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September 15, 2017

NPAF Statement on the Graham-Cassidy Proposal

Senators Bill Cassidy and Lindsey Graham have proposed a health care bill that they describe as emphasizing state flexibility and eliminating inequity in payments across states. However, the proposal as written represents billions of dollars in cuts to current public programs, along with the potential to do away with now-sacred patient protections, such as the prohibition on discrimination based on a preexisting condition. We believe these changes are detrimental to the progress we’ve made in securing access to affordable, quality care for all people, and can not support this proposal.

The bill would end the Affordable Care Acts (ACA)’s Medicaid expansions, premium tax credits and cost-sharing reduction payments, along with other programs, and redistribute that money to the states. Medicaid would be transformed, with mandatory per capita grants imposed and an option for states to take up a block grant as well.

The Graham-Cassidy bill would repeal both the individual and employer mandates. It repeals the prevention and public health fund established by the ACA, and insurers could offer catastrophic coverage, starting in 2019. While the bill does not formally repeal the prohibition on discriminating against preexisting conditions, states have broad waiver abilities that could allow insurers to charge more for premiums based on health status or age. States could also waive the essential health benefits and medical loss ratio requirements.

While touting flexibility, the Graham-Cassidy bill only really gives insurers and administrators flexibility. Under such a law, patients instead will be stuck with more expensive plans with less coverage.

Without a CBO score, it is impossible to say exactly what damage this bill could cause. However, based on previous CBO estimates from other GOP proposals, we know that this bill would be catastrophic for patients—especially those with preexisting conditions—along with their families and caregivers.

NPAF urges Congress to continue forward with a bipartisan effort to improve existing features of the ACA. All people should be free from inequitable insurance practices and should be able to purchase quality plans that meet their needs and budget. As an organization representing patient voices across the United States, we urge Congress to heed constituent concerns and cease misguided efforts to repeal the ACA.