CEDAR RAPIDS — Although President Donald Trump has thrown his support behind the Graham-Cassidy health care overhaul, Sen. Chuck Grassley thinks Republicans are one to two votes short of being able to pass the Obamacare replacement bill.
“And I don’t see those other one or two votes coming,” Grassley told Iowa reporters Wednesday morning. “I hope I’m wrong.”
Grassley is “leaning” toward supporting the legislation, but didn’t give it the full-throated endorsement that the president tweeted earlier Wednesday. The president called Graham-Cassidy “GREAT! Ends Ocare.”
Grassley said he could list 10 reasons why the bill shouldn’t be considered, but said the GOP needs to carry through on its promise to repeal and replace the Affordable Care Act.
“Republicans campaigned on this so often that we have a responsibility to carry out what you said in the campaign,” Grassley said in a conference call with Iowa reporters. “That’s pretty much as much of a reason as the substance of the bill.”
And there are things in the bill he likes and believes would benefit Iowa. He called it a “deregulation bill” that will provide the resources “so each state can run their health care system to fit their state to meet the needs of their people as they see it, not how Washington sees it.”
Graham-Cassidy would provide states with block grants as well as repeal parts of the 2010 Obamacare law. It would keep most of the taxes that the ACA created.
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According to some analyses of the plan, Iowa will see a $2.3 billion decrease in federal health care funding by 2027 and an overall 27-percent decrease in funding from 2020 to 2036.
“Just the opposite,” Grassley said when asked about those estimates. Sen. Bill Cassidy, R-Louisiana, provided him with numbers showing Iowa would be a “net gainer” as result of legislation. For one thing, he said, four states now get 45 percent of all of the money for expanded Medicaid. Graham-Cassidy would redistribute those funds so all states, including Iowa, would share in the funding.
Grassley disputed warnings that Graham-Cassidy would cut funds for Medicaid, let insurers charge older Americans higher premiums, increase out-of-pocket costs and end guaranteed protections for those with pre-existing conditions.
“You’re assuming that all 50 states are going to do what you just said,” he said. However, “we have a diverse country, very vast geographically, our population is very heterogeneous and what might fit Massachusetts and New York and Maryland doesn’t fit Iowa very well. So the upside of it is that we’re going to give states the opportunity to deliver health care more efficiently and effectively in a more affordable manner than Obamacare has in the past.”
Senate Majority Leader Mitch McConnell has not said when he will bring Graham-Cassidy up for a vote. House Speaker Paul Ryan has predicted it would win House approval if the Senate sends it the legislation.
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