President Trump tweeted he ”.. would not sign Graham-Cassidy if it did not include coverage of pre-existing conditions. It does! A great Bill. Repeal & Replace.” IT DOESN’T!

As HuffPost’s Jonathan Cohn explains, the bill, sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), leaves most decisions on health insurance to states, as it converts federal money to state grants. States could dismantle key provisions of the Affordable Care Act, such as the requirement that people with preexisting conditions are not denied coverage. Without that requirement, insurers could charge higher insurance premiums based on patients’ medical status.” (A)

“In releasing a revised version of their legislation to repeal and replace the Affordable Care Act (ACA), Senators Bill Cassidy and Lindsey Graham, along with co-sponsors Dean Heller and Ron Johnson, claimed that their bill isn’t a “partisan” approach and doesn’t include “draconian cuts.” In reality, however, the Cassidy-Graham bill would have the same harmful consequences as those prior bills. IT WOULD CAUSE MANY MILLIONS OF PEOPLE TO LOSE COVERAGE, RADICALLY RESTRUCTURE AND DEEPLY CUT MEDICAID, AND INCREASE OUT-OF-POCKET COSTS FOR INDIVIDUAL MARKET CONSUMERS. It would cause many millions of people to lose coverage, radically restructure and deeply cut Medicaid, eliminate or weaken protections for people with pre-existing conditions, and increase out-of-pocket costs for individual market consumers.” (B)

“One GOP senator on Thursday, however, seemed to suggest that the new bill could leave sick Americans worse off. Sen. Jeff Flake of Arizona, a Republican supporter of the Graham-Cassidy bill, said on MSNBC’s “Morning Joe” Thursday that the new plan could allow states to undermine protections for people with preexisting condition. He argued, however, that that wouldn’t end up happening.
“There are provisions in there, I’ve heard it said, that would allow a race to the bottom and states to deny coverage or allow insurance companies to deny coverage [based] on preexisting conditions,” Flake said. “If they’re able to, de jure, de facto, they won’t be able to.”” (C)

“Senators Lindsey Graham and Bill Cassidy, the sponsors of the Graham-Cassidy repeal bill, claim that their bill is different—that it simply shifts health care decisions to the states. This is false. Just like the failed repeal bills that came before it, Graham-Cassidy would result in millions of Americans losing health coverage. And in crucial respects, it’s the most harmful version of repeal yet….
Although Graham and Cassidy claim that this will increase flexibility for states, in reality it will do the opposite. Slashing federal funding will force states to cut eligibility or benefits based on budgetary limits.” (D)

“Graham-Cassidy doesn’t let states waive the part of the Affordable Care Act that says insurers have to cover sick people. But it does allow states to opt out of several other ACA rules that can cause people with pre-existing conditions to pay more for their health care. Those provisions include:
The ban on charging sick people higher premiums than healthy people. The requirement that insurers cover “essential health benefits,” including prescription drugs. People who need expensive drugs might not have access to a plan that covers those drugs, requiring them to pay out of pocket. Services that aren’t “essential” benefits aren’t subject to the ACA’s ban on annual and lifetime limits.
The bill also would also loosen rules about how much insurers can raise their premiums because of a customer’s age. (Older people are more likely to have pre-existing conditions.” (E)

“On Tuesday I wrote that the chances for Senate Republicans’ last stab at Obamacare repeal, Graham-Cassdidy, “may well hang on what offer Republican leaders are willing to make on Alaska’s behalf in the next week” in order to secure Sen. Lisa Murkowski’s pivotal vote. A couple of reports Thursday afternoon show us how that offer may be shaping up. To put it as generously as possible, it’s not subtle…
Independent Journal Review, citing a “Republican Senate aide,” reports what would be the most incredible package of carve-outs known to mankind. It would allow Alaska—and Hawaii, tossed in as a poor effort for political and legal cover—to keep Obamacare in the Obamacare repeal bill. And then some.” (F)

“The bill would allow states to opt to waive Obamacare rules requiring basic health benefits, essentially cutting protections for sick people in an effort to keep premiums from rising. The waivers allow states to charge more for health insurance offered to people with pre-existing conditions—including cancer, heart disease, Alzheimer’s (or dementia), cerebral palsy and even pregnancy, among other medical factors that could have resulted in denied coverage prior to Obamacare—while continuing to receive federal block grant funding.
Experts say the bill could raise health care costs for those with pre-existing conditions to a point where insurance would be virtually unaffordable for millions of people.” (G)

“When Iowa reporters asked Sen. Chuck Grassley on Wednesday about the attempt to repeal and replace Obamacare, his answer was remarkable and revealing.
“You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” the Iowa Republican said. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.” (H)

“The bill is structured as a sort of slow-motion repeal of the health law’s main coverage programs. Though the bill establishes the new state block grant program for a decade, all of the program’s money expires after 2026. That makes it different from the Obamacare overhaul bill passed by the House and a previous bill considered by the Senate, which would have made modifications and cuts to those programs, but preserved them in perpetuity. The expiration of the health law’s programs alone would probably mean that about 23 million fewer Americans would have health coverage, if compared with current law, according to an estimate the Congressional Budget Office made in regard to a previous repeal bill.” (I)

(A) Trump Is Misrepresenting What’s In The Health Care Bill He Wants To Pass, by Marina Fang, http://www.huffingtonpost.com/entry/trump-graham-cassidy-health-care-bill_us_59c3a74ee4b0c90504fbdcd7
(B) Like Other ACA Repeal Bills, Cassidy-Graham Plan Would Add Millions to Uninsured, Destabilize Individual Market, by JACOB LEIBENLUFT EDWIN PARK MATT BROADDUS AVIVA ARON-DINE, https://www.cbpp.org/research/health/like-other-aca-repeal-bills-cassidy-graham-plan-would-add-millions-to-uninsured
(C) GOP senator admits new healthcare bill could harm people with preexisting conditions, but says it won’t happen, by Bob Bryan, https://finance.yahoo.com/news/gop-senator-admits-healthcare-bill-160014682.html
(D) Graham-Cassidy Is the Worst Obamacare Repeal Bill Yet, by Thomas Huelskoetter, http://fortune.com/2017/09/20/graham-cassidy-health-care-bill-obamacare-repeal/
(E) What Graham-Cassidy means for pre-existing conditions, by Caitlin Owens, https://www.axios.com/what-graham-cassidy-really-means-for-pre-existing-conditions-2487720743.html
(F) Report: GOP Is Trying to Buy Murkowski’s Obamacare Repeal Vote by Letting Alaska Keep Obamacare, by Jim Newell, http://www.slate.com/blogs/the_slatest/2017/09/21/murkowski_buyoff_watch_senate_gop_may_just_let_alaska_keep_obamacare.html
(G) TRUMP FALSELY CLAIMS AMERICANS WITH PRE-EXISTING CONDITIONS ARE GUARANTEED COVERAGE UNDER NEW HEALTH BILL, by CHRIS RIOTTA, http://www.newsweek.com/donald-trump-pre-existing-conditions-health-care-graham-cassidy-false-669001
(H) How one Chuck Grassley quote sums up the entire GOP repeal and replace effort, by Chris Cillizza, http://www.cnn.com/2017/09/21/politics/grassley-trump-health-care/index.html
(I) How the Latest Obamacare Repeal Plan Would Work, by REED ABELSON and MARGOT SANGER-KATZ, https://www.nytimes.com/2017/09/20/upshot/obamacare-repeal-bill-offers-both-enormous-flexibility-and-uncertainty.html