ObamaCare’s Last Stand


This week Republicans get their last chance to replace ObamaCare. If they fail now the country can count on more ObamaCare – at higher prices – or single-payer healthcare – which is even worse.

Senate Republicans Bill Cassidy and Lindsey Graham have introduced a bill referred to as Graham- Cassidy, which tries one last time to get 51 votes in the Senate to undue the damage of ObamaCare. They have until September 30th to pass it under the Senate rules of reconciliation or wait until 2018. (I explained this new bill in an earlier post called Another ObamaCare Replacment Plan.)

The main advantage to this bill over previous bills is block grants. The states will be given federal dollars, which they can then use to provide healthcare to their residents in new and creative ways they choose. Liberal states like California may choose single-payer healthcare and eliminate all choice of other systems. Conservative states like Indiana may choose a free-market system that incentivizes health savings accounts and lower-cost consumer-driven insurance products tailored to the specific needs of individuals. Others may retain ObamaCare.

At this writing the success or failure of the bill is riding on the votes of four Republican senators. All of the Democrats oppose the bill because they oppose any changes to ObamaCare – except if it is replaced by a single-payer system. The four crucial senators are Lisa Murkowski (AK), Susan Collins (ME), John McCain (AZ) and Rand Paul (KY).

Senator Paul has openly refused to vote for the bill, even though he did vote for the so-called “skinny repeal” bill that preceded this one. His current opposition defies understanding since a “no” vote may ensure the continuation of ObamaCare – which he opposes. Senator Collins usually finds a way to vote against Republican bills she calls “disappointing.” Her opposition will probably come from the bill’s defunding of Planned Parenthood, although the same money will be sent to community health centers to treat women not requesting abortions. The other two are riding the fence as I write these words.

Kimberley Strassel, columnist for The Wall Street Journal, believes Senator McCain will ultimately support the bill since the governor of Arizona is a supporter and the bill’s sponsor, Senator Graham, is his best friend in the Senate. That leaves the fate of the bill up to Alaska Senator Lisa Murkowski.

Strassel says the decision ought to be an easy one for Murkowski. No state has suffered higher premiums than Alaska, which has seen increases over 200% and now leads the nation. Only one insurer is left to choose on the exchanges. Doctors are overwhelmed with the new Medicaid enrollees.

Furthermore, Strassel points out that Alaska benefits greatly from federal largess that supports its small population. Alaska gets more dollars per capita than any other state. It receives billions in annual federal grants and billions more in defense spending. Federal dollars support an estimated one-third of all the jobs and household income in the state. A “no” vote on healthcare could dry up this support.

Lanhee J. Chen, writing in The Wall Street Journal, discusses the objections of opponents. He says their misguided complaints are these:

  • Insurers may discriminate against sick patients. The bill still requires states to provide coverage for those with pre-existing conditions, despite false accusations from liberal celebrities like Jimmy Kimmel. These protections of ObamaCare will remain.
  • Caps on Medicaid spending. The status quo of Medicaid spending is unsustainable. That’s the hard truth liberals won’t face. ObamaCare greatly expanded the initial intent of Medicaid to cover only poor women and children and the disabled, expanding coverage to able-bodied adults. This must be curtailed or those who truly need the program won’t get the care they need.
  • Lower block grant funding in some states. The current Medicaid funding disproportionately benefits the rich states at the expense of the poor states. This is especially true in those states that expanded Medicaid under ObamaCare. This bill is intended to create funding parity, regardless of Medicaid expansion. Naturally some states will complain but those states have been milking the system and that must end.


There is plenty of room for complaining about this legislation for the purists that want everything (like Rand Paul). But reality forces us to consider the alternatives. If this bill goes down in flames like the last one, the country will be forced to endure more ObamaCare at even higher prices than last year. Many individuals will have no insurance choices on the ObamaCare exchanges as insurers bail out of the market.

The alternative is the single-payer system that Democrats want. If that’s what you want you can move to Canada. But if that was the solution then why are so many Canadians coming here for their healthcare?

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