Graham–Cassidy health care amendment

Lindsey Graham, Official Portrait 2006

Graham–Cassidy health care amendment was a proposed amendment to the Affordable Care Act (ACA), also known as Obamacare, introduced by U.S. Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, both members of the Republican Party. The amendment aimed to repeal major provisions of the ACA and replace them with block grants given to states to manage their own health care systems. The proposal was part of the Republican Party's ongoing efforts to repeal and replace the ACA.

Overview

The Graham–Cassidy amendment sought to fundamentally change the structure of American health care financing and delivery. It proposed to eliminate the ACA's Medicaid expansion, subsidies for private insurance, and the individual mandate requiring individuals to have health insurance. Instead, the plan would have allocated block grants to states, allowing them more flexibility to design their own health care systems. The size of these grants would have been determined by a complex formula, taking into account the number of low-income residents in each state and other factors.

Key Provisions

• Block Grants to States: The core component of the Graham–Cassidy amendment was the provision of block grants to states. This was intended to give states the autonomy to manage their health care systems without federal intervention.
• Repeal of the Individual Mandate: The amendment proposed to repeal the ACA's requirement that most Americans obtain health insurance or pay a penalty.
• Changes to Medicaid: The plan included significant changes to Medicaid, transitioning the program to a per-capita cap funding model, which would limit federal funding per enrollee.
• Pre-existing Conditions: While the amendment claimed to protect individuals with pre-existing conditions, critics argued that the details allowed states to waive certain protections, potentially leading to higher costs for those individuals.

Criticism and Support

The Graham–Cassidy amendment faced widespread criticism from health care advocacy groups, medical associations, and some bipartisan lawmakers. Critics argued that the amendment would result in millions of Americans losing their health insurance coverage, increased premiums, and weakened protections for individuals with pre-existing conditions. Supporters of the amendment argued that it would restore power to the states, increase flexibility, and reduce federal spending on health care.

Legislative Process

The Graham–Cassidy amendment was introduced in the Senate in September 2017. Despite efforts by its sponsors and the White House to gather support, the amendment ultimately failed to secure enough votes for passage. The Senate decided not to vote on the amendment, marking another setback in the Republican Party's efforts to repeal and replace the ACA.

Impact and Legacy

Although the Graham–Cassidy amendment did not become law, it represented a significant moment in the ongoing debate over health care policy in the United States. It highlighted the deep divisions within Congress and the country over how to best provide access to affordable health care. The failure of the amendment also underscored the challenges of making substantial changes to the ACA, which had become deeply entrenched in the American health care system.