In response to Jimmy Kimmel’s entirely accurate criticisms of his unspeakably dreadful healthcare bill, Bill Casssidy was outraged that Kimmel wasn’t taking the bill’s handwaving provisions, which required states to meet some vague and (if a Republican was in the White House) meaningless standards pretending to cover people with pre-existing conditions to get waivers to terminate the ACA in their states.
The new version of Graham-Cassidy…removes even these largely useless protections:
First, there are those changes to the rules for pre-existing conditions. Under the newly revised bill, states would have an even easier time junking rules that prohibit insurers from charging higher premiums to people with cancer, diabetes, or other medical conditions. They could also waive existing rules limiting out-of-pocket expenses, or setting minimum levels of coverage.
To do this, state officials wouldn’t even have to apply for a formal waiver. All they would have to do is file a plan explaining their proposal, and why officials believe it would provide “adequate and affordable” coverage for people with prior medical problems.
That’s not much protection, experts warned.
“States don’t have to submit waivers, they just have to describe the rules they set, if any,” Larry Levitt, senior vice president at the Henry J. Kaiser Family Foundation, told HuffPost. “It goes well beyond the previous bill by making clear that the federal out-of-pocket maximum and actuarial value requirements can be changed. That opens the door to very bare-bones insurance.”
The new pretense that they’re covering people with pre-existing conditions is the establishment of high-risk pools that would be worthless at any level Republicans would conceivably fund them.
The strategy to get this passed involves stuffing teh shit sandwich with a little ham for targeted states:
As for the extra money, the biggest boost seems to be in the form of extra Medicaid matching funds for states that have poverty guidelines separate from the rest of the country. Only two states do that: Alaska and Hawaii.
Alaska would also benefit from some other funding changes, as would some other states.
Alaska matters politically because one of its Republican senators, Lisa Murkowski, was among the three Republicans who voted against repeal in July. She has not committed to a position on Graham-Cassidy, but has said she will look closely at its impact on her state.
Precisely how much the new funds help Alaska isn’t clear ― and may not be clear for a while, because that’s the kind of exercise that requires careful study and in some cases complex modeling.
Will this work? I dunno, but it’s a bad sign that they’re still trying. Keep on the phones.