“It ain’t over till it’s over.” (Yogi Berra). But, John McCain said he “cannot in good conscience vote for the Graham Cassidy proposal.”

“As I have repeatedly stressed, health care reform legislation ought to be the product of regular order in the Senate. Committees of jurisdiction should mark up legislation with input from all committee members, and send their bill to the floor for debate and amendment. That is the only way we might achieve bipartisan consensus on lasting reform, without which a policy that affects one-fifth of our economy and every single American family will be subject to reversal with every change of administration and congressional majority.
“I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment. But that has not been the case. Instead, the specter of September 30th budget reconciliation deadline has hung over this entire process….” (A)

The latest Republican effort to dismantle the Affordable Care Act stood on the brink of failure Friday after Sen. John McCain (R-Ariz.) announced his opposition to the proposal and Sen. Susan Collins (R-Maine) said she was leaning against it.
The intensifying resistance dealt a potentially decisive blow to the renewed attempt to fulfill a seven-year-old GOP promise. McCain joined Sen. Rand Paul (R-Ky.) in formally opposing the plan, leaving party leaders one senator away from defeat.
Friday’s developments forced Senate Majority Leader Mitch McConnell (R-Ky.) and President Trump into a difficult corner. They must now decide whether to continue to pursue a vote that increasingly appears likely to fail, or short-circuit the endeavor and deal with the backlash after another unsuccessful try. (B)

“..Here’s a giveway about how bad the new Senate health care bill is: Bill Cassidy, one of its authors, keeps trying to sell it by telling untruths. “The relatively new phenomenon of just ‘up is down’ lying about your bill’s impacts is jarring,” says Loren Adler of the USC-Brookings-Schaeffer Initiative on Health Policy.
Most egregiously, Cassidy is claiming that the bill would not ultimately deprive sick people of health insurance. That’s false, as NPR calmly explained when Cassidy said otherwise. In fact, the bill — known as Graham-Cassidy — would free states to remove insurance protections for people with pre-existing conditions. Without those protections, insurers could price such people out of the market.
“If you get cancer (or even have a family history of it) or your child is born with a birth defect — among many, many other health issues — you could find yourself unable to buy insurance. Without insurance, you could be denied crucial treatments. In a tangible way, Graham-Cassidy would harm millions of Americans.” (C)

Bernard Tyson, chairman and CEO of the sprawling Kaiser Permanente nonprofit health system: “At Kaiser Permanente, we believe that changes to our nation’s health care laws should increase access to high-quality, affordable care and coverage for as many people as possible. The Graham-Cassidy bill does not meet any of those tests,” .. “The block grant proposal in the bill would erode coverage of needed medical services and pose major issues for state budgets. Repealing the individual mandate without alternative incentives for enrollment will lead to fewer people enrolled and higher premiums,” he said. Doctor and hospital groups like the American Medical Association (AMA) and the Association of American Medical Colleges (AAMC) have similarly denounced the legislation.” (D)

“The current language in Cassidy-Graham — which the Senate may vote on next week — complies with conservatives’ litmus test. But activists acknowledge the Senate parliamentarian will probably strip the Hyde language from the measure altogether, meaning that federally subsidized plans could keep covering abortions.
In the last go-round, that’s exactly what conservatives were worried about, too: that the Hyde amendment would be eliminated from the (now defeated) Better Care Reconciliation Act pushed by Senate Republicans under special rules governing the budget process. (That’s the vehicle Republicans are using to try to overturn much of the ACA because it doesn’t require Democratic votes.) Democrats believed that the parliamentarian agreed with them in that the Hyde language had to go, though Republicans said that guidance wasn’t final.” (E)

“…because it was bipartisan, non-extreme and did not afford the Republican Senate a win for the sake of winning and the chance to get back in the good graces of the manifestly unfit and unstable president, Senate Majority Leader Mitch McConnell (R-Ky.) stepped in to nix it.
That is what, according to multiple sources, happened yesterday as Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) cleared the decks on substantive issues. But then Alexander got yanked back. He hinted at the pressure he was under when he told the press he was “not a magician.” Too embarrassed to acknowledge he’d been stomped on by McConnell, he put out a patently disingenuous statement. “Senator Murray and I had hoped to agree early this week on a limited, bipartisan plan to stabilize 2018 premiums in the individual health insurance market that we could take to Senate leaders by the end of the month,” he said. “During the last month, we have worked hard and in good faith, but have not found the necessary consensus among Republicans and Democrats to put a bill in the Senate leaders’ hands that could be enacted.” In fact the only problem was his majority leadership, desperately straining to please the president with a partisan, fly-by-night repeal of Obamacare.” (F)

4 charts that explain what Graham-Cassidy will do, By Chris Cillizza and Sam Petulla, highlight and click on http://www.cnn.com/2017/09/22/politics/cassidy-graham-charts/index.html

‘…Since the bill doesn’t define what “access to adequate and affordable coverage” means, critics say that it is effectively sanctioning a return to the days before the A.C.A., when sick people in many parts of the country found it extremely difficult and costly to get health coverage.
Usually, in these types of disputes, the nonpartisan analysts at the Congressional Budget Office act as the arbiters. When “scoring” a health-care bill such as Graham-Cassidy, they go through each of its major proposals and provide numerical estimates of its likely effects. In this instance, though, the Republicans are exploiting the fact that the C.B.O. hasn’t had time to do a detailed analysis of their bill—it is expected to produce just a truncated report before next week’s vote.” (G)

“If the latest Republican bill to repeal Obamacare passes, 21 million fewer people will have insurance by 2026, according to a new analysis Friday…
The authors of the Brookings study cautioned that the effects of the bill were difficult to predict given the many paths individual states could take, but they looked a variety of scenarios based on how much block grant funding states devoted to coverage and on how many states maintained Obamacare’s protections for patients with pre-existing conditions, which states could weaken under the bill.
At the same time, the report said that its conclusion “likely understates the reductions in insurance coverage,” because it doesn’t consider potential turmoil if states can’t enact a functional health care system by 2020, when they would transition from Obamacare to the new block grants. Experts have also warned that the bill could cause premium spikes and instability as insurers struggle to manage the shift from Obamacare’s exchanges, which are already in fragile shape. Some areas could be left without any insurers on the individual market.” (H)

“Sen. Rand Paul (R-KY) has consistently said he opposes the plan, arguing that it keeps too much of Obamacare for his support. Sen. Susan Collins (R-ME) has not taken a definitive position, but she has raised concerns about how the bill affects people with preexisting conditions and its Medicaid cuts. She is widely considered a “no” vote.
There are a few others, most notably Sen. Lisa Murkowski (R-AK), who haven’t yet said whether they support or oppose the bill, but whose support is thought to be in doubt.
McCain’s opposition comes with the clock ticking down for Senate Republicans to repeal Obamacare. The special privileges they are using to pass a bill with only 51 votes and avoid a Democratic filibuster expire on September 30. After that, they would need to start the process over by passing a budget resolution.
Senate leaders had said that they intended to bring Graham-Cassidy up for a vote next week, though it’s not clear if they would still hold the vote knowing that the bill would fail.” (I)

(A) Sen. John McCain says he cannot support Graham-Cassidy Obamacare repeal bill, by Christina Wilkie, https://www.cnbc.com/2017/09/22/senator-john-mccain-says-he-cannot-support-graham-cassidy-obamacare-repeal-bill.html
(B) Latest GOP effort to dismantle Obamacare on the brink of failure after defections, byy Sean Sullivan, Juliet Eilperin and Kelsey Snell, https://www.washingtonpost.com/powerpost/mccain-says-he-will-vote-no-for-gop-health-care-bill-dealing-major-blow-to-repeal-effort/2017/09/22/077ba8a4-9fc0-11e7-9c8d-cf053ff30921_story.html?deferJs=true&outputType=default-article&utm_term=.6e18092ebe3d
(C) Senator Cassidy, Please Stop Lying about Health Care, by David Leonhardt, https://www.nytimes.com/2017/09/21/opinion/cassidy-graham-health-care.html?_r=0
(D) One of America’s Most Influential Health Care CEOs Just Trashed the Graham Cassidy Obamacare Bill, by Sy Mukherjee, http://fortune.com/2017/09/20/graham-cassidy-obamacare-kaiser-permanente-ceo/
(E) The Health 202: Cassidy-Graham’s abortion ban workaround, by Paige Winfield Cunningham, https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/09/22/the-health-202-cassidy-graham-s-abortion-ban-workaround/59c4196030fb0468cea81a6b/?utm_term=.665c3649c4d0
(F) The McConnell mentality keeps the Senate and Congress dysfunctional, by Jennifer Rubin, https://www.washingtonpost.com/blogs/right-turn/wp/2017/09/20/mcconnell-mentality-keeps-the-senate-and-congress-dysfunctional/?utm_term=.b1808d926aa3
(G) The Graham-Cassidy Health-Care Bill Is a Clear Danger to People with Preëxisting Conditions, by John Cassidy, https://www.newyorker.com/news/john-cassidy/the-graham-cassidy-health-care-bill-is-a-clear-danger-to-people-with-preexisting-conditions
(H) Study: 21 Million More Uninsured Under Graham-Cassidy Health Care Bill, by Benjy Sarlin, https://www.nbcnews.com/politics/congress/study-21-million-more-uninsured-under-graham-cassidy-health-care-n803801
(I) John McCain opposes Graham-Cassidy, in possible death blow to Obamacare repeal, by Dylan, Scott, https://www.vox.com/policy-and-politics/2017/9/22/16351494/john-mccain-graham-cassidy-obamacare-repeal

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