The latest Republican Congressional attempt to repeal and replace the Affordable Care Act (ACA) has foundered, as three Republican senators announced they will join Democratic senators in opposing the "Graham-Cassidy" repeal plan.

Very broadly, Graham-Cassidy would, among other things:

  • Eliminate the penalties and mandates that individuals buy insurance and certain employers offer insurance;
  • Replace insurance premium subsidies and funding for Medicaid expansion with block grants to the states (with greatly reduced federal contributions);
  • Give states wide latitude in determining the parameters of insurance coverage and premiums; and
  • Revise the tax treatment of certain medical expenses.

Senate GOP leaders intended to bring Graham-Cassidy to the floor for a vote this week – before special "budget reconciliation" rules that allow passage on a simple majority vote expire at the end of this month.  On September 25, 2017, the Congressional Budget Office released a preliminary estimate of the impact Graham-Cassidy would have on health insurance coverage and federal spending.  The CBO projects that the bill would cut Medicaid by $1 trillion and result in millions of individuals losing insurance coverage.  These projections prompted Senator Susan Collins (R-ME) to declare her opposition to the bill (joining Republican Senators John McCain and Rand Paul).  Congressional leaders have now shelved the vote in light of the dim prospects for passage.

This article is presented for informational purposes only and is not intended to constitute legal advice.