September 20, 2017

Senate Republicans Must Choose between a Bipartisan Path Forward or Continuing Unpopular Repeal and Replace Efforts

The Senate has only a few working days to decide what it is going to prioritize. It can focus on renewing the Children’s Health Insurance Program (CHIP) and stabilizing individual health insurance markets to protect people from rising premiums –both of which are popular ideas and have broad bipartisan support. Or it can attempt another Republican-only effort to slash Medicaid and eliminate protections for people who need health insurance. Time is running out. The senate cannot do both, so they must choose.

Path One:  Both Parties Work Together to Continue the Children’s Health Insurance Program and Stabilize the Individual Insurance Marketplace

The Senate Health Committee held bipartisan hearings and listened to experts from both sides of the aisle. Expert witnesses stressed the importance of shoring up the individual insurance markets for people who get their health coverage through the Affordable Care Act. Their testimony was clear: keep the government’s promise to fund the cost-sharing reduction payments, help states reduce the cost of their sickest participants, and make it easier for states to innovate, while still maintaining consumer protections.

The Senate Finance Committee held a hearing on the importance of renewing support for the Children’s Health Insurance Program (CHIP), which in partnership with Medicaid provides affordable health coverage for nearly 500,000 Wisconsin kids and 9 million nationwide. Funding for the program expires after September 30 this year. Senators heard from experts who explained how important this program is for children’s and families’ health and well-being. Last week the Finance Committee announced that it had an agreement to renew funding to continue providing health insurance for kids.

Path Two:  Continue the Unpopular, Republican-only Revival to Repeal and Replace the Affordable Care Act

The other choice is the highly partisan Graham-Cassidy bill to repeal and replace the Affordable Care Act. The bill makes deep cuts to our health safety-net, destabilizes the individual insurance market, threatens the rights of people with preexisting conditions, and allows states to stop covering services like mental health, prescription drugs, and substance use treatment. While this bill is being messaged as a compromise, that is not the case.

The Graham-Cassidy bill is bad for Wisconsin kids and families. It proposes massive cuts to Medicaid that have been rejected again and again. It restructures Medicaid into a per capita cap program, which will not grow with the rising cost of health care or respond in times of crisis. It will raise the cost of health insurance and take coverage away from those who can least afford it. It would result in millions of kids, low-income families, people with disabilities, and seniors with no access to affordable health care.

Graham-Cassidy eliminates the tax credits and other financial assistance that help many middle and working class families afford and use health insurance. It also removes funding for states that expanded Medicaid. The bill consolidates those funds and, after a substantial cut, creates a block grant, which allows states to spend that money with very few restrictions or patient protections. The plan, which like previous versions was developed behind closed doors, without input from health care experts, does nothing to lower health costs or improve the Affordable Care Act.

Here’s the kicker though, the Graham-Cassidy proposal eliminates all of that funding by the end of 2026, leaving Wisconsin holding the bag for whatever health care program it’s administering.  By 2027 the country will face a nearly $300 billion cut in health spending in that year alone, and the cuts will only worsen over time.


In addition to devastating cuts to Medicaid and eliminating nearly all popular parts of the Affordable Care Act, Graham-Cassidy is derailing important, bipartisan efforts to renew funding for the Children’s Health Insurance Program (CHIP) and threatens the viability of Republican and Democratic senators’ efforts to stabilize the individual insurance market. The Senate has until the end of September to renew CHIP and even less time to stabilize the individual insurance market. Funding for CHIP expires after September 30, and insurers have until September 27 to decide if they are going to participate in the individual insurance market under the ACA.

The Senate has to choose between these two separate paths. It can either continue its unpopular, partisan, misguided attempt to the repeal the ACA and cut Medicaid OR it can build upon its recent bipartisan efforts to strengthen health care access for kids and families.

There is no time to do both, so the Senate must decide on which path it is going to travel. People from both parties need to see that Republicans and Democrats can set aside some of their differences and work together to improve our health care system.

William Parke-Sutherland