TRUMP/ GRAHAM/ CASSIDY. “If there’s a billion more going to Maine … that’s a heck of a lot,” Cassidy said.

“The latest Republican push to repeal key parts of the Affordable Care Act appears to have met the fate of all previous Senate repeal efforts this year — it doesn’t have the votes needed to pass the chamber.
Maine Sen. Susan Collins announced Monday that she will oppose the bill, authored by South Carolina Sen. Lindsey Graham and Louisiana Sen. Bill Cassidy. Collins’ decision means three Republicans have now publicly said they are against the bill — and that is one more than the GOP could afford to lose…
Cassidy was asked earlier Monday on CNN whether Collins’ opposition would mean it’s over for the bill and said, “Yes, it is.” It’s not clear yet whether Senate Majority Leader Mitch McConnell will still bring the bill to the floor for a vote now that its fate is clear.” (A)

“Collins delivered a scathing assessment of the bill in a statement, saying the fourth version that the senators had produced in an effort to win over her vote and others’ “is as deeply flawed as the previous iterations.”
“Health care is a deeply personal, complex issue that affects every single one of us and one-sixth of the American economy,” she said. “Sweeping reforms to our health care system and to Medicaid can’t be done well in a compressed time frame, especially when the actual bill is a moving target.” (B)

“The proposal the Senate is considering that would repeal and replace the Affordable Care Act will result in millions losing health insurance and a $133 billion reduction in the deficit by 2026, according to the Congressional Budget Office’s report on the Graham-Cassidy legislation.
The CBO did not have enough time to estimate specifically how many people’s insurance would be affected as they have done when they have scored previous repeal bills. But, the analysis it released Monday evening says, “the number of people with comprehensive health insurance that covers high-cost medical events would be reduced by millions” compared to current law.” (C)

“Cassidy said Graham and Santorum facilitated conversations with Sens. Lisa Murkowski (Alaska), Susan Collins (Maine) and John McCain (Ariz.), whose states would receive more federal health-care funding under his revamped bill compared to a previous version…
But he acknowledged that the new version would indeed provide more funding to those states compared to the first iteration of his bill, stressing that it would include $1 billion more in block grants for Maine. And he expressed hope that Collins would support the measure.
“If there’s a billion more going to Maine . . . that’s a heck of a lot,” Cassidy said. “It’s not for Susan, it’s for the Mainers. But she cares so passionately about those Mainers, I’m hoping those extra dollars going to her state . . . would make a difference to her.”” (D)

“An internal GOP analysis, circulated to Senate offices, shows spending boosts states like Alaska and Kentucky — data that will almost certainly be used to sell the revised proposal in the days ahead.
But notably, those increases in the projection incorporate savings from ending the state match of Medicaid expansion. So in total, there is still a reduction in health care spending in these states when compared to current law. (For example, Alaska would get a $100 billion cut via its block grant in the bill, but the GOP analysis shows it would receive a boost of three percent.) The analysis also doesn’t address the overhaul of the Medicaid program, from an open-ended entitlement program to a per person cap.” (E)

“Top Republicans had amended their measure overnight, adding billions of extra dollars for states and easing coverage requirements under President Barack Obama’s statute to win over wavering GOP senators. Paul, R-Ky., had opposed the earlier version of the bill, saying it spent too much money.
Asked Monday if Paul’s position had changed, spokesman Sergio Gor provided a document listing three demands. It said the “primary” one was a “significant” reduction in $1 trillion in spending under Obama’s 2010 overhaul. Paul also wants elimination of requirements that insurers cover specified medical services and other coverage mandates, and establishment of “association” health plans consumers could join to pay lower prices.
“That’s the only way he gets to a yes,” Gor said in an email.” (F)

“This is like legislating blind,” said University of North Carolina political scientist Jonathan Oberlander, who has written extensively on the history of major healthcare legislation. “It is really hard to find an example of something where Congress was this reckless.” (G)

(A) 3 GOP Senators Oppose Graham-Cassidy, Effectively Blocking Health Care Bill, by Scott Detrow, http://www.npr.org/2017/09/25/553429714/3-gop-senators-oppose-graham-cassidy-effectively-blocking-health-care-bill
(B) Collins, Paul list concerns about Cassidy-Graham bill, by Sean Sullivan and Juliet Eilperin, https://www.washingtonpost.com/powerpost/new-version-of-health-care-bill-will-help-alaska-and-maine–home-of-two-holdout-senators/2017/09/25/24697f62-a188-11e7-b14f-f41773cd5a14_story.html?utm_term=.a23e190bad99
(C) ‘Millions’ May Lose Coverage Under GOP Health Bill, Says CBO Analysis, by Alison Kodjak, http://www.npr.org/sections/health-shots/2017/09/25/553459455/-millions-may-lose-coverage-under-gop-health-bill-says-cbo-analysis
(D) Cassidy on new health-care plan: ‘It’s not for Susan, it’s for the Mainers’, by Paige Winfield Cunningham, https://www.washingtonpost.com/powerpost/cassidy-on-new-health-care-plan-its-not-for-susan-its-for-the-mainers/2017/09/25/3dc5d74e-a20f-11e7-b14f-f41773cd5a14_story.html?ut
(E) Republican health care bill revised to target key votes, by MJ Lee, Lauren Fox, Phil Mattingly and Tami Luhby, http://www.cnn.com/2017/09/24/politics/revised-graham-cassidy-bill/index.html
(F) New blow to GOP health bill: Paul opposes revised measure, by Alan Fram, http://abcnews.go.com/Health/wireStory/health-care-bill-teeters-gop-adds-money-woo-50070227
(G) Senate Republicans unsure what their healthcare bill would do, even as they push ahead on it, by Noam N. Levey, http://www.latimes.com/politics/la-na-pol-obamacare-senate-mystery-20170924-story.html

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