for one last vote.

Yesterday, September 13th, they introduced a bill, and we need to know what you want us to do.

Before we go any further, we know you want full repeal of ObamaCare. So do I, and so does every member of the Tea Party Patriots Support Team. Please know that our goal of full repeal will not change, not matter what you decide after reading the rest of this email.

The Graham-Cassidy bill is based on the successful welfare reform of the 1990s. Rather than repeal ObamaCare entirely – which is made impossible by the Senate GOP leadership’s unwillingness to challenge the ruling of the Senate parliamentarian that ObamaCare’s insurance company regulations cannot be repealed using the reconciliation process – the bill shifts as much control and money as possible out of Washington and to the states.

On the good side, the bill begins by repealing the individual mandate and the employer mandate. It would no longer be a requirement of the law that individuals who do not receive health insurance from their employer or from a government program of some kind go out and purchase their health insurance from an ObamaCare exchange or pay a tax penalty. And it would no longer be a requirement of the law that employers with more than 49 employees offer health insurance to their employees or pay a penalty. The removal of that legal requirement for employers would allow many small businesses to grow beyond their current size – they’ve been arbitrarily capped at 49 by employers who can’t afford to hire that 50th employee, because that would trip the employer mandate requirement.

In addition, the bill repeals the Medical Device Tax – a tax that encourages our most important medical innovators to move their research and development operations overseas. And repealing that tax would return between $250-$300 billion to the economy over ten years.

Further, the bill repeals all ObamaCare subsidies and spending. No more insurance company bailouts!

So the bill cuts taxes, cuts spending, and cuts the deficit. Those are all good.

Perhaps most importantly, the bill ends the federal entitlement to Medicaid, and equalizes the per-person spending in ObamaCare.

ObamaCare spending is tilted unfairly toward states that choose to have high Medicaid costs. Under ObamaCare’s current spending formula, for instance, Massachusetts, a state with just two percent of the nation’s population, receives seven percent of the total money spent. That’s twice as much as the next-highest state, California, which itself receives far more on a per-capita basis than all but Massachusetts.

In fact, ObamaCare’s spending formula is so lopsided toward high-cost states that just four states – Massachusetts, California, New York, and Maryland – with just 20 percent of the nation’s population receive 40 percent of the total ObamaCare funding.

The Graham-Cassidy bill addresses this inequity by repealing ObamaCare’s funding formula and instituting a formula that is much more equitable. When it is fully phased in in 2026, each state’s spending would be capped on a per-capita basis, with every state receiving exactly the same amount of money for each funding recipient. That means there would no longer be an advantage for states that want to offer high-cost Medicaid coverage to their populations – they would no longer be able to foist the cost off on federal taxpayers all over the country, but would have their spending limited instead.

With ObamaCare funding moving from Washington to the states, innovation would rule. States would be able to design their own healthcare systems, tailored to the needs of their individual populations. Some would experiment with expanded Health Savings Accounts, while others might try to implement a single-payer system. The states would once again be laboratories for healthcare innovation, and the nation as a whole would benefit from seeing what works and what doesn’t.

On the bad side, the bill does not fully repeal ObamaCare. It leaves in place most of the tax increases, and all of the insurance company regulations that have been driving premium prices through the roof. It does not explicitly repeal Congress’ illegal special exemption from ObamaCare.

And because it would allow states to design their own plans, that means that some states could even choose to implement single-payer systems – and Republicans who passed this plan would be, in some ways, responsible for that.

ObamaCare is failing. Perhaps we should simply let ObamaCare fail on its own. Some might see that as an immoral shirking of our responsibility to our fellow citizens, but others will insist that Republicans promised full repeal, and anything less than full repeal is unacceptable.

Keep in mind, opposing the bill because ObamaCare will ultimately collapse on its own may carry risks of its own – we could be blamed for its collapse for not doing what we could to save it. That would carry a political price.

Graham-Cassidy supporter former Senator Rick Santorum, who joined me earlier today for a Tea Party Patriots Facebook Live! session, reminded us that the left has succeeded in growing the size and scope of the federal government over the last 50 years by pushing as hard as they can for the whole loaf, but being willing to accept a single slice at a time when necessary. He even pointed to ObamaCare itself as an example of that dynamic – as he pointed out, no one on the left wanted ObamaCare, they all wanted a single-payer system. But they knew they couldn’t achieve it, because the country wasn’t ready for it. So, instead, they created ObamaCare, with massive government control over the private health insurance industry, for the express purpose of destroying the private health insurance industry – so they could later argue that they’d tried the private sector option, and it had failed, and it was time to move to single-payer, government-run healthcare.

And that’s exactly what they’ve done.

So now the time comes once again for you to tell us what you want from Tea Party Patriots.

Do you want Tea Party Patriots to support this plan as a step toward ObamaCare repeal? Do you want Tea Party Patriots to remain neutral on Graham-Cassidy? Or do you want Tea Party Patriots to oppose Graham-Cassidy outright?

If there is no majority for one of these three positions, then should Tea Party Patriots support the bill? Yes, or no?

Please vote to tell us what you want next.