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Despite their failure in July, Trump, many Republicans in Congress, GOP mega- donors and a hysterical hard-right base still want to repeal the Affordable Care Act (ACA). Leading the charge – Wisconsin Republicans House Speaker Paul Ryan, Senator Ron Johnson and Governor Scott Walker.

Ryan told Senate GOP leaders that he opposed a promising bipartisan plan to fund ACA cost-sharing reduction payments (out-of-pocket costs) and other steps to strengthen the ACA. He stomped his feet for repeal. Similarly, Johnson rejected bipartisan cooperation. Instead, he is hyping Graham-Cassidy-Heller-Johnson (GCHJ) to eviscerate the ACA. And, Walker told the alt-right Breitbart News that he played a big role in GCHJ. Walker said: “I think it’s awesome”. Moreover, he touted potential bipartisan support. Didn’t happen. However, eight GOP governors oppose GCHJ. Why?

Nevada GOP Governor Brian Sandoval denounced GCHJ: “Flexibility with reduced funding is a false choice. I will not pit seniors, children, families, the mentally ill, the critically ill, hospitals, care providers, or any other Nevadan against each other because of cuts to Nevada’s healthcare delivery system proposed by the Graham-Cassidy amendment”. He is not alone.

Conservative Washington Post blogger Jennifer Rubin opined: GOP leaders want “big cuts to Medicaid that will help pay for tax cuts for the rich and for corporations …. Whatever the motive, it is the worst sort of legislation – thoughtless, partisan, cynical and injurious to the most vulnerable in our society”. There’s more.

GCHJ would end Medicaid expansion, while capping Medicaid spending, eliminate federal-state marketplaces, end federal tax credits and cost-sharing reductions to pay for private insurance, allow states to waive coverage of essential health benefits and “jack up prices on sick people” (Washington Post). In a nutshell the ACA would become a block grant program, leading to millions more uninsured. Over 30 states would lose hundreds of billions by 2027, while all states would see cuts of $4 trillion by 2036 (Avalere Health). Note: the block grants end after 2026! Wisconsin, like some other states that did not expand Medicaid, would get a short-lived deal (gain), but by 2036 would see steep cuts — $29 billion (Avalere Health).

There is another way. On Friday, Arizona GOP Senator John McCain, who earlier opposed ACA repeal, stepped up again: “I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will effect insurance premiums, and how many people will be helped or hurt by it. Without a full CBO (Congressional Budget Office) score, … we won’t have reliable answers to any of those questions”.

McCain hopes that the bipartisan work in the Senate on funding cost-sharing reductions and strengthening the ACA will resume. Wisconsin Democratic Senator Tammy Baldwin agrees: “We should make things better by getting the job done on bipartisan solutions that stabilize and strengthen the health care marketplace, lower costs, make health care more affordable, and expand coverage”. Amen!

— Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 – 2009.


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