Plan would give states more flexibility but faces hurdles with Senate

 

Sen. Lindsey Graham (R., SC), center, has proposed giving states more flexibility to craft their own health plans.
Sen. Lindsey Graham (R., SC), center, has proposed giving states more flexibility to craft their own health plans. PHOTO: CHIP SOMODEVILLA/GETTY IMAGES

 

Aug. 1, 2017 7:04 p.m. ET

WASHINGTON—The White House and some Republicans who want to keep up efforts to repeal the Affordable Care Act have seized on a proposal aimed at giving states significant flexibility, though Senate leaders are suggesting they won’t revisit the health-care issue in the near future.

The proposal, which Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.) unveiled when the GOP’s primary legislation to overhaul the 2010 health-care law was faltering, is designed to let states craft their own health systems to some degree.

It would repeal a requirement that most people purchase insurance or pay a penalty and a related mandate that most employers offer it. The plan would keep the ACA’s taxes except one on medical devices. But rather than using the money for premium subsidies and a Medicaid expansion, as the ACA does, it would be offered as block grants to states so they could address their health-care needs.

The White House has hosted multiple meetings on the proposal, including a session Monday with Mr. Cassidy, Health and Human Services Secretary Tom Price and four GOP governors.

But the plan faces long odds in the Senate, where Republican leaders have said repeatedly in recent days they have no plans to bring another health proposal to the floor anytime soon.

With the absence of Sen. John McCain (R., Ariz.), who is undergoing brain-cancer treatment, Republicans don’t have enough votes to reopen debate on health-care legislation, and Senate Majority Leader Mitch McConnell (R., Ky.) has indicated he is eager to move on to tax reform and other legislative goals.

Still, Mr. McConnell did suggest Tuesday he would submit the Graham-Cassidy plan, along with other proposals, to the Congressional Budget Office for an estimate of its impact on costs and coverage.

The proposal’s supporters say it avoids the pitfalls of previous bills by allowing states to craft health plans that fit their needs and political leanings.

“I believe that returning power to the states so that they can come up with their own tailored approach to solving their unique health-care problems is a workable solution,” said Sen. Dean Heller (R., Nev.), who has signed on to the plan.

But the idea has gotten a chilly reception from Democrats as well as conservative groups. Because it is intended to pass under special rules with a simple majority, the plan doesn’t touch the ACA’s insurance regulations, which require insurance companies to cover people with pre-existing conditions and offer a mandated set of 10 medical benefits.

“Any bill has to tackle the insurance regulations imposed by Obamacare,” said Dan Holler, a spokesman for Heritage Action. “Leaving the core regulatory architecture of Obamacare in place is unacceptable.”

When he first unveiled the idea, Mr. Graham said he believed it might appeal to Democrats because blue states could use the block-granted money to re-create state models of the ACA. But Democrats and other supporters of the health-care law say the plan is unworkable because it effectively ends the ACA’s subsidies and Medicaid expansion.

Appeared in the August 2, 2017, print edition as ‘A Bid to Keep Health Overhaul Going.’

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