Yesterday, Senators Graham (R-SC), Cassidy (R-LA), Heller (R-NV), and Johnson (R-WI) released legislative language of their bill that would repeal and replace the Affordable Care Act. This is part of an effort to revive the ACA repeal process using reconciliation, which would enable the Senate to pass a bill with only 50 votes instead of the normal 60-vote threshold. This process is tied to the Federal Fiscal Year and therefore requires any legislation to be passed in both the House and the Senate by the end of the month. We note that several key members of Senate leadership have expressed skepticism regarding the prospects for passage. For example, Senate Majority Whip Cornyn (R-TX), who is responsible for securing votes to pass legislation, stated last week that he did not believe that the bill would come up for a floor vote.
Despite the challenging prospects for passing the legislation, it is receiving increased attention in the media as well as in Congress. There is also a slight possibility that the bill could be enacted, given that Congress can sometimes move more quickly than expected. Therefore, we believe it is worth understanding the provisions within the legislation. Towards that end, we read the bill text and have written a detailed analysis of the policies contained within, with an emphasis on Medicaid and LTSS implications.
Please note that, although most of the discussion about the bill focuses on its creation of a block-grant for states that replaces the ACA premium credits, cost-sharing subsidies, and Medicaid expansion, the bill has a number of significant and important changes to the underlying Medicaid program as well. The Medicaid components of the legislation are very similar to prior versions of ACA repeal that were passed by the House and debated in the Senate.
Click here to read NASUAD's analysis of the Graham-Cassidy ACA Repeal Proposal.