Republican Health Care Is Now Very Deep Down a Rabbit Hole

Alex Edelman via ZUMA

Mitch McConnell is circulating another health care bill today, and it’s like a game of whack-a-mole. The original bill would de-insure millions of people, so the new one puts a bunch of patches in place. But those patches cause obvious problems, so there are patches for the patches. It’s a purely political exercise in vote-getting that has no connection to actual health care. Good luck to the CBO trying to score this Rube Goldberg contraption.

Meanwhile, we now have another health care bill, this one from Bill Cassidy and Lindsey Graham:

The Senate GOP’s push to rewrite the Affordable Care Act suffered an ill-timed setback Thursday, as two centrist Republicans announced plans to offer their own health-care plan just as leaders released an updated bill of their own….In a joint interview with CNN on Thursday, Cassidy and Graham said that they would take the billions of dollars the federal government now receives in taxes under the ACA and direct that revenue to the states.

….“Our problem has been trying to combine tax reform with replacement of Obamacare,” Cassidy said. “We’re giving the money back to the states. The states can do what they want to do. A blue state can do a blue thing; a red state can do a red thing.”

Um, what? Just hand big pots of money to the states and tell them to paint the town red? Apparently so. Here are the details from Graham’s website:

  1. Federal dollars currently spent on Obamacare health insurance — an estimated $110 billion in 2016 — would be block-granted to the states.
  2. The individual mandate and employer mandate instituted under Obamacare would be repealed under Senate reconciliation rules which only require 50 votes.
  3. The Obamacare requirements covering pre-existing conditions would be retained.
  4. The Obamacare medical device tax would be eliminated but other Obamacare taxes would remain in place.
  5. Federal Medicaid funding to the states will continue to grow in a sustainable manner, adjusted for inflation….
  6. Federal funds would be restricted to health care spending only. These funds could be distributed by the states in the forms of tax credits, subsidies, health savings account premiums, and other means as the individual states see fit to meet their health care needs.

This should go over well with the insurance industry. They will be required to insure everyone at the same price, but they have no idea what rules will be in place to ensure against a death spiral. That’s genius.

By the way, there are lots of other Obamacare rules and regulations that can’t be repealed without 60 votes, so you have to account for how that’s going to play out too. CBO is really going to tear its hair out over this brainstorm from Graham and Cassidy.

For a party that prides itself on paying attention to economics, unlike those spendthrift Democrats who think the law of supply and demand is just a suggestion, Republicans sure don’t want to pay attention to basic health economics. This stuff isn’t rocket science, either. Sure, the details are tricky, but the basics are pretty easy to follow. As near as I can tell, though, Republicans just don’t want to follow them. Why? I suppose because Obamacare mostly does follow them, so that makes them bad. Or something.


Mother Jones was founded as a nonprofit in 1976 because we knew corporations and the wealthy wouldn't fund the type of hard-hitting journalism we set out to do.

Today, reader support makes up about two-thirds of our budget, allows us to dig deep on stories that matter, and lets us keep our reporting free for everyone. If you value what you get from Mother Jones, please join us with a tax-deductible donation today so we can keep on doing the type of journalism 2019 demands.

We Recommend


Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.


Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.


We have a new comment system! We are now using Coral, from Vox Media, for comments on all new articles. We'd love your feedback.