Republicans love to brag that they don’t believe in choosing winners and losers. The latest Obamacare repeal bill picks winners and losers and Iowa would be a major loser. The Graham-Cassidy repeal plan will specifically penalize Iowa. Yet, Governor Reynolds endorsed Graham-Cassidy, saying, “[It] can work for the repeal and replacement of Obamacare.” The Senate must bring it to a vote by September 30, so they are expected to bring it to a vote next week.
Once again we must organize and call both Senator Ernst and Grassley and demand they vote against this bill. We killed the last bill attempt, but it has risen from the dead.
The bill not only cuts total federal spending coming to Iowa, but will give a percentage of Iowa’s current share to other states. It’s estimated by the Center on Budget and Policy Priorities (CBPP) that Iowa would lose $525 million in 2026. The Graham-Cassidy repeal proposal would not only cut overall Medicaid spending nationally by $80 billion but redistribute the remaining federal dollars among the states. It would take money from states like Iowa that have expanded Medicaid and give extra money to states that refused expansion. It would generally benefit states with Republican governors that refused to expand Medicaid and penalize Democratic governors that expanded Medicaid. Branstad/Reynolds expanded Medicaid so Iowa would see a bigger percentage cut than 14 other states.
Texas would see the biggest percentage increase. Is Governor Reynolds representing Iowa or Texas? She is endorsing cutting federal dollars coming to Iowa and rewarding Texas with a higher percentage.
This unfair redistribution of federal dollars to Iowa is just one of the major reasons Iowans should reject this latest Republican repeal scheme. The Graham-Cassidy bill would have the same harmful impact as previous Republican bills. Millions of people will lose coverage, it will result in deep cuts to Medicaid, threaten or end protections for people with pre-existing conditions, and increase out-of-pocket costs for healthcare consumers. CBPP specifically lists the following horrible consequences of this latest GOP bill:
“Eliminate the ACA’s marketplace subsidies and enhanced matching rate for the Medicaid expansion and replace them with an inadequate block grant. Block grant funding would be well below current law federal funding for coverage, would not adjust based on need, would disappear altogether after 2026, and could be spent on virtually any health care purpose, with no requirement to offer low- and moderate-income people coverage or financial assistance.
Convert Medicaid’s current federal-state financial partnership to a per capita cap, which would cap and cut federal Medicaid per-beneficiary funding for seniors, people with disabilities, and families with children.
Eliminate or weaken protections for people with pre-existing conditions by allowing states to waive the ACA’s prohibition against charging higher premiums based on health status and the requirement that insurers cover essential health benefits including mental health, substance abuse treatment, and maternity care.
Destabilize the individual insurance market in the short run — by eliminating the ACA’s federal subsidies to purchase individual market coverage and eliminating the ACA’s individual mandate to have insurance or pay a penalty —and risk collapse of the individual market in the long run.
Eventually result in larger coverage losses than under proposals to repeal ACA’s major coverage provisions without replacement. The Congressional Budget Office (CBO) has previously estimated that repeal-without-replace would cause 32 million people to lose coverage. The Cassidy-Graham bill would likely lead to greater numbers of uninsured after 2026, however, because it would not only entirely eliminate its block grant funding — effectively repealing the ACA’s major coverage expansions — but also make increasingly severe federal funding cuts to the rest of the Medicaid program (outside of the expansion) under its per capita cap.”
The overall impact of this bill on Iowa would be devastating. Iowa is already in a deep financial hole as a result of the Branstad/Reynolds fiscal budget bungling. Under this proposal the state will be forced to increase their share of funding for Medicaid or make draconian cuts to services.
Governor Reynolds’ endorsement of a repeal plan that strips coverage, increases costs and penalizes those Iowans with pre-existing conditions is a cruel hoax. As of this writing, Senator Grassley and Ernst haven’t weighed in. They should ignore Reynolds’ endorsement and vote to kill this dangerous bill. We must remind them that it’s their responsibility to protect the most vulnerable Iowans from these devastating cuts and loss of healthcare.
by Rick Smith