U.S. Senate Abandons Graham-Cassidy Proposal

Earlier this week, Senate Republicans announced they would not hold a vote on the last-ditch Graham-Cassidy proposal to repeal and replace the Affordable Care Act (ACA). Over the weekend and early this week, a handful of senators continued to express uncertainty and opposition to the proposal, including Senators Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), John McCain (R-Arizona), and Rand Paul (R-Kentucky). As a result, Senators Lindsey Graham (R-South Carolina) and Bill Cassidy (R-Louisiana) attempted to court undecided and opposed senators by releasing a revised proposal on Monday which reworked provisions and would have directed additional funds to those senators’ states.

On Monday, the Senate Finance Committee held a hearing on the bill which featured impassioned testimony from elected officials and health policy experts, both in support and opposition to the measure. The Congressional Budget Office (CBO) also released a preliminary analysis of the Graham-Cassidy proposal, though it lacked many specifics. The CBO indicated it did not have enough time to estimate the impact of the proposal on health insurance coverage and marketplaces as it had done with the previous ACA repeal bills. In its analysis, the CBO estimated that people with health insurance “would be reduced by millions” compared to the ACA and that a $133 billion deficit reduction would occur by 2026 as a result of smaller block grants and federal funds shifting away from states that expanded Medicaid and toward states that did not.

Shortly following the release of the CBO analysis on Monday, Senator Susan Collins (R-Maine) announced her firm opposition to the Graham-Cassidy proposal, effectively sinking the Republicans’ latest attempt to repeal the ACA. With uncertainty still lingering around whether a vote would still be held on the measure, Senate Republicans met Tuesday to  discuss their next steps. Ultimately, after determining no viable option forward given the expiration of key procedural powers this week and the lack of votes, Senate Republicans announced their decision to abandon a vote on the Graham-Cassidy proposal.

Though Congressional action around federal health insurance reform remains highly uncertain, CHEAC staff will continue to closely monitor federal activity on the issue.