Graham-Cassidy: The GOP’s Worst Effort Yet

  • Ryan Ross
  • Sep 23, 2017 11:06AM

Lindsey Graham burnished a name for himself as one of the few remaining moderate Republicans, the guy to whom Democrats could turn for bipartisan support — as long as the policy in question was good for America. Like his colleague and best friend John McCain, Lindsey Graham has a reputation as a “maverick” politician, the kind of clear-eyed straight shooter who isn’t afraid to wage war with members of his own party when his conscience demands he do so.

Reality, however, paints a different picture.

Far from being the voice of sanity in an increasingly divisive political landscape, Graham is instead regarded (if he is regarded at all) on both sides as a waffler. He is a Church Lady, publicly clutching his pearls at the nastiness of the political discourse as he vows to Do The Right Thing…only to reliably toe the party line in a close vote (or cast a meaningless vote of so-called conscience when the outcome is all but assured). Graham may consider himself more pure and honest than partisan hacks like Trey Gowdy and former Rep. Jason Chaffetz, but when the rubber meets the road, he’s the same product in a different package.

For a while, Graham tested the waters of a potential run at the presidency, believing that his performative centrism would make him more appealing to a broader swath of voters. What Graham didn’t realize, however, is that centrism is not regarded on either side of the aisle as evidence of a good politician; quite the contrary, in fact. Centrism is synonymous with cowardice; it is half-measures designed not to piss off too many people, with the ultimate goal of somewhat satisfying just enough voters to win re-election.

Like Hillary Clinton, Graham clung for far too long to this outmoded idea of governance; unlike Clinton, however, the GOP abandoned any pretense of bipartisanship or cooperation long ago. Clinton was still viewed as a viable option in the current political climate (for reasons passing understanding) on the left; on the right, however, Graham was the odd man out, the last one standing when the music stops.

At the outset of Donald Trump’s presidential campaign, Graham called Trump a “jackass” in a July 2015 interview with CNN; when Trump secured the Republican nomination, Graham made it clear that he would not vote for – to say nothing of endorse – Donald Trump for President. Since Trump’s inauguration, Graham has positioned himself, according to Politico, as a “fierce critic” of the Trump administration, having taken every opportunity to act as a thorn in its side.

Graham did this because, at the time, he could afford to do it. Early on in the Trump administration, it was widely assumed that a Republican-led Congress, backed by a Republican in the White House, would have free reign to pass whatever legislation it wanted. As a result, it was easy for Graham to continue playing his favorite role; he could cast his protest votes and say all the right things to make himself look like the “kind-hearted conservative,” secure in the knowledge that the GOP’s goals would still be achieved.

And then the wheels came off.

Now, largely due to overwhelming public pressure, the Republicans’ legislative agenda has hit a wall, most notably with the GOP’s multiple failed attempts to repeal the Affordable Care Act. Given the opportunity to fulfill the promises on which they’ve campaigned for nearly the past decade, Republicans have little to show for it. This is, ostensibly, the point at which Lindsey Graham could step up and submit a piece of legislation that puts its money where his mouth is: one with bipartisan cooperation, one that ignores all the party-line rhetoric and focuses solely on fixing what’s wrong with the ACA and improving people’s lives.

Wherever expectations exist, rest assured that Lindsey Graham is lurking somewhere nearby, ready to fall short of them. The Graham-Cassidy health care bill, co-written by Senator Bill Cassidy (R-La.), achieves the impossible: it somehow manages to be worse and more harmful than the last piece of garbage masquerading as health care legislation the GOP tried to jam through in the dead of night.

The bill would roll back the Medicaid expansion and subsidy funding provided by the ACA, dropping to zero in 2027 — despite Graham’s repeated insistence that his plan would allow individuals to keep their ACA coverage. Republicans, for their part, insist that this plan is still workable, assuming the states that took advantage of the Medicaid expansion can streamline their operations. If they can’t, however, the more a state invested in the Medicaid expansion, the harder-hit it would be; California, for example, could stand to lose up to roughly $28 billion in federal funding.

Not only that, but the rest of Medicaid would also be converted to a block-grant program, under which states would be given a chunk of money to spend on health care. This tracks with the typical GOP thinking that states should be allowed to do what they want with their money; however, there are serious problems with block grants.

The biggest issue is that block grant funds are typically insufficient to actually meet the states’ needs. Moreover, the amounts are set in stone — each state gets what they get, and if the money runs out, too bad. Which means if you live in an area that suddenly undergoes a dramatic recession (think Detroit), the federal government will not provide more money to fund necessary programs like health care. That is, of course, assuming that your state’s representatives actually use the block grant money for its intended purpose; block grants can be used in whatever manner the state government sees fit.

On top of that, the Graham-Cassidy bill would eliminate subsidies to insurance companies and the employer and individual mandates. You might think this is great because “freedom,” but before you get too excited, look at it this way: With the elimination of the employer mandate, your job can suddenly decide they don’t want to offer health insurance anymore, which means you’ll have to shop for your own insurance. But if companies aren’t given a subsidy to offer affordable coverage to everyone, then they’ll look to make that money back through other means; i.e., charging you more money for insurance.

The bill would also allow insurers to charge individuals with preexisting conditions more for coverage, just as it would give insurers the option of reinstituting the lifetime coverage limits. (In fairness, the bill doesn’t strictly say that; instead, they put everything in the hands of the states. But the states will allow the insurance companies to operate however they want; if they don’t, insurers won’t do business in that state, which means more people requiring government-funded healthcare.)

On top of all that, the bill would also redirect some of the money spent on the ACA to Republican-led states that decided not to take advantage of the Medicaid expansion, effectively rewarding Republican governors for disregarding their constituents’ health and financial security in order to score cheap political points.

In essence, the bill punishes states like New York and California for (I guess) being liberal, while rewarding the states whose federal funding is typically paid for by New York and California with free government money. The cost of that money? According to the Commonwealth Fund, just the well-being of 32 million people in the next 9 years. (I would have liked to use the CBO estimates, but wouldn’t you know it, they won’t be ready until the absolute last minute before the vote.)

Maybe you’re thinking “Well, if those liberal New Yorkers want single-payer so badly, they can just use the block-grant money to set it up!” That would be great; seeing single-payer in action on a state level would allow us to effectively measure its viability without all the rhetoric and hyperbole. For the GOP, that would mean the risk of single-payer working so well that even red state voters would start asking for it; naturally, they’re considering adding a provision banning states from using block-grant money to implement single-payer. They’re not the party of limited government for nothing, folks.

Graham-Cassidy is, in no uncertain terms, garbage. It is essentially a legislative version of Lindsey Graham’s political career: it tries to serve as many masters as possible, only to disappoint most of them. And yet, there’s a very real possibility that it could end up being the crowning achievement of a political career rife with mediocrity and missed expectations. We can only hope that like most everything else Graham does, this effort also comes up short.