By Joel T. Vernile and Adrienne St. Clair
WASHINGTON – Arizona Sen. John McCain, a key vote in the failure of the last Obamacare repeal attempt, refused to say Tuesday how he will vote on a new GOP plan, which is being supported by his fellow Republicans, Gov. Doug Ducey and Sen. Jeff Flake.
The bill would strip out many provisions of the Affordable Care Act, including mandates for individuals to buy insurance, subsidies for low-income patients and a guarantee of coverage despite any pre-existing conditions. It would also reallocate Medicaid funds to states to use as a block grant.
Supporters, including Flake and Ducey, say the bill would return decision-making power to the states, with Ducey calling it “the best path forward” to replace the Affordable Care Act.
But critics say the bill would cause as many as 32 million to lose health insurance and would result in the loss of $299 billion in federal funding to states by 2027 – Arizona alone would face the loss of $6.9 billion, according to an estimate released Tuesday by the Center on Budget and Policy Priorities.
Democratic leaders railed Tuesday against the “evil bill,” which they said was worse than the GOP attempt that failed in late July.
The new bill was introduced last week by a group of Republican senators, including Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, for whom it is named. Senate leaders are expected to push for a vote on the Graham-Cassidy bill next week, to beat a Sept. 30 deadline before which it will only need 51 votes to pass under current Senate rules.
But that is the kind of rush that led McCain to vote against the last health care repeal bill, which was produced behind closed doors by Senate leadership and brought to the floor without committee hearings.
When asked Tuesday if he thought the new effort followed the Senate’s “regular order,” McCain shot back that regular order should include “hearings and debates and amendments and then to the floor with debates and discussion and amendments.”
“Do you think that that’s regular order?” McCain asked of the shortened timeline for Graham-Cassidy.
The Congressional Budget Office is not expected to provide even a “preliminary assessment” until early next week, when the bill is likely to have a hearing.
McCain did not rule out a vote for the bill, however, telling reporters he wants “enough assurance that the bill would help my state of Arizona and would be good for the country.”
But Ducey is ready for the Senate to act.
“Congress has 12 days to say, ‘Yes,’ to Graham-Cassidy. It’s time for them to get the job done,” Ducey said in a statement released by his office Monday.
Flake – who voted for the last repeal bill – said he will likely do the same now.
“Given the choice between Arizona or Washington deciding how federal health care dollars are spent in the state, I’ll take Arizona every day of the week,” he said in a statement Tuesday.
Flake said Graham-Cassidy “puts that decision-making power back in the hands of the states,” and will take care of those with pre-existing conditions.
But the Center on Budget and Policy Priorities said in a conference call Tuesday that the bill could strip protections for people with pre-existing medical conditions. Center spokeswoman Shannon Spillane said the co-sponsors are using “misguiding numbers” to sell their bill.
“Every state loses under this bill,” Spillane said. “There are no winners.”
The bill would take funding currently directed toward Medicaid expansion in states and convert it to a block grant beginning in 2020. The grants will not reflect states’ current spending, which will have the effect of penalizing states – like Arizona – that expanded their Medicaid programs under the ACA, said Edwin Park, the center’s vice president of health policy.
The block grants would end in 2026, leaving states to find funding – or cut services.
“It’s incredibly unrealistic to have these things up and running by 2020,” Park said.
Arizona Rep. Tom O’Halleran, D-Sedona, called the bill “dangerous” in a statement Tuesday. He urged the Senate “to work with the House to implement our policy proposals that stabilize the health insurance market, bring down costs, and reinforce patient protections.”
Those sentiments were echoed – passionately – by a crowd of about 100 protesters outside the Capitol Tuesday, some carrying pink Planned Parenthood signs or homemade posters calling GOP members sadists and pleading for them to “do the right thing.”
A steady stream of Democratic senators urged the crowd to speak out against the bill.
Several senators encouraged the crowd to flood their own elected officials’ inboxes and phone lines, with Sen. Cory Booker, D-New Jersey, saying “the power of the people is greater than the people in power” and Sen. Ron Wyden, D-Oregon, calling for “people power.”
Democrats vowed to present a united front, as they did when all 48 voted against the last bill. If the Democrats hold firm, Republicans can only afford to lose two of their own senators for the bill to succeed.
Senate Minority Leader Chuck Schumer of New York encouraged the crowd to stay strong, even though, he said, it may be easy to become complacent.
“It is easy to say, ‘Oh boy, we went through this once, why do we have to go through it again?’” Schumer said. The reason, he said, is the “30 million Americans who will lose health care if this evil bill passes!”
As the crowd chanted “health care is a human right” and other slogans, Sen. Bernie Sanders, I-Vermont, called healthcare a “profound moral issue.” Other speakers worried about the groups they claim will be hardest hit by the bill, like women, the disabled, seniors, the poor and veterans.
Booker, who called the new bill “Nightmare on Capitol Hill Part Five,” noted that senators were able to work across party lines this week to pass the National Defense Authorization Act and said that if the United States can have the world’s best military, “we should have the world’s best health care.”
Schumer ended his remarks by raising his fist in the air and shouting, “On to victory!”