Commonwealth Fund: What Are the Potential Effects of the Graham-Cassidy ACA Repeal-and-Replace Bill? Past Estimates Provide Some Clues
Last week, Sens. Lindsey Graham (R–S.C.) and Bill Cassidy (R–La.) unveiled congressional Republicans’ latest bill to repeal and replace the Affordable Care Act (ACA). The Congressional Budget Office (CBO) has indicated that it will not release a score of the bill that includes its effects on insurance coverage for several weeks, but Senate leaders have indicated they will hold a vote without a score. The bill, however, is similar to prior ACA repeal-and-replace bills for which we do have CBO scores. Based on those estimates, it is likely that the bill, if enacted, would lead to a loss of health insurance for at least 32 million people after 2026.
The bill can be boiled down to five key provisions:
- Repeals the ACA marketplace subsidies and federal funding for the Medicaid expansion in 2020.
- Creates temporary block grants for states that end in 2026. States can use the funds for a wide range of purposes.
- Repeals the individual and employer mandates.
- Creates a waiver program for states that would allow insurers to charge people more based on their health and cut benefits like maternity care.
- Places per capita spending limits on funding for the traditional Medicaid program.