Are senate cosponsors misleading their colleagues about their bill to repeal ACA?

Political writer Jonathan Cohn says they may be.   In an article for HuffPost, Cohn writes:

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"The co-sponsors of new Senate legislation to repeal the Affordable Care Act are misleading America about the effects of their proposal. They may also be misleading their own colleagues.

"The story Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) tell about their legislation during speeches and news conferences is a straightforward, seemingly innocuous one ― that they are simply transferring money and authority away from the federal government.

"To their colleagues in the Senate, Graham and Cassidy make a different, more nuanced pitch. With key Republicans nervous about what the bill would mean for coverage of their constituents, Graham and Cassidy are promising the vast majority of Republican states would end up with more money, not less, if the proposal becomes law.

"The story Graham and Cassidy are telling the public is a vast over-simplification, one that leaves out the bill’s most important elements.  And the story they are peddling to colleagues?  That’s even more misleading.

"The bottom line is that the Graham-Cassidy bill is like every other repeal proposal that’s come before Congress this year. It would mean millions more people struggling to get care or being exposed to financial hardship. And it’d most certainly hit some Republican-leaning states hard. 

"What Graham-Cassidy would actually do

"Graham and Cassidy are telling the truth when they say their proposal turns [over] control of the Affordable Care Act to the states. Specifically, they would transform the program into a “block grant,” giving states enormous leeway over how to spend the money that, in today’s system, goes to finance expanded Medicaid programs and subsidized private insurance.

"But the proposal actually does a great deal more than simply give states more control over how to spend dollars now going to health care. It also gives them less of that money to spend.

"On the whole, the block grant would be smaller than what states would receive if the Affordable Care Act remains in place. That is very much by design, because Graham and Cassidy want to reduce federal spending. But the cut would be substantial ― to the tune of $239 billion over the first 10 years, according to the Center on Budget and Policy Priorities, which so far is the only independent organization to conduct this kind of analysis.

"That’s a smaller cut than the Senate’s leadership bill from July envisioned, but almost surely, it’s still enough to affect health insurance for at least a few million people. More important, the block grant would expire after 10 years. That’s right, funding to “replace” Obamacare would drop to zero.  At that point, Congress could always authorize new spending. But given the parliamentary obstacles to such expenditures, it would quite likely appropriate less ― and maybe a lot less.

"Meanwhile, the bill calls for redistributing funds among the states ― in general, taking from those, like California, where officials have tried diligently to expand coverage and giving to those, like Texas, where officials have done nothing or even tried to undermine the [ACA].

"And then, on top of all that, the bill would cut Medicaid by introducing a “per capita cap,” reducing projected spending on the program by roughly $179 billion in the first 10 years, based on Congressional Budget Office assessments of previous legislation. This is a change that would affect the entire Medicaid program, including the parts that existed before the [ACA} came along, which would mean less coverage for groups like poor children and the disabled that Republicans have frequently promised to protect.

"How Cassidy is trying to cover up the bill’s effects

"Judging by how many GOP senators voted for repeal bills in July, most are willing to live with such cuts, at least on a national level, even if they don’t like to advertise them. But many of those senators remain skittish about the precise effects cuts would have on their own constituents ― and that’s a big political problem for the Graham-Cassidy bill, thanks in part to how it redistributes that money among the states.

"In general, the bill would move money from Democratic to Republican states. Graham and Cassidy have generally acknowledged this, when pressed, and sometimes justified it in the name of fairness.  

"But when the Center on Budget and Policy Priorities looked at the effect of Graham-Cassidy on a state-by-state basis, it found that plenty of GOP states would end up losing out in the first decade.'

[Cohn then lists some of the Republican states that the Center says would get less money in this plan.   They include Alaska (Sen. Murkowski), Arizona (Sen. McCain), Maine (Sen. Collins) the three Republicans that voted No on the last bill, resulting in its defeat.   In addition, states losing money would also include Ohio (Sen Rob Portman) and West Virginia (Sen. Shelley Moore Capito) -- two senators who are known to have wavered about voting against the last bill.]

[Cohn further states that Sen. Cassidy has put out a spread sheet, purportedly showing something different, where "states with key Republican senators end up with more money, not less."   Cohn then goes into detail about the erroneous figures that Cassidy is using, which ignores the fact that health care costs are rising faster than inflation.   He also points out that Cassidy's spread sheet ignores the effects of the per-capita caps on Medicaid which the bill imposes and which zero out any funds in 10 years.]

"In short, the cuts are much deeper than Cassidy’s spreadsheet shows, and the bill would hurt many more states than the document acknowledges.

"In a normal legislative debate, such propaganda wouldn’t really matter. Multiple independent experts, including those at the Congressional Budget Office, would have plenty of time to analyze the proposal. Lawmakers, in turn, would have plenty of time to study those results ― and reach their own conclusions about which projections were the most reliable and which raised issues that mattered most to them.

"But with the debate suddenly moving at breakneck speed, and a possible vote next week, that won’t happen. Already the CBO has said it doesn’t have time to provide a full analysis, including effects on coverage and premiums, as it did for previous bills. As a result, Cassidy’s misleading numbers could sway one or two key senators, potentially making the difference in whether millions of Americans lose access to health care."

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So here we are again.   Republicans trying once again to sneak one over when there is no time for analysis and study of a change in how we manage one-sixth of our nation's economy -- which also happens to affect the lives of millions of their own constituents.

Lindsey Graham is trying to sell this on the virtues of "local control," and someone to complain to who will listen if you have problems with it.   But ten governors, five Democrats and five Republicans, signed a letter urging senators not to pass this bill.   They don't want it.   And Obamacare now has a majority of people in polls who like it.   There is no real movement to get rid of it -- except among Republican politicians -- and their wealthy donors who want to get rid of the tax on them that is part of Obamacare.

Have they no conscience?   Have they no shame?   Is scoring "a win" so important that they will try to pass, by stealth and deception, what the American people do not want them to do and what they have failed to pass dozens of times already?

Ralph