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Legislative Updates

Health care repeal legislation scored by CBO, faces failure

The latest attempt in the Senate to repeal and replace the Affordable Care Act (ACA, also known as “Obamacare”) may be facing the same fate as those before it.

Sens. Bill Cassidy (R-LA), Lindsey Graham (R-SC), Dean Heller (R-NV) and Ron Johnson (R-WI) introduced S. Amt. 391, an amendment to the American Healthcare Act of 2017 (H.R.1628), which passed the House in May. Among the Cassidy-Graham bill’s many effects is a proposal to end the expansion of Medicaid and its subsidies, replacing them with block grants for states.

By using budget reconciliation as a tool to circumvent the typical 60-vote threshold, Senate Majority Leader Mitch McConnell (R-KY) suggested that he would hold a vote on the measure if he could secure the 50 votes necessary for it to pass the Senate via reconciliation.

That goal may be out of reach now, though.

With Sen. Rand Paul (R-KY) and John McCain (R-AZ) publicly opposing the measure, and with Sen. Susan Collins (R-ME) joining them minutes after the release of a preliminary report from the independent Congressional Budget Office (CBO), Cassidy-Graham appears destined to fail.

The CBO report estimated that, while the measure—if passed—would reduce the federal deficit by at least $133 billion, this reduction would come at the expense of millions of Americans either losing health care or being denied access to it. Such coverage losses would be the result of Medicaid cuts, cuts to tax subsidies for people to purchase private insurance, and the repeal of the ACA’s individual mandate.

Should the vote still take place, however, it must pass both the Senate and the House of Representative by this Saturday, Sept. 30, to make use of the reconciliation process. Since Fiscal Year 2018 begins on Oct. 1, any attempt to pass a health care bill after Sept. 1 would require at least 60 votes—that is, it would need support from Democrats under a bipartisan effort, something many Republicans are hoping to avoid.

Letter carriers and the Federal Employees Health Benefit Program (FEHBP) would not be immune to the consequences of repeal. Here are four reasons why:

  1. The bill would take insurance away from millions of Americans, making premiums rise nationwide to recoup the cost of providing uncompensated health care (FEHBP, too).
  2. The bill would waive insurance regulations, allowing health exchanges to collapse, weakening protections for those with pre-existing conditions and exposing FEHBP to similar disastrous consequences in the near future.
  3. Corporations and the wealthy would get tax breaks through federal funds meant to pay for the ACA.
  4. The “employer mandate,” requiring USPS to provide health care for city carrier assistants (CCAs) and others, would be repealed. Although CCA coverage would still be guaranteed by our contract, without the mandate, USPS might try to drop CCA coverage in future rounds of bargaining.

NALC members are encouraged to tell their senators to oppose Cassidy-Graham—the Senate’s last-ditch effort to dismantle the ACA.

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