Zombies are everywhere in popular culture. Now they have invaded the U.S. Senate through the introduction of “Zombie Care” by Sens. Lindsey Graham and Bill Cassidy. Many thought the Republican effort to repeal and replace Obamacare was dead, but they were wrong.
The Graham-Cassidy bill bypasses the normal process and ignores bipartisan support to fix the Affordable Care Act. Sens. Patty Murray, a Washington Democrat, and Lamar Alexander, a Tennessee Republican, had legislation working through the Senate. In addition, the bipartisan Problem Solvers Caucus supports common-sense solutions to stabilize the health insurance marketplace and lower premiums for families and businesses.
With each resurrection, the repeal legislation gets worse for the average American. The Congressional Budget Office estimated that 24 million Americans would lose insurance coverage under a previous bill. New estimates say that as many as 32 million Americans would lose insurance coverage under Graham-Cassidy.
“Zombie Care” makes deep cuts to Medicaid because block grants to states would not keep up with inflation or the 4 percent projected annual growth in Medicaid costs. Even worse, Medicaid funding could end entirely after 2026.
The bill takes the current total spending from the 30 states that expanded Medicaid and divides it among all 50 states. For Texas, which did not expand Medicaid, this would be a win. But California would face drastic cuts – along with Massachusetts and New York, 65 percent of the cuts.
How would our most vulnerable citizens fair under this bill? It would cut Medicaid spending for seniors and people with disabilities by 15 percent. These are not people feigning disability by claiming to have a bad back; we are talking about people on ventilators, kids with muscular dystrophy and poor seniors. They can’t completely help themselves and rely on the compassion of their fellow citizens. How will care be provided if not by Medicaid?
The caps on spending are fixed, leaving no room for adjustments for breakthrough treatments, increases in prescription drug prices or the rising cost of long-term care as the baby boomer generation increasingly turns to Medicaid for help. Remember that 53 percent of long-term care is paid by Medicaid, not Medicare.
Besides those on Medicaid, “Zombie Care” also hurts those buying insurance through state marketplaces. This bill requires insurers to guarantee coverage to everyone, but eliminates the requirement that people buy insurance. It’s like allowing people to wait until after a traffic accident to buy auto insurance, but requiring that no one be turned away by insurance companies. You don’t have to be an actuary to see that this is unfair and will destabilize the health insurance market.
Under Obamacare, moderate-income Americans are guaranteed tax credits to help them pay for meaningful insurance coverage. This bill allows states to eliminate those guarantees and to spend their federal funds for virtually any health care purpose. For example, states could eliminate maternity care and mental health benefits, charge unaffordable premiums, or increase copays and deductibles. Other unpopular policies such as lifetime caps on insurance spending could be re-instituted, putting insurance out of reach for children with congenital heart disease, like Jimmy Kimmel’s infant son. “Zombie Care” fails the “Kimmel test.”
Under Graham-Cassidy, health care will increasingly become a privilege that only the wealthy can afford. The senators should get in step with the American people and support bipartisan efforts to repair Obamacare.
J. Mario Molina of Long Beach is the former CEO of Molina Healthcare, which offers Medicaid plans in California and 12 other states. He can be contacted at firstname.lastname@example.org.