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Friday, July 28, 2017

Louisiana senators support failed attempt to repeal ACA: what's next

Posted By on Fri, Jul 28, 2017 at 12:00 PM

click to enlarge Bill Cassidy. - PHOTO BY GAGE SKIDMORE/CREATIVE COMMONS
  • PHOTO BY GAGE SKIDMORE/CREATIVE COMMONS
  • Bill Cassidy.

Louisiana Sens. Bill Cassidy and John Neely Kennedy supported the Senate's latest attempts to gut the Affordable Care Act, including a late-night vote on a so-called "skinny" repeal, amid Republicans' failed efforts to dismantle the health care plan.

In its latest vote held early Friday morning (on the week of the 52nd anniversary of the passage of Medicaid), the Senate failed to pass a "skinny" repeal measure that the Congressional Budget Office estimated would increase the number of uninsured people in the U.S. by 15 million in 2018. Premiums for people buying their own insurance would likely rise by 20 percent.

The "skinny" repeal plan — an eight-page bill dubbed the Health Care Freedom Act, unveiled just hours before senators voted on it — would strike the individual mandate from the ACA, roll back requirements for employers to offer insurance to employees, cut funding to Planned Parenthood and increase funding to community health centers, and cut funds to numerous public health programs earmarked by the ACA.

Voting against the measure were all 48 Senate Democrats and three Republicans — Susan Collins, Lisa Murkowski, and John McCain, who on July 25 had voted to put the bills up for debate and then railed against partisan drafting processes on the Senate floor. In a statement following last night's vote, McCain said Congress should "return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable health care for the American people."

Senate Majority Leader Mitch McConnell called the Senate's failure a "disappointing moment."
Cassidy told Politico he believed McCain "was a 'yes' and had been told he was a 'yes'" when Cassidy arrived on the floor. "So when I came down and there were issues, I still — for whatever reason — thought they might be resolved," Cassidy said. "And then they were not.”

In the weeks leading up to the votes, Cassidy didn't explicitly announce support for ACA repeal efforts and rallied for support around his alternative plan and amendments with fellow GOP Sen. Lindsey Graham. Meanwhile, Cassidy's vote was the target of several demonstrations at his Metairie office — where three people were arrested for sitting in his lobby in protest — and in town halls and on endless phone calls where residents pressed him to vote against the repeal. But Cassidy (and Kennedy) ultimately supported putting the repeal attempts up for a vote.

In a statement earlier this week after his support for the debate, Cassidy   aid “nothing changes until the first step is taken."

"There will be many others," he said. "But we must replace Obamacare with something which fulfils President Trump’s campaign pledges to maintain coverage, protect those with preexisting conditions, and lower premiums without mandates. Power needs to be returned to the patients and states."
Kennedy, meanwhile, remained steadfast in his support for repealing the ACA. In his statement supporting moving forward with a vote, Kennedy called it a "a dismal failure."

"I made a promise to the people of Louisiana that I would repeal Obamacare given the chance," he said. "I look forward to continuing to work with my colleagues on both sides of the aisle to deliver a health care system to the American people that looks like it was designed on purpose.”

After last night's blow to President Donald Trump's administration, Trump wrote on Twitter that Senators voting against the measure "let the American people down."

"As I said from the beginning, let ObamaCare implode, then deal. Watch!" he said.

Louisiana braced for potentially devastating impacts to a repeal, which would drain Medicaid in a state that has signed up more than 433,000 people following its expansion under the ACA in 2016, according to the state's Department of Health. According to the Urban Institute, more than 752,000 people in Louisiana would lose insurance under a version of the Senate plan by 2022. The Century Foundation estimates the "skinny" repeal would drop coverage for more than 216,000 people by 2018.

Under the state's Medicaid expansion over the last year, more than 100,000 people received preventive care, more than 15,000 people received breast cancer screenings (from which 154 people were diagnosed with breast cancer), more than 10,000 people received colon cancer screenings (from which more than 3,000 people had polyps removed), and more than 25,000 people received mental health services.

In a statement, the Louisiana Budget Project said it's "relieved that the Senate rejected this ultra-partisan legislation that would have raised premiums on the middle class and jeopardized the health care that Louisianans depend on. Our senators should read this as a mandate to strengthen the Affordable Care Act in an open, bipartisan process that includes an opportunity for all lawmakers, stakeholders and everyday citizens to participate."

This week, Louisiana Gov. John Bel Edwards joined a bipartisan group of governors across the U.S. urging Congress to heed McCain's advice and "set aside this flawed bill and work with governors, both Democrats and Republicans, on solutions that will make health care more available and affordable for every American."

In his remarks on the Senate floor, a defeated McConnell asked Democrats for their ideas to address a complicated health care system and the unstable insurance market. "We look forward to our colleagues on the other side suggesting what they have in mind," he said.

Those ideas McConnell facetiously admitted may include moving toward a single-payer health care system — an idea supported by a growing number of Americans, a majority of which also agree that the government is responsible for insuring, according to Pew. Republican Sen. Steve Daines ironically offered up a single-payer amendment during the repeal debates, which single-payer advocate Sen. Bernie Sanders called a "political trick ... to embarrass Democrats" as Republicans struggled to gain enough support for a host of amendments.

Single-payer is supported by more than half of Democrats. Gov. Edwards, however, says he doesn't support it "right now."

Congress could begin drafting another round of bills or a repeal, though they will face the same issues and opposition without addressing bipartisanship and an unstable insurance market — and they'd have to act fast. The U.S. Department of Health and Human Services also could intervene.

Cassidy says Trump is the wild card.

“The wildcard is what the president does,” he told The Hill. “Obviously the president, through executive action, can make things ever more difficult. And that’s a possibility.”

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