A bill proposed by Republican Senators Bill Cassidy (LA) and Lindsey Graham (SC) would dramatically reduce federal funding for health care over the course of the next decade, according to a new report.

Released Wednesday, the Graham-Cassidy bill is seemingly the last viable option for Republicans hoping to repeal the Affordable Care Act, or ACA, this year. The bill faces a steep — and likely doomed — battle in Congress: it has yet to be scored by the Congressional Budget Office (CBO) or be cleared by the Senate parliamentarian, and several lawmakers have indicated they will push to hold hearings before they vote.

But should the bill survive, experts are sounding the alarm about its likely impact — and the picture is a grim one.

Under the bill, federal health care funds would decrease by $299 billion across all states in 2027 alone relative to current law, the Center on Budget and Policy Priorities (CBPP) said Friday. Like other health care solutions floated by conservatives, the bill by Cassidy and Graham would also likely leave a staggering number of Americans without health insurance. Projections from the CBO have estimated that repealing the ACA without a replacement would leave around 32 million people without coverage; the CBPP report argues the Graham-Cassidy bill could lead to an even higher number.


The report’s findings are bad news for Republicans, who are currently working to bypass a stalemate in Congress. President Donald Trump vowed prior to taking office that he would repeal the ACA, but his efforts have met with extraordinary opposition and infighting. After multiple attempts to pass a new health care bill, Senate Republicans appeared to surrender on ACA repeal last month, seemingly concluding a six-month effort after several GOP senators rejected yet another proposed bill.

“[The] problem on health care was not the Democrats,” Senate Majority Leader Mitch McConnell (R-KY) told reporters at the time. “We didn’t have 50 Republicans.”

But the Graham-Cassidy bill is a sign that some Republicans haven’t completely moved on. They’re also running out of time — lawmakers have a little over 10 days to pass a bill using the reconciliation process employed to move ACA repeal along. That looming deadline is making the Graham-Cassidy effort more appealing — but reports like the CBPP’s are sounding the alarm for opponents, who argue the bill’s methodology would be just as bad, if not worse, than other Republican health care proposals.

Under the Graham-Cassidy plan, Medicaid expansion would be cut and health care would be placed in the hands of the states.


“How about this idea: Instead of trying to re-do Obamacare in Washington, why don’t you turn to the governors,” Graham said last month. “Take all the money you would spend in Washington on health care, block grant it back to the states and let them design health care systems closer to your family.”

But that block granting proposal is one many health policy experts have strongly cautioned against, arguing that shifting costs off of the federal government would result in millions of people either losing their coverage or continuing without health care. Higher premiums could also become a serious problem — imperiling insurance markets and cuing the dreaded “death spiral” policymakers have long sought to avoid.

That reality hasn’t discouraged the bill’s sponsors. “I’m confident we’ll get there on the Republican side,” Cassidy told reporters Friday. “People are coming out and saying they are for it, either publicly or privately.”

The Louisiana senator said the bill has the support of approximately 48 or 49 Republicans, meaning only one more senator is necessary for the bill’s passage. (Vice President Mike Pence will serve as the tie-breaking vote, if needed.) But Cassidy’s optimism reflects comments made by other Republicans prior to the failure of earlier bills — something that has led to skepticism over whether anything is different this time.

Some Republicans have already come out against the bill. On Friday, Sen. Rand Paul (R-TN) emphasized on Twitter that he would not support the effort.

“I can’t support a bill that keeps 90% of Obamacare in place,” he wrote. “#GrahamCassidy is not repeal or replace, it is more Obamacare Lite.”

I can't support a bill that keeps 90% of Obamacare in place. #GrahamCassidy is not repeal or replace, it is more Obamacare Lite — Senator Rand Paul (@RandPaul) September 15, 2017

Still, some are cautioning that the bill is closer to passing than previous efforts. In an email sent Friday, Brad Woodhouse, director of the Protect Our Care Campaign, warned that the Graham-Cassidy proposal could garner unexpected support from conservatives.


“Given Republicans will have to ram this partisan repeal bill through the Senate in the next two weeks in order to meet this September 30 deadline there will be no time for a regular process for the public to fully understand the impacts on their health care — with no time for adequate hearings, consultations with experts, constituent input, and amendments,” Woodhouse wrote, going on to emphasize that the bill should be taken seriously.

“The American people need to know the facts about how this bill will impact them,” he underscored.