'It's OK to fall short,' Graham says, suggesting ACA repeal efforts may continue

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Sen. Lindsey Graham
Sen. Lindsey Graham

Update: Republicans announced Tuesday that they will not vote on the Graham-Cassidy bill, lacking the votes to pass it.


Sen. Lindsey Graham (R-SC) on Monday night appeared ready to proceed to a vote on the healthcare reform bill that bears his name, even after the release of a negative preliminary analysis from the Congressional Budget Office and the loss of another Republican vote just hours earlier.

“We're going to press on. It's OK to vote. It's OK to fall short, if you do, for an idea that you believe in,” he said.

Sunday, White House Director of Legislative Affairs Marc Short said on “Meet the Press” that a vote on the the Graham-Cassidy bill, also named for Sen. Bill Cassidy (R-LA), could come this week, perhaps Wednesday, although a spokesperson for Senate Majority Leader Mitch McConnell (R-KY) would not confirm a timeline to the New York Times.

The prospects of the bill to repeal and replace the Affordable Care Act appeared bleak Monday, however, after the CBO released an analysis of an earlier version of the legislation in the afternoon. That analysis found that, from 2017 to 2026, the bill would reduce the on-budget deficit by at least $133 billion, mainly due to the fact that outlays for block grants to states for Medicaid between 2020 and 2026 are smaller than the reduction in net federal subsidies for health insurance.

The CBO said it would need “at least several weeks” to calculate point estimates of the effects on the deficit, health insurance coverage or premiums.

Based on the preliminary CBO analysis, however, Sen. Susan Collins (R-ME) committed to voting ‘no' on the bill, a position she had said she was leaning toward a day earlier.

“The CBO's analysis on the earlier version of the bill, incomplete though it is due to time constraints, confirms that this bill will have a substantially negative impact on the number of people covered by insurance,” she said Monday in a statement.

Collins repeated assertions that she had made on Sunday talk shows that the bill's “sweeping changes and cuts in the Medicaid program” were a reason for her opposition.

“Expert projections show that more than $1 trillion would be taken out of the Medicaid program between the years 2020 and 2036,” she said in her statement. “This would have a devastating impact to a program that has been on the books for 50 years and provides healthcare to our most vulnerable citizens, including disabled children and low-income seniors.”

With Sens. Rand Paul (R-KY) and John McCain (R-AZ) and all Democrats also opposed to the legislation, it appears to have no chance of passing.

Graham, however, told the debate moderators that his efforts to secure enough votes for passage included “talking to Alaska,” apparently alluding to an attempt to sway Republican Sen. Lisa Murkowski of Alaska by adding provisions to the bill that would benefit the residents of her state.

Groups representing senior living providers also oppose the bill, in part because states could limit financial support for the home- and community-based services that some assisted living communities provide to some residents through Medicaid waivers. With the capped Medicaid funding amounts that would occur under the bill, states may look to cut HCBS funding since it is not mandatory.

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