Lots of observers, including some very well placed ones in Congress, argue that health care will just be put aside now for a time and will wait for a later opportunity. They say it’s time to turn to tax reform. The “put it aside” argument assumes that the Trump administration will just continue to administer Obamacare as it has been, which is unlikely. This fall we may well see a much expanded “hardship exemption” for the individual mandate that could render the mandate essentially void, and the administration may also stop providing funds for cost-sharing reduction payments if Congress does not appropriate money for them.

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Senate Republicans on Tuesday abandoned their latest effort to replace ObamaCare, or, more precisely, a handful of Senators defeated the Graham-Cassidy proposal despite their campaign rhetoric. Mark them down as ObamaCare’s saviors.

Top billing goes to Kentucky’s Rand Paul, who rode into Congress in 2010 on repealing the Affordable Care Act but in office has become the definition of a feckless libertarian. He helped to kill the Senate’s first replacement bill over the summer because it did not repeal every last footnote in the law. Then he supported “skinny repeal” that merely repealed the individual and employer mandates and medical-device tax, justifying that vote as realistic.
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Senate Majority Whip John Cornyn (R-Texas) on Tuesday said Congress should move onto tax reform and not try to pair it with a new plan to repeal ObamaCare.

Cornyn signaled the widespread GOP fear that adding a health-care debate to the tax bill will only bog down a reform package that is President Trump’s new top priority.

Cornyn, the No. 2 Republican in the Senate, said he does not support combining tax reform and ObamaCare repeal in a single budget reconciliation measure that would allow the GOP to protect their bill from a Democratic filibuster.
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Republicans in the U.S. Senate have just over a week, until Sept. 30, to pass an Obamacare repeal bill with a bare majority (instead of 60 votes). But in the rush of whip counts and CBO scores, don’t forget: This is an incredibly dangerous debate for Republicans. The public, through a variety of poll results, has made plain that it doesn’t like what the GOP is doing.

The latest YouGov poll, for example, found that 38 percent of respondents picked Democrats as the party that would do “a better job handling the problem of health care”; 24 percent picked Republicans. The Affordable Care Act, meanwhile, has a positive net favorable rating, and the various GOP repeal-and-replace bills have generally polled terribly.
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Only in government does modestly slowing spending growth mean severe “cuts.” Opponents of the Graham-Cassidy-Heller-Johnson (GCHJ) proposal to change ObamaCare falsely claim that it will result in massive spending cuts, especially in Medicaid. That simply is not true.

The bill does not spend fewer dollars. In fact, under this bill, taxpayers will spend more over the next 10 years than they are spending right now. The “severe” change being referenced in almost every news story is a reduction in the rate of growth. Some ObamaCare supporters have even claimed that Congress will be unable to afford the GCHJ block grants.
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With time running short, the authors of the latest plan to repeal and replace the Affordable Care Act shifted money in the bill to Alaska and Maine, which are represented by Republican senators who appear reluctant to support it.

The revised version of the bill, written by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, would provide extra money for an unnamed “high-spending low-density state,” a last-minute change seemingly aimed at Alaska and its holdout Republican senator, Lisa Murkowski, who has yet to say how she will vote. It would also send money toward Maine, whose Republican senator, Susan Collins, had said earlier on Sunday that she would almost certainly vote no.
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John McCain is an American war hero with many political accomplishments. That legacy, though will be diminished by not one but two decisions to kill Republican health-care reform. And no one should let Senator Rand Paul off the hook, either.

Mr. McCain said in a Friday statement that he “cannot in good conscience” vote for a proposal from Lindsey Graham and Bill Cassidy that would devolve ObamaCare funding to the states, as well as repeal the medical-device tax and the employer and individual mandates. The deadline to pass the bill with 51 votes is Sept. 30 thanks to arcane Senate budget procedures. Mr. McCain’s no vote almost certainly dooms the project, as Mr. Paul has already declared his opposition and Susan Collins of Maine is thought to be a reliable no vote as well.

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The last train is leaving Reconciliation Station. Republican efforts to repeal and replace Obamacare — derailed just weeks ago — now seem back on track. GOP senators Lindsey Graham of South Carolina, Bill Cassidy M.D., of Louisiana, Dean Heller of Nevada, and Ron Johnson of Wisconsin seek 47 more votes (including, if necessary, that of Vice President Mike Pence, to break a 50–50 tie) to pass their legislation within the Senate’s filibuster-proof reconciliation window. It closes September 30. Having snored through August, Republicans are scrambling to keep the repeal/replacement pledges that secured them the House, Senate, and White House.

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Sen. John McCain (R-Ariz.) on Friday announced that he will vote against the latest proposal to repeal ObamaCare, potentially dooming the legislation and, with it, the GOP’s last shot at passing a health care overhaul this year.

“I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” he said in a statement, referring to the legislation spearheaded by GOP Sens. Lindsey Graham (S.C) and Bill Cassidy (La.).
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Democrats once liked a federalist solution to health care, and Sen. Lindsey Graham was one of those who worked with them. In 2007 he and Wisconsin Democrat Russ Feingold proposed the State-Based Health Reform Act that would have given states even more freedom than Graham-Cassidy. But these days Democrats fear that state laboratories would discredit the command and control approach to health care that they hope will lead to single-payer. The choice Republicans face isn’t between Graham-Cassidy or some bipartisan beau ideal. Their choice is to pass their own bill, which now means Graham-Cassidy, or fail again and cede the health-care advantage to the single-payer wing of the Democratic Party.

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