FYI: Graham-Cassidy is worse than anything we've seen

Friday afternoon, Senate Democratic Leader Chuck Schumer sent a warning on Twitter that the tens of thousands of Americans who could die if Trumpcare becomes law are not out of the woods yet.

The bill Schumer refers to is a proposal by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA), which couples steep cuts to federal health care spending with an overhaul of much of the nation’s health care system. According to an analysis shared by Andy Slavitt, who ran the Centers for Medicare and Medicaid Services under President Obama, an estimated 32 million people could lose health coverage by the end of the decade if Graham-Cassidy becomes law.

At the core of Graham-Cassidy are provisions that repeal Obamacare tax credits for middle-income individuals, certain other subsidies for lower-income Americans, and the law’s Medicaid expansion. It replaces all of these provisions with a block grant that is smaller than the total amount of the money it takes away. The block grant then expires in 2027, causing health care spending to fall off a cliff.


Additionally, the bill allows states receiving these block grants to waive certain federal laws that protect health insurance consumers — primarily laws which were enacted during the Obama administration. One of those provisions allows for an especially sweeping waiver, requiring the Secretary of Health and Human Services to waive:

Any provision that prevents a health insurance issuer offering a coverage plan in the individual or small group market from requiring an individual to pay a premium or contribution (as a condition of enrollment or continued enrollment under the plan) which is greater than such premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health status-related factor in relation to the individual or to an individual enrolled under the plan as a dependent of the individual.

To translate this a bit, currently the Affordable Care Act forbids insurers from discriminating against sick patients by denying them coverage or charging them higher premiums. Graham-Cassidy, however, wouldn’t simply allow waivers of Obamacare’s protections for people with preexisting conditions. It would also permit insurers to charge higher premiums to people who are currently insured through the Obamacare exchanges as a condition of “continued enrollment.”

In essence, an insurer could take someone’s money for years while that individual is healthy. Then, on the day that that person is diagnosed with cancer, jack up their premiums so high that they are no longer affordable. Healthy people would have insurance until the moment they need it, at which point their premiums could become prohibitively expensive.

Health “insurance” under Graham-Cassidy, in other words, would no longer provide any real insurance whatsoever.