Obamacare Repeal: 5 Things To Know About The GOP's New Graham-Cassidy Bill

WASHINGTON, DC — Obamacare repeal has cast a tall shadow across President Trump's first term, a seven-year promise from the Republicans Party that the GOP has repeatedly failed to fulfill. Now, with its best chance to pass some kind of Republican alternative to the health care law ending in less than two weeks, the party is pushing forward with a plan that that has received little debate or scrutiny.

The Graham-Cassidy bill, devised by the senators it was named after, is in many ways more dramatic than previous versions of Obamacare "repeal" bills. It essentially ends the federal spending on Obamacare insurance subsidies and Medicaid expansion, instead giving states lump sums of money for covering their residents' health care costs. States that expanded Medicaid would get less money than they do now, while those that didn't expand would get more. (For more information on this and other political stories, subscribe to the White House Patch to receive daily newsletters and breaking news alerts.)

Republicans need 50 lawmakers — in addition to Vice President Pence's tie-breaking vote — to pass the bill through the Senate before it would go to the House of Representatives. It's not clear they have that yet; at least four Republicans are believed to have serious doubts about the bill, and there may be others who are quietly opposed. But the Graham-Cassidy bill could pass, so here's what you need to know about it:

1. It would cut Obamacare funding while sending money directly to the states.

Currently, Obamacare helps people afford health insurance through payments to insurers, subsidies to patients and by funding an expansion of Medicaid in states that choose to accept it. Graham-Cassidy would end all this spending and instead send lump sums — calculated based on the size and makeup of each population — to state governments that will have flexibility in how they choose to spend the funds.

2. Medicaid will be cut

While states will still receive some of the funding that was previously allocated for Medicaid recipients, the amount will grow at a significantly slower rate under Graham-Cassidy. This means that over time, fewer people would get health insurance than they would have under Obamacare.

Since some states decided to expand Medicaid and others didn't, the Graham Cassidy plan would cut much more funding to states like Massachusetts, California and New York — Democratic-leaning states — and more would go to Republican-leaning states like Texas. Defenders of the bill have touted this redistribution away from the Northeast and West Coast as part of its appeal.

3. Obamacare's regulations would be weakened.

Because the states will have much more power over their health insurance funds, the bill allows governors and legislatures to waive certain Obamacare regulations. For example, if a state wanted to, it could allow insurers to charge people with preexisting conditions more than healthy people, a practice that Obamacare outlawed.

Graham-Cassidy would, however, still provide protection for women and minority groups from discriminatory pricing.

Additionally, the bill ends the mandates for individuals to buy health insurance and for large companies to cover employees.

4. We don't know what the law's effects would really be.

It's difficult to know exactly what the effects of the legislation would be, in part because it would leave so much up to the discretion of state governments. But Congress and the American people won't even get an official educated guess before the Senate votes on the bill, because the Congressional Budget Office said it does not have enough time to thoroughly evaluate the bill. That means Republicans are likely to push a vote on the bill without an adequate estimate of the law's effects on health care premiums, how many more people could become uninsured because of the legislation or what it will do to the deficit.

Outside analysts believe the bill will add millions of people to the rolls of the uninsured, just as the other Republican health care bills were expected to do.

5. It has a slim margin for victory, but passage is possible.

With 52 Republicans in the Senate, the GOP can only lose two votes of its own party members and still pass the bill. Sen. Rand Paul of Kentucky, Sen. John McCain of Arizona, Sen. Lisa Murkowski of Alaska and Sen. Susan Collins of Maine appear to be most likely to vote against the bill.

McCain has expressed support for the bill, which was conceived of by his close friend Sen. Lindsey Graham, but he has also bemoaned the hurried and unusual process of bringing the legislation up for a vote.

Murkowski and Collins both lean toward the liberal end of the Republican spectrum, and they previously voted against all GOP efforts to overhaul Obamacare.

Paul's opposition to the bill comes from another direction — he has said that he cannot support the bill because it preserves too much of Obamacare, dubbing it "Obamacare Lite."

Watch: The GOP Has Another Shot To Repeal Obamacare, And It's Coming Up Quick

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