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The Future Of Graham-Cassidy In Doubt

LULU GARCIA-NAVARRO, HOST:

From politics on the field to the policy debate over health care. Republicans have proposed a new health care bill that they hope to bring to a vote this week. Senator John McCain announced on Friday that he could not in good conscience vote for it. And now Senator Susan Collins has said on CNN that it would be difficult to envision a scenario where she'll vote for the bill. The bill needs 50 votes to pass. And its future is now further in doubt. So what happens now? Noam Levey covers health care for the LA Times and he joined me in the studio. And we started off by talking about what's in that health care proposal.

NOAM LEVEY: Number one, what this bill does is to essentially blow up the whole system that the federal government uses to provide safety net health coverage to almost 100 million Americans. And what the bill would then do is redistribute money between states, moving money from states that have expanded coverage through the Affordable Care Act - states like Kentucky, West Virginia, Arkansas - and shifts it to states that have not expanded their safety nets - Texas, Florida and some other primarily red states. Every independent analysis of what this proposal would do suggests that many, many Americans - poor Americans - will likely lose health coverage.

GARCIA-NAVARRO: So you're saying that this is not only going to affect people on the exchanges but also people who are on Medicaid and Medicare?

LEVEY: That's right. The Affordable Care Act extended coverage to 20 million previously uninsured Americans. And the important thing to understand about the law is that it did that in a number of different ways. The marketplaces, the exchanges have gotten the lion's share of attention here. But the amount of money and assistance that's gone to states to expand eligibility for Medicaid is enormous. And it's, in fact, there where most of the gains in coverage have been and for the same reason what Senators Graham and Cassidy are proposing because it would cut Medicaid so dramatically over time, would erode coverage most dramatically there, as well.

GARCIA-NAVARRO: The Affordable Care Act is still in force. How is it doing?

LEVEY: So there are substantial challenges for the Affordable Care Act right now. There are a lot of Americans who are seeing their health insurance premiums rise - in some cases, very steeply. These are primarily the Americans who get health insurance on their own. These are people who don't qualify for government programs and don't get health insurance through an employer. It's a relatively small part of the American health care system. But nonetheless, for 10-20 million Americans, this is real. So there is an overwhelming feeling on the part of health insurers, on the part of hospitals, doctors, and actually on the part of lawmakers on both sides of the aisle that something should be done to bolster health insurance markets where these people get their coverage.

GARCIA-NAVARRO: So when we look at this, what is the future of the Affordable Care Act? Do we know?

LEVEY: Well, we don't know. The Senate has only until the end of next week before a deadline passes, and they can no - the Republicans can no longer use this process that allows them to pass a bill with a simple majority in the Senate. The conventional wisdom would suggest that once that deadline is passed, Republicans want to move on to something else. They want to move on to tax reform. So, perhaps, is the Affordable Care Act protected? It may be. But one thing I think this year has shown is that there is such an appetite on the right, on the conservative base of the Republican Party to repeal Obamacare that it's very hard for a lot of Republican politicians to simply drop this.

GARCIA-NAVARRO: Noam Levey covers health care for the LA Times. Thank you so much for joining us.

LEVEY: My pleasure. Transcript provided by NPR, Copyright NPR.