Healthcare reform 1.4 - what's really in the Senate proposal that's already on life support:
Bottom Line: The Graham-Cassidy proposal which is the Congresses last, and in my opinion, best effort to reform healthcare this year is on life-support after John McCain's last hypocritical stand and massive question marks with three other key GOP Senators. While I think the concept has been fairly well communicated (take the Affordable Care Act and essentially hands it to the states to tailor for their constituents), it's still helpful to have more info to ensure an informed opinion is made. Here's are the key changes with this 140 page bill: https://www.lgraham.senate.gov/public/_cache/files/06822f49-b801-4d9f-95f5-d7b5406e9aa9/lyn17709.pdf (copy and paste it into your browser if you'd like to read).
Ends the federal employer and individual mandates of the ACA (states could incorporate one if desired)
Block grants essentially all of the federal money spent on the ACA to states
Ends all federal credits for ACA policies
Ends the federal expansion of Medicaid after 2019 (states would make decisions on Medicaid with use of the block grant funds)
Preexisting condition considerations for insurance would be determined at the state level
Provides latitude for states to create their own exchanges and insurance marketplaces
Defunds Planned Parenthood from the federal level
Ends the ACA tax on investment and medical devices - keeps the "Cadillac tax" and ACA Medicare tax in place
Allows for the expansion of HSA accounts
The simplicity of this initiative from the federal level is pretty clear because most of the details are determined at the state level. While I don't support the retention of the "Cadillac tax" and the Medicare tax - I'm supportive of just about everything else. For longer than I can now remember I've called for the end of the "insurance first" model. This provides a path towards that eventually by dropping the federal insurance mandates and expanding the HSA allowances. It also allows each state to meet the needs of their people in a way that makes the most sense for their state. I can't possibility see why that wouldn't be better than having the one-size fits all federal debacle we've experienced continuing. Up to now I've called the GOP plans about 50% less awful than Obamacare. This proposal is just plain about 90% good in my view. I sincerely hope it passes for the benefit of all of us - despite the likelihood that Washington politicking will likely prevail once again instead.