Government affairs

This week, a new attempt in the Senate got underway to repeal and replace the Affordable Care Act (ACA, also known as Obamacare).

Sens. Bill Cassidy (R-LA), Lindsey Graham (R-SC), Dean Heller (R-NV) and Ron Johnson (R-WI) have introduced S. Amt. 391, an amendment to the American Healthcare Act of 2017 (H.R. 1628), which passed the House of Representatives in May. Among S. Amt. 391’s many effects, the proposal—commonly called the Cassidy-Graham bill—would end Medicaid’s expansion and subsidies, replacing them with block grants for states.

A vote on Cassidy-Graham could take place next week if Senate Majority Leader Mitch McConnell (R-KY) can secure the 50 votes necessary to pass the measure on the Senate floor, using the reconciliation process as a tool to circumvent the typical 60-vote threshold.

The vote must take place and pass both chambers to make use of the reconciliation process, and that must happen before the end of Fiscal Year 2017 on Sept. 30. Since FY2018 begins on Oct. 1, any attempt to pass a health care bill after that point would require at least 60 votes—that is, it would need support from Democrats under a bipartisan effort, something many Republicans are hoping to avoid.

NALC members are encouraged to tell their senators to oppose this latest effort to dismantle the ACA, because letter carriers and the Federal Employees Health Benefit Program (FEHBP) would not be immune to the consequences of repeal. Here are four reasons why:

1. The bill would take insurance away from millions of Americans, making premiums rise nationwide to recoup the cost of providing uncompensated health care (FEHBP, too).
2. The bill would waive insurance regulations, allowing health exchanges to collapse, weakening protections for those with pre-existing conditions and exposing FEHBP to similar disastrous consequences in the near future.
3. Corporations and the wealthy would get tax breaks through federal funds meant to pay for the ACA.
4. The “employer mandate,” requiring USPS to provide health care for city carrier assistants (CCAs) and others, would be repealed. Although CCA coverage would still be guaranteed by our National Agreement with the Postal Service, without the mandate, USPS might try to drop CCA coverage in future rounds of bargaining.

Cassidy-Graham currently enjoys widespread Republican support in the Senate—estimates hover around 48 or 49 votes in favor. Sen. Rand Paul (R-KY) has declared his opposition to the bill already, stating it is too much like the ACA for him to vote in favor.

Sens. Lisa Murkowski (R-AK), John McCain (R-AZ) and Susan Collins (R-ME) voted in July against a “skinny repeal” bill measure. If at least two of these three end up indicating approval of Cassidy-Graham, that would bring the count to a 50-50 tie, with Vice President Mike Pence a lock to cast the tie-breaking vote. This would all need to happen prior to the procedural deadline of Sept. 30.

Before McConnell brings the bill to the Senate floor, the Senate Finance Committee will hold a hearing on Cassidy-Graham on Sept. 25. It is expected that the independent Congressional Budget Office soon will be able to provide a preliminary assessment of the bill, if not a full scoring.

Call your senators now and tell them to oppose Cassidy-Graham.