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One last last chance: GOP strains for Obamacare repeal votes

Sen. Bill Cassidy, R-La., left, and Sen. Lindsey Graham, R-S.C., right, talk July 13 while walking to a meeting on Capitol Hill in Washington. Senate Republicans are planning a final, uphill push to erase President Barack Obama’s health care law. But Democrats and their allies are going all-out to stop the drive. The initial Republican effort crashed in July in the GOP-run Senate. Majority Leader Mitch McConnell said after that defeat that he’d not revisit the issue without the votes to succeed. Graham and Cassidy are leading the new GOP charge and they’d transform much of Obama’s law into block grants and let states decide how to spend the money.

The AARP sent a letter to every U.S. senator Tuesday warning of the negative effects that could be brought on by Republicans’ latest attempt to repeal the Affordable Care Act, a proposal that a local official said could be “devastating” to older Americans.

Earlier this month, Republican Sens. Lindsey Graham and Bill Cassidy proposed a measure to repeal the ACA, rolling back several of its features and restoring a vast amount of health care policy power to states. Among other things, the bill would repeal the requirement that Americans have insurance, allow states to waive essential health benefits and would provide states Medicaid funding in the form of block grants.

It would also allow states to waive an ACA rule that prevents insurance companies from charging senior citizens more than three times what’s assessed to younger people.

The AARP decried the bill and sent a letter to every lawmaker urging them to reject the measure. The organization said the bill would remove protections and increase costs for older and sicker Americans.

Older Americans “need and deserve affordable premiums, lower out-of-pocket costs, and coverage they can count on as they age,” the letter said. “On behalf of our nearly 38 million members in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, AARP is urging the Senate to reject the Graham/Cassidy/Heller/Johnson bill because it would do precisely the opposite.”

But Senate Majority Leader Mitch McConnell, a Kentucky Republican, praised the bill Tuesday. It’s his party’s first attempt in roughly two months to repeal Obamacare, after several failed attempts.

The bill would let states “implement better health care ideas by taking more decision-making power out of Washington,” McConnell said.

The bill’s proposals — to re-institute what critics have called an “age tax,” to waive essential health benefits and to change Medicaid funding — could have “devastating” effects on older Americans, said Sam Shumway, the head of the AARP in Wyoming.

He noted that Wyoming — which has an aging population — is already bracing for a deficit in state Medicaid funding that’s only going to worsen in the years to come. And that shortfall comes on the back of $90 million in cuts to the state Department of Health.

In other words, even with solely the deficit that the state faces from internal forces, it’s going to be tough for Wyoming’s Medicaid program to continue providing the services that it has been, officials have said. The effects of more revenue losses — like those that could come from Graham and Cassidy’s proposal — are difficult to determine, simply because of how drastic they might be.

Shumway pointed out that 70 percent of older Wyomingites in long-term care facilities rely on Medicaid. The new Republican bill — which Senate leadership is rushing to hold a vote on before a crucial deadline passes at the end of this month — would cap Medicaid funding sent to states. Shumway said that because “it’s impossible” to predict inflation in health care spending, it would likely be true that the caps would be insufficient to meet states’ needs.

“The growth rates set forth in the bill are far below historic Medicaid growth rates at a time when the number of Americans is significantly growing and needing greater coverage and services,” the AARP wrote to lawmakers. “Per capita caps and block grants would not accurately reflect the cost of care for individuals in each state ... “

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Something would have to give.

“The state would get left with some amount of funding that’s a deficit,” Shumway said. “It’d have to cut services or go into state coffers, and frankly, Wyoming, we’re coming out of a deficit. We don’t have a bunch of extra money to fund Medicaid services. They would cut Medicaid services or change the requirements for older people.”

The bill’s future remains unclear. Several other, Republican-backed repeal efforts have failed in recent months because GOP leadership was unable to corral the needed votes. Opponents of previous versions — chiefly Sens. Susan Collins of Maine, John McCain of Arizona and Lisa Murkowski of Alaska — have expressed concern about this latest attempt. Sen. Rand Paul, a Kentucky Republican, has said he won’t support it.

Republicans hold a 52-48 seat majority in the Senate. Because Democrats and Independents are uniformly opposed to the proposal, it would take only three GOP defections to kill the bill.

Similarly unclear is the bill’s exact impact. The Congressional Budget Office has not yet scored the bill to determine how much it would save or how many people may lose coverage should it become law, and it appears unlikely such an evaluation will happen before senators call for a vote.

The Associated Press contributed to this report.

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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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