Graham-Cassidy ACA repeal bill tabled: ‘We’re coming back to this’

Senate Republicans have decided not to vote on the Graham-Cassidy legislation to repeal the Affordable Care Act (ACA), putting an end to months of efforts to pass a repeal bill before a Sept. 30 deadline for it to clear the Senate with a simple majority.

The decision was made during a party lunch on Sept. 26, with leaders deciding not to push forward with a vote after Sens. Susan Collins, R-Maine, John McCain, R-Arizona, Rand Paul, R-Kentucky and Ted Cruz, R-Texas, had already come out against it—enough to ensure it wouldn’t pass.

“We don’t have the votes,” said one of the legislation’s namesakes, Sen. Bill Cassidy, MD, R-Louisiana, told reporters at the Capitol.

The legislation would have turned the ACA’s funding for premium support and Medicaid expansion into block grants administered by states, with funding generally being redistributed from expansion states to states which opted not to expand Medicaid eligibility. The proposal was strongly opposed by healthcare organizations, citing the estimated reductions in insurance coverage if it became law. The industry would also lose an estimated 267,000 jobs.

The sponsors continued to defend the merits of the bill after it was decided not to hold a vote, arguing it would offered greater flexibility for states. The problem, according to Sen. Lindsey Graham, R-South Carolina, was with how quickly the bill had to be pushed through the Senate to meet the deadline for passing it under budget reconciliation rules.

The next fiscal year could provide another vehicle for reconciliation—allowing Republicans to repeal and replace the ACA with no Democratic support—but Graham said for now, the party is moving onto other legislative priorities, namely tax reform, but promised Republicans are “going to come back to this after taxes.”

As for turning back to talks involving both parties on short-term fixes for the individual market, Cassidy said he’s open to those discussions. Graham didn’t say the same, instead criticizing Democratic support for Sen. Bernie Sanders’s, I-Vermont, single-payer proposal.

“This is going to collapse,” he said. “They’re going to try to have more government. We’re going to take a collapsing Obamacare system, take the same amount of money and put it in the hands of people that are closer to you,” adding that he’s confident the Graham-Cassidy bill will be considered again during this Congress.

Senate Minority Leader Chuck Schumer, D-New York, said talks should shift quickly back to discussions in the Senate health committee on short-term stabilization efforts for the ACA markets, which had been tabled as Graham-Cassidy began gaining momentum. The ranking Democrat on that committee, Sen. Patty Murray of Washington, indicated she’s eager to restart those talks, but it might be too late, as insurers will have to finalize contracts to offer plans on the federal exchange on Sept. 27.

“We need to pick up right where we left off and we need to do it right now,” Murray said.