Graham not giving up on health care overhaul

Sen. John McCain, R-Ariz., leaves a meeting of Senate Republicans on Tuesday in Washington. His decision to oppose the GOP's latest effort to repeal Obamacare means the bill is likely dead.

Jacquelyn Martin, AP

The latest attempt by Republican lawmakers to overhaul American health care received a mixed reaction from Wyoming’s governor and other officials, though it appears to be a moot discussion as opposition from a few Republican senators has almost certainly doomed the bill.

Sen. John McCain — who ultimately killed the last Republican health care bill in July — announced Friday that he would not support this measure, known as the Graham-Cassidy bill.

Meanwhile, Gov. Matt Mead said Friday that he supported the bill’s concept of returning autonomy to the states but was wary about the lack of details available. Sen. John Barrasso praised the measure for the same reason Mead expressed interest. Sen. Mike Enzi’s spokesman said the politician hadn’t taken a position, and a Wyoming Hospital Association official said his organization had taken a neutral stance on the bill, a marked change from the group’s staunch opposition to previous measures.

“I certainly like the concept of states having more say, but if its going to not cover those that need to be covered, if it’s limited in time, I’m not sure,” Mead said, referring to a crucial Sept. 30 deadline that Republican leadership needed to meet if it wanted to avoid an inevitable Democratic filibuster.

Rep. Liz Cheney, who supported the House’s successful effort to pass a repeal bill that later died in the Senate, did not return a request for comment. A spokeswoman for Michele Chulick, the CEO of the Wyoming Medical Center, declined to comment. The hospital’s recently retired CEO, Vickie Diamond, had been a strong critic of past efforts.

Details questioned

In his statement, McCain criticized the lack of information available about the bill. As Senate leadership hurried to pass the bill before a Sept. 30 deadline, the Congressional Budget Office was unable to provide a score on the measure, which left the exact, official implications of the bill unclear.

“I cannot in good conscience vote for the Graham-Cassidy proposal,” McCain said in a statement. His opposition likely leaves the bill at least one vote short of the support needed for passage, given opposition from Sen. Rand Paul of Kentucky and strong hesitancy from Sens. Susan Collins of Maine and Lisa Murkowski of Maine.

Mead reiterated that he liked the idea the bill put forward but that lack of Congressional Budget Office evaluation left him unsure on the details and the effects on Wyoming.

Max D’Onofrio, a spokesman for Enzi, said that even if the bill failed, it would not mean the end of the Republican Party’s plans to repeal the Affordable Care Act. Enzi had not taken a position on Graham-Cassidy as of Friday afternoon and was still reviewing the measure.

“Senator Enzi strongly believes that Congress still has a responsibility to provide relief to Americans who are suffering under the failures of Obamacare,” D’Onofrio said.

“No matter what happens with this legislation, this will not be the end to health care discussion,” he added. “Obamacare caused massive upheaval to our health care system and it could take a long time to right the ship.”

Barrasso — a vocal critic of Obamacare who, with Enzi, helped draft previous Senate legislation that would have rolled it back — praised Graham-Cassidy and said it provided states with the ability to institute their own health care systems.

But McCain criticized the bill’s partisan nature and the lack of information available about what it costs.

“I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” McCain said. “Nor could I support it without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it.”

Mead said he thinks the path forward is a bipartisan effort that would find a solution to health care.

Eric Boley, the president of the hospital association, said it was a shame that senators from the two parties couldn’t come together to find a bipartisan solution to health care.

He said he didn’t have a position on Graham-Cassidy and that he was still trying to analyze what it would mean. But, he said, it could bring millions of Medicaid dollars to the state, which did not expand the program and currently faces a significant Medicaid shortfall.

Uncertain impact

The exact impact on that front is difficult to decipher: A study by the Kaiser Family Foundation suggested Wyoming would actually lose millions of dollars from the changes the bill would bring to Medicaid. But Boley said he didn’t put much stock in that examination because it went against everything he had heard.

He said he favored another study, conducted by Manatt Health, that found Wyoming would receive hundreds of millions more.

Mead said his office’s evaluation suggested Wyoming would receive more Medicaid money, but added that he, too, had seen different studies that arrived at opposite conclusions.

The bill would get rid of unpopular mandates for people to carry insurance or face penalties. It would repeal the financing for Obama’s health insurance expansion and create a big pot of money that states could tap to set up their own programs, with less federal oversight. It would also limit spending for Medicaid, the federal-state program that now covers more than 70 million low-income people. Insurance rules that protect people with pre-existing conditions could be loosened through state waivers.

Essentially, it would repeal major pillars of former President Barack Obama’s law, replacing them with block grants to states to design their own programs. Major medical groups are opposed, saying millions would lose insurance coverage and protections, and a bipartisan group of governors also has announced opposition.

Whether the state receives more or less has far-reaching and vital implications. Not only could such an increase offset a potentially $30 million deficit in the Medicaid system here, but it could help residents of long-term facilities, roughly 70 percent of whom receive Medicaid.

The measure would also allow states to waive a provision that prevents insurers from charging older Americans and people with pre-existing conditions more than younger, healthier customers. The AARP strongly criticized the bill’s “age tax,” and Sam Shumway, who runs the AARP in Wyoming, said it could have dire effects on the state’s aging population.

Boley said that in addition to offsetting the deficit, the bill could help smaller, rural facilities stay afloat. With past Obamacare repeal efforts, he said they had the potential to push those hospitals out of business and would reduce funding to the state.

But, he added later, the bill is likely dead. Mead agreed.

President Donald Trump and Senate Majority Leader Mitch McConnell have both been pushing hard for the bill in recent days, and McCain’s best friend in the Senate, Graham, was an author. Trump declared during the presidential campaign that he would quickly demolish Obamacare and “it will be easy.”

GOP leaders had hoped to bring the legislation to the floor next week. They face a Sept. 30 deadline, at which point special rules that prevent a Democratic filibuster will expire.

Despite past failures and the tight timeline, Republican congressional leaders, goaded by GOP voters and the president himself, were determined to give it one last try. Trump spent much of August needling McConnell for his failure to pass a repeal bill, and Republican lawmakers back home during Congress’ summer recess heard repeatedly from voters angered that after seven years of promises to get rid of “Obamacare,” the party had not delivered.

The House passed its own repeal bill back in May, prompting Trump to convene a Rose Garden celebration, which soon began to look premature.

The Associated Press contributed to this report.

Follow education reporter Seth Klamann on Twitter @SethKlamann

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Education and Health Reporter

Seth Klamann joined the Star-Tribune in 2016 and covers education and health. A 2015 graduate of the University of Missouri and proud Kansas City native, Seth worked for newspapers in Milwaukee and Omaha before coming to Casper.

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