“Sen. Cassidy failed to repeal ObamaCare, but the defeat hasn’t stopped Louisiana’s senior senator from trying to raise money from the effort.
A fundraising pitch sent this week from Cassidy’s campaign urged supporters to send donations by a Saturday deadline to “help Bill keep fighting for what we all know is right.”
The email describes Cassidy as working “to keep every Republican’s promise in repealing and replacing the disastrous Obamacare” and said he’s become a “target of liberals across the country” because of it.
The fundraising request doesn’t mention that Cassidy’s legislation, co-sponsored by South Carolina Sen. Lindsey Graham, didn’t have enough GOP support for passage and was shelved this week as the Senate moves on to a debate about taxes.” (A)

“Bipartisan health insurance proposal expected next week. “What we’re trying to do is not just see whether Sen. Murray and I can agree, but whether the two of us can find a significant number of Democrats and Republicans who can agree on a limited, bipartisan proposal that could actually pass,” said Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee.
Murray, the committee’s top Democrat, also is optimistic about the discussions. “After all the partisanship we’ve seen from Republicans on health care, I’m glad we’ve been able to restart our conversations about ways to actually make health care work better for families — beginning with steps to help lower premiums — and I’m hopeful we can reach a final agreement soon,” she said.
While negotiations are still ongoing, Alexander and Murray are looking to give states more flexibility in the type of policies that they can approve and to extend for two years the federal cost-sharing payments that enable insurance companies to reduce premiums for lower- and middle-class Americans. President Trump has threatened to stop the payments, which are worth about $7 billion this year. “ (B)

“Republicans who control Congress moved one step closer Friday to overhauling the tax code — one of their top legislative goals — in an effort that also puts a repeal of the Affordable Care Act on the back burner for at least the near future….
Republicans want to pass tax reform using budget reconciliation, a procedural tool that would allow them to advance their bill with a simple 51-vote majority, rather than the typical 60. Since Republicans have a 52 to 48 majority in the Senate, the lower voting threshold would make it possible for them to pass tax reform without help from Democrats.
Senate Republicans used budget reconciliation — which can only be used once per fiscal year — in their attempt to repeal and replace Obamacare this year. But despite many attempts, they failed to pass a health care bill in their allotted time to do so under reconciliation, which expires Saturday.” (C)

“Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., the two authors of the latest Republicans effort to overhaul Obamacare to collapse in the Senate, met with President Trump on Thursday and afterwards said they look forward to continue the debate over healthcare, even as Congress turns its focus to tax reform….
“Over the coming weeks and months, we are committed to holding congressional hearings and working with our nations’ governors who believe returning power to states is a vast improvement over Obamacare,” the duo said in a statement after meeting Trump, who was a major proponent of their efforts….
…. the senators said they have the backing of the president who “remains committed to repealing and replacing Obamacare” and furthermore “the principles brought forward in Graham-Cassidy-Heller-Johnson.” “ (D)

“President Trump’s selection of a secretary of health and human services could be a turning point in a health care debate that has polarized Washington, as he faces a choice of working with Democrats to fix the current system or continuing his so-far failed efforts to dismantle his predecessor’s program…
The White House had no comment Saturday, but the two most frequently mentioned candidates to succeed Price are two officials who work in the department: Seema Verma, administrator of the Centers for Medicare and Medicaid Services, and Scott Gottlieb, commissioner of the Food and Drug Administration…
If Trump picks Verma to succeed Price at the Department of Health and Human Services, it would be taken as a sign among many that he wants to continue vigorous opposition to the Affordable Care Act, with the government doing the minimum required by the law to implement its provisions.” (E)

“Another potential candidate is Florida’s Republican Gov. Rick Scott, a former hospital executive who is term-limited after 2018. But Scott is expected to mount a Senate campaign against Democratic incumbent Sen. Bill Nelson next year, and he may have ambitions and interests beyond health care…
Also mentioned is Louisiana GOP Sen. Bill Cassidy, co-author of the last Republican health care bill that failed to advance. Cassidy would probably win confirmation easily, but his prospects in the Senate appear bright, and he may not want to depart for a Cabinet post in a tumultuous administration.” (F)

(A) U.S. Sen. Bill Cassidy asks for campaign donations after health care legislation fails, http://www.wdsu.com/article/us-sen-bill-cassidy-asks-for-campaign-donations-after-health-care-legislation-fails/12655941
(B) Sen. Lamar Alexander: Bipartisan health insurance proposal expected next week, by Michael Collins, http://www.tennessean.com/story/news/politics/2017/09/29/sen-lamar-alexander-bipartisan-health-insurance-proposal-expected-next-week/717579001/?from=global&sessionKey=&autologin=
(C) Budget panel officially sidelines Obamacare repeal, makes path for GOP tax plan, by Ashley Killough and Ted Barrett, http://www.cnn.com/2017/09/29/politics/tax-reform-budget-repeal-obamacare/index.html
(D) Graham-Cassidy authors ‘committed’ to hearings on healthcare after meeting with Trump, by Daniel Chaitin, http://www.washingtonexaminer.com/graham-cassidy-authors-committed-to-hearings-on-healthcare-after-meeting-with-trump/article/2636025
(E) Choice of new health secretary may offer clue to Trump’s next move on health law, by Peter Baker, https://www.bostonglobe.com/news/nation/2017/09/30/choice-new-health-secretary-may-offer-clue-trump-next-move-health-law/22SKFwfSaqtv8CuYcfMgJL/story.html
(F) Price’s Exit Further Complicates GOP Health Care Push, by JILL COLVIN and RICARDO ALONSO-ZALDIVAR, https://www.usnews.com/news/business/articles/2017-09-30/prices-exit-further-complicates-gop-health-care-push

“Frustration overtook Senate Republicans on Tuesday as the reality sunk in that they had failed again in fulfilling a seven-year campaign promise to repeal the 2010 health care law. And senators were looking to cast blame wherever they could find it.
They decried the time constraints of the budget reconciliation procedure they chose to advance a bill with only Republican support.
They chastised Democrats for their lack of assistance, despite making no serious effort to work across the aisle during the past nine months.
They blamed the top-down approach to negotiating the legislation that leadership employed.
Some criticized the carve-outs to states whose senators were skeptical of the proposal, a strategy that resulted in near daily updates to the already complex legislation….” (A)

“Two U.S. senators from both parties are close to finalizing a bipartisan deal to shore up the health insurance exchanges created under Obamacare, the chamber’s top Democrat said on Thursday…
Schumer said Senate Health, Education, Labor and Pension Committee Chairman Lamar Alexander, a Republican, and ranking Democrat Patty Murray had resurrected a bipartisan approach, which had been cast aside amid the latest near-vote on a repeal bill.
Alexander and Murray had been working to protect the government payments made to insurers to help reduce medical expenses for low-income Americans enrolled in Obamacare. Alexander also wanted states to have more flexibility to design insurance plans under the program…
The pact could buoy health insurance companies, which came out forcefully against the Republican repeal effort and have faced uncertainty since the November election of Republican President Donald Trump, who vowed to sink the law.” (B)

“It’s far from clear that any deal Murray and Alexander work out could win approval from the full Senate, let alone pass the House.
Many other Senate Republicans, including Senate Finance Committee Chairman Orrin Hatch (R-Utah), are more skeptical of a deal to stabilize ObamaCare than Alexander is.
And the House and White House are another question entirely.
Speaker Paul Ryan (R-Wis.) has told the Senate that an Alexander-Murray deal “isn’t viable” for the House GOP.
As Republicans sought to win support for their repeal effort, some spoke dismissively of the Alexander-Murray talks, suggesting anything the senators agreed upon would go nowhere in the House…
An expansion of waivers currently in ObamaCare that allow states to innovate and change regulations are also said to be part of the potential deal, though it is not clear how far those waiver changes will go.
Those provisions are both Republican requests.
The main provision for Democrats would be funding for key ObamaCare payments known as cost-sharing reductions, which President Trump has threatened to cancel in a bid to make the health-care law “implode.”” (C)

(A) Senate Republicans Commence Health Care Blame Game, by Joe Williams, http://www.msn.com/en-us/news/politics/senate-republicans-commence-health-care-blame-game/ar-AAsv5qg?li=BBmkt5R
(B) Senators close to bipartisan deal on health exchanges: Schumer, https://www.reuters.com/article/us-usa-healthcare/senators-close-to-bipartisan-deal-on-health-exchanges-schumer-idUSKCN1C32UL
(C) Senators zero in on deal to stabilize ObamaCare markets, by PETER SULLIVAN, http://thehill.com/policy/healthcare/352957-senators-zero-in-on-deal-to-stabilize-obamacare-markets

“.. now that it’s over, the old Graham is back and more than willing to laugh at how improbable it was that a national security expert briefly held the national limelight as a supposed health policy wonk.
Graham, though, said he was not alone in his lack of understanding of health care. “Nobody in our conference believes Obamacare works. It must be replaced. But until now, we didn’t know how to do it,” Graham told reporters in the Capitol on Tuesday, audio of which is posted below.
A reporter pointed out that such ignorance at this late stage is hard to understand. “You’ve been working to overhaul this for seven years. Why is this so hard?” she asked. “Well, I’ve been doing it for about a month. I thought everybody else knew what the hell they were talking about, but apparently not,” Graham clarified, adding he had assumed “these really smart people will figure it out.” (A)

“Stung by another health care defeat this week, President Trump said Wednesday he will begin talking with Democrats on legislation that can replace the law signed by predecessor Barack Obama.
“I will negotiate with Democrats to see if we can make a bipartisan bill,” Trump told reporters at the White House, the day after Senate Republicans’ last-ditch proposal to unwind the Affordable Care Act collapsed on Capitol Hill. The president said he hopes for a health care vote in January, February or March.
In the meantime, the president said he plans to sign an executive order – likely next week – that would enable people to buy health insurance across state lines, though there is some question as to whether a president has the authority to effect such a change.” (B)

“Sen. Rand Paul, R-Ky., predicted Wednesday that President Trump would soon move on his own to make health insurance more affordable, after the Senate failed again this week to advance any bill to reform federal healthcare policy.
“I believe that President Trump can legalize on his own the ability of individuals to join a group or a health association across state lines and buy insurance,” he added.
Paul he has been pitching the idea of using the Employee Retirement Income Security Act to let people buy insurance across state lines. That law already allows corporations to buy insurance across state lines for their workers if they are located in several states.” (C)

“Sen. John Cornyn (R-Texas) is floating potentially tying a bipartisan deal on stabilizing the health insurance market to structural reforms favored by Republicans, after the latest bill to repeal and replace ObamaCare fell apart.
“Sen. [Lamar] Alexander [R-Tenn.] and Sen. [Patty] Murray [D-Wash] are working on some ideas on stabilizing the market, but more importantly, to me, Sen. [Bill] Cassidy [R-La.] and Sen. [Lindsey] Graham [R-S.C.] are looking at structural reform,” the No. 2 Senate Republican told reporters Tuesday.
Cornyn hasn’t previously appeared optimistic that he would be able to support a potential deal hatched by Alexander and Murray — the top two members on the Senate Health Committee — aimed at stabilizing the insurance market and providing ObamaCare’s cost-sharing reduction payments to insurance companies.
He added on Tuesday that he still wasn’t optimistic of the potential agreement as a stand-alone bill, saying, “I remain unconvinced that bailing out insurance companies is going to fix the problem.”
“That’s why if somehow we can combine the efforts of Cassidy and Graham for real reform, that might provide a potential solution,” he said.” (D)

“Graham and his co-conspirators previously said they would demand that tax cuts and health care reform be lumped together if they failed to make headway on health care in September. But on Tuesday, Graham changed course, saying he is now willing to let tax reform go ahead on its own because he had been unaware how complex tying the two together would be. Then, in the spring, Graham said, he will insist on a new budget resolution that allows for another crack at repeal using a 50-vote threshold — what is called budget reconciliation in the Senate.
Before Republicans spend another year plotting an ACA repeal, they may want to reflect on whether they have what it takes to get those 50 votes…..” (E)

“Trump said there would be another vote on healthcare in the first few months of 2018 and he would work with Democrats to make the effort more bipartisan. Democrats strongly oppose repealing and replacing Obama’s signature domestic policy achievement.
“I am … going to meet with Democrats and I will see if I can get a healthcare plan that’s even better,” Trump said. “So I will negotiate with Democrats, but from the Republican standpoint, we have the votes. We’ll vote in January, February or March.”
Trump did not explain the discrepancy between his conviction that the votes were there and the fact that not enough Republican senators supported the latest bill, forcing Republican leaders to scrap plans to hold a vote.” (F)

(A) LINDSEY GRAHAM ON OBAMACARE REPEAL: I HAD NO IDEA WHAT I WAS DOING, Ryan Grim, Aída Chávez, https://theintercept.com/2017/09/27/lindsey-graham-on-obamacare-repeal-i-had-no-idea-what-i-was-doing/
(B) Trump says he’ll negotiate with Democrats on health care plan, by David Jackson, https://www.usatoday.com/story/news/politics/2017/09/27/trump-says-hell-negotiate-democrats-health-care-plan/708790001/
(C) Rand Paul: Trump will take executive action on healthcare after Senate failure, by Pete Kasperowicz, http://www.washingtonexaminer.com/rand-paul-trump-will-take-executive-action-on-healthcare-after-senate-failure/article/2635769
(D) Key GOP senator floats tying bipartisan insurance stabilization deal to reforms, by JORDAIN CARNEY, http://thehill.com/policy/healthcare/352585-key-gop-senator-floats-tying-bipartisan-insurance-stabilization-deal-to
(E) THE GOP’S UNPREDICTABLE PATH TO HEALTH CARE REPEAL IN 2018, by Ryan Grim, Aída Chávez, https://theintercept.com/2017/09/28/republican-health-care-repeal-2018-graham-cassidy/
(F) Trump vows another healthcare vote next year, eyes executive order, by Jeff Mason, Susan Cornwell, http://www.reuters.com/article/us-usa-healthcare/trump-vows-another-healthcare-vote-next-year-eyes-executive-order-idUSKCN1C21IA

“Republican senators released a new version of their health care proposal Sunday night aimed at winning support from a handful of still undecided senators. The legislation includes language that gives states that expanded Medicaid after December 2015, access to an additional $750 million a year between 2023 and 2026.
Experts at both the Kaiser Family Foundation and the Brookings Institution confirmed CNN’s understanding that the provision would only make two states eligible for the millions in funding: Montana and Louisiana. That money, however, wouldn’t just be divided evenly — Louisiana would get tens of millions more because it’s population is larger, according to one expert.” (A)

“For now, people who get their insurance through Medicaid can rest easy…. Those with employer insurance can also coast along with the status quo….Most Obamacare customers won’t feel the sting of higher premiums, because government subsidies limit their exposure to a percentage of their income. But there are still millions of people who buy their own insurance and earn too much to qualify for subsidies. The rocky market will be worse for them, and possibly unaffordable.
Senators in the Health, Education, Labor and Pensions committee had been negotiating over a possible bipartisan deal to help stabilize the markets. The expected package would have guaranteed the disputed payments to insurers and provided states with some policy flexibility in future years.
But that effort was shelved by congressional leadership as part of the failed push to pass the Graham-Cassidy health care overhaul. Now, with contract signings imminent, it is probably too late for lawmakers to improve conditions much for next year.” (B)

“Already, state insurance regulators are approving big rate increases based on the assumption that Trump will discontinue CSR payments and Congress will not appropriate them….
It’s not just the CSR’s raising rates. Industry analysts say companies are also pricing in doubts about whether the White House will enforce the Obamacare individual mandate, which requires people to maintain coverage.” (C)

“The push to repeal Obamacare took on new life after a party lunch meeting two weeks ago at the Senate GOP’s campaign headquarters. There, they were presented with a dour assessment of the party’s finances as donors rebelled against a party that had abandoned its promise.
“Failure of health care has made the problem we had worse. It’s not just [contested] primaries but donors. Let me tell you, online giving went down 40 percent after we failed on health care. Pledges to the Republican Party went down 60 percent. And I understand that,” said Graham, who cheekily called such feedback “employer assessments.”” (D)

“ “We haven’t given up on changing the American health care system,” Senator Mitch McConnell of Kentucky, the majority leader, said after a lunchtime meeting of Republican senators. “We are not going to be able to do that this week, but it still lies ahead of us, and we haven’t given up on that.”
Democrats, who have spent all year fighting to protect the Affordable Care Act, a law that is a pillar of President Barack Obama’s legacy, responded by calling for the resumption of bipartisan negotiations to stabilize health insurance markets. Republican leaders had squelched those talks as the latest repeal plan, written by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, gained steam…
Senator Lamar Alexander, Republican of Tennessee and the chairman of the Senate health committee, and Senator Patty Murray of Washington, the senior Democrat on the panel, have been working on legislation to stabilize insurance markets and hold down premiums in the next couple of years. Both said on Tuesday that they hoped to resume those efforts.” (E)

“President Donald Trump tweeted his assurance Wednesday that Republicans will have enough votes to repeal Obamacare, one day after the GOP canceled its vote on the Graham-Cassidy healthcare bill…
“We will have the votes for Healthcare but not for the reconciliation deadline of Friday, after which we need 60,” Trump said. “Get rid of Filibuster Rule!” (F)

(A) Newest Graham-Cassidy bill has a pretty sweet deal — for Cassidy, by Lauren Fox, http://www.cnn.com/2017/09/25/politics/graham-cassidy-deal-for-sponsor/index.html
(B) How Failure of the Obamacare Repeal Affects Consumers, by Margot Sanger-Katz, https://www.nytimes.com/2017/09/26/upshot/how-the-failure-of-obamacare-repeal-affects-consumers.html?mcubz=0
(C) Obamacare Repeal Failed, but the Damage Is Already Done, by BENJY SARLIN, https://www.nbcnews.com/politics/congress/obamacare-repeal-failed-some-damage-already-done-n804956
(D) Inside the life and death of Graham-Cassidy, by JENNIFER HABERKORN, BURGESS EVERETT and SEUNG MIN KIM, http://www.politico.com/story/2017/09/27/obamacare-repeal-graham-cassidy-243178
(E) Senate Republicans Say They Will Not Vote on Health Bill, by THOMAS KAPLAN and ROBERT PEAR, https://www.nytimes.com/2017/09/26/us/politics/mcconnell-obamacare-repeal-graham-cassidy-trump.html?mcubz=0
(F) Trump tweets ‘we have the HCare Vote, but not for Friday!’ after the Graham-Cassidy healthcare bill collapses by Jonathan Ernst, http://www.businessinsider.com/trump-tweets-on-healthcare-bill-graham-cassidy-failure-filibuster-2017-9

“ “They’re going to find they can’t pay for it, they’re going to find that it doesn’t work. . . . Now that will make it tough on everybody. Maybe that’s what it take to wise people up.”
Wednesday is the deadline for insurers to sign contracts with the federal government so that they can sell health plans on the ACA marketplaces for 2018. Many companies are hiking these rates by double digits, but they have suggested they would curb such increases if they had assurances that the federal government would provide cost-sharing reduction payments for all of next year. Those subsidies provide discounts to lower-income customers for their health plan’s deductibles and other out-of- pocket costs.” (A)

“Senate Republicans gave up on their last-ditch bid to repeal Obamacare Tuesday as opposition in their own ranks ended months of fruitless efforts to deliver on a seven-year promise, and leaders said they would turn instead to overhauling the U.S. tax system.
“We don’t have the votes” for the health-care bill, co-sponsor Bill Cassidy of Louisiana told reporters in Washington. “We’ve made the decision, since we don’t have the votes, we’ll postpone that vote.” (B)

“Graham said that “it’s not if but when” Republicans will pass his healthcare bill, but said there was still work to be done before the bill was passed.
“We know what we’re against,” Graham said. “We’ve had a hard time articulating what we’re for.”” (C)

“One idea — which hardly enjoys widespread support at the moment — is to tie both health care and tax reform to the 2018 budget.
Graham and Sen. Ron Johnson, who both sit on the budget committee, have advocated for this idea. It has raised concerns among Republican lawmakers and staff alike who know just how messy that could potentially be. One GOP aide bluntly described that scenario as “a nightmare.” “(D)

“That means the GOP must either work with Democrats to get eight more votes on a healthcare bill or wait for mount another effort under reconciliation rules in either the fiscal year 2018 or 2019 budget.
“Look, we haven’t given up on changing the American healthcare system, we’re not going to do that this week,” McConnell said. “But it still lies ahead of us.”” (E)

“The ACA has helped millions to get health coverage, bringing the number of people without insurance to historic lows and improving both access to care and financial security. But because people at higher incomes don’t qualify for the law’s tax credits, many of them face high premiums and high out-of-pocket costs ― in some cases, more than they paid previously and, in the worst instances, more than they can realistically afford.
Those higher costs are largely a function of the law’s new requirements on insurers ― to cover everybody, regardless of pre-existing conditions, and to provide comprehensive benefits with each policy. Republicans have decried these effects, but every plan they proposed would have left many millions without insurance and gutted protections for pre-existing conditions.” (F)

“Meanwhile, the Trump administration has threatened to stop reimbursing insurers for covering the out-of-pocket costs of low-income customers, as the ACA requires. To hold down premiums in the exchanges, Congress should find a way to spread costs more broadly and guarantee the reimbursements for out-of-pocket costs. And the Trump administration needs to stop treating the exchanges like the enemy and focus instead on helping people get coverage.
With Graham-Cassidy-Heller-Johnson off the table, senators should resume the bipartisan efforts to stabilize the markets that the GOP leadership snuffed last week. And although Paul may still blanch at spending money on healthcare subsidies, most of his colleagues were ready to vote for a proposal that would have dedicated tens of billions of tax dollars to subsidizing coverage and care. It would be hypocritical and cynical for those Republicans to oppose efforts to help the exchange customers who are feeling the pinch now.” (G)

(A) Senate GOP abandons latest effort to unwind the Affordable Care Act, by Juliet Eilperin and Sean Sullivan, http://www.msn.com/en-us/news/politics/senate-gop-abandons-latest-effort-to-unwind-the-affordable-care-act/ar-AAstYYp?li=BBmkt5R&ocid=spartandhp
(B) GOP Kills Health-Care Bill, Ending Obamacare Repeal Quest, by Laura Litvan and Steven T. Dennis, https://www.bloomberg.com/news/articles/2017-09-26/senate-gop-drops-obamacare-repeal-effort-for-lack-of-support
(C) IT’S OVER: Republicans will not vote on Graham-Cassidy health care bill, by Bob Bryan, https://www.aol.com/article/news/2017/09/26/its-over-republicans-will-not-vote-on-graham-cassidy-health-care-bill/23223713/
(D) Senate won’t vote on GOP health care bill, by Lauren Fox, MJ Lee, Dana Bash and Deirdre Walsh, http://www.cnn.com/2017/09/26/politics/health-care-republican-senate-vote/index.html
(E) IT’S OVER: Republicans will not vote on Graham-Cassidy health care bill, by Bob Bryan, https://www.aol.com/article/news/2017/09/26/its-over-republicans-will-not-vote-on-graham-cassidy-health-care-bill/23223713/
(F) The GOP’s Latest Obamacare Repeal Bill Is Dead, , by Jonathan Cohn, http://www.huffingtonpost.com/entry/graham-cassidy-failure_us_59ca9a35e4b07e9ca11f3d1b
(G) Editorial Graham-Cassidy is dead. Now stop treating Obamacare like the enemy and help get Americans health coverage, http://www.latimes.com/opinion/editorials/la-ed-graham-cassidy-dead-20170926-story.html

“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

“In fact, the Obamacare legislation required coverage of pre-existing conditions. This legislation does not change that. So pre-existing conditions continue to be covered,” Short said on CBS News’ “Face the Nation.”
While he assured that the proposed legislation “guarantees” that pre-existing conditions will continue to be covered, experts say that people with health problems or with pre-existing medical conditions could be charged more if the state they live in obtains a waiver from current requirements that forbid insurers from charging higher premiums based on health status.” (A)

“One of the biggest issues in the repeal/replace debate has been coverage for pre-existing conditions, genetic risks and chronic illness. Before the Affordable Care Act, insurers could deny coverage to people with diseases like diabetes or charge them much higher premiums. The ACA requires insurers to cover pre-existing conditions without charging more. The GOP bills passed or proposed would give states the power to waive that requirement. People with disabilities or chronic diseases, people who have had cancer, and parents of children born with health problems like late-night host Jimmy Kimmel say that could make insurance unaffordable.” (B)

“The GOP’s latest attempt at an Obamacare repeal bill seemed to take more fatal blows Sunday, with Republican Sens. Susan Collins and Ted Cruz announcing they will likely not vote for the legislation.
Cruz’s call is especially surprising since he voted for earlier bills attempting to repeal and replace Obamacare, and even authored an amendment to help usher one of the failed bills through the Senate…
Cruz said the bill — which calls for Obamacare to be dismantled in favor of state-based plans — doesn’t match his desire to see a more competitive health care market…
Collins, from Maine, said her “no” vote is all but official… “It’s difficult for me to envision a scenario where I would end up voting for this bill,” she told CNN’s “State of the Union.”
“We already have a problem under the Affordable Care act with the cost of premiums and deductibles, and finally, I’m very concerned about the erosion of protections for people with pre-existing conditions.” (C)

“Sen. Lindsey Graham, R-S.C., directly addressed fellow Republican Sen. Rand Paul of Kentucky over his opposition to the latest GOP bill aiming to repeal and replace Obamacare, saying the new legislation would “save a lot of money.”
“Rand Paul objects to the taxes, but when you look at the bill, Rand, we save a lot of money over time for Medicaid,” Graham said in an interview with ABC News Chief Global Affairs Correspondent Martha Raddatz on “This Week” Sunday. “We’ve put a cap on Obamacare growth to make it more sustainable, more affordable, more flexible.”” (D)

“Short meanwhile on Sunday continued to claim that under Graham-Cassidy, people with pre-existing conditions would be “protected,” although in the current version of the bill, that is not as straightforward.
The requirements would be loosened compared to what is currently law under the Affordable Care Act.
Under Graham-Cassidy’s language, a state must show how it “intends to maintain access to adequate and affordable health insurance coverage for individuals with pre-existing conditions” if it requests a waiver. However, it offers no additional guidance or details on how that would be binding, leaving major questions for coverage for people with pre-existing conditions. (E)”

(A) WH’s Marc Short claims Graham-Cassidy guarantees coverage for pre-existing conditions, https://www.cbsnews.com/news/whs-marc-short-claims-graham-cassidy-guarantees-coverage-for-pre-existing-conditions/
(B) Biggest Flash Points In The Graham-Cassidy Health Care Bill, by NANCY SHUTE, http://www.npr.org/sections/health-shots/2017/09/24/552891450/biggest-flash-points-in-the-graham-cassidy-health-care-bill
(C) Sens. Ted Cruz and Susan Collins announce opposition to Graham-Cassidy health care bill, by Jason Silverstein, http://www.nydailynews.com/news/politics/ted-cruz-susan-collins-announce-opposition-gop-health-bill-article-1.3517860
(D) GOP health care act sponsor to a Republican opponent: The bill will ‘save a lot of money’, by NICKI ZINK, http://abcnews.go.com/Politics/gop-health-care-act-sponsor-republican-opponent-bill/story?id=50047278
(E) White House ‘Planning’ on Health Care Vote This Week, by KAILANI KOENIG, https://www.nbcnews.com/politics/congress/white-house-planning-health-care-vote-week-n804271