The Cassidy-Graham bill would repeal the ACA’s tax credits for middle-income Americans, the cost-sharing reduction subsides for low-income Americans, and the Medicaid expansion in 2020. It replaces all those programs with a market-based health care grant program, which would send states a lump sum of money to put toward health care–related purposes. Under Cassidy-Graham, this money could be spent on funding high-risk pools, sending payments to insurers to “stabilize premiums and promote State health insurance market participation, or making payments directly to health care providers, like doctors and hospitals.

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