For seven years, Republicans in Congress have promised that repealing Obamacare would be a top priority.  They have failed, at least for now.

The Republican Senate made the decision yesterday not to have a vote on the Graham-Cassidy-Heller-Johnson legislation that would have repealed and replaced the Patient Protection and Affordable Care Act (ACA), or Obamacare.  At least 50 votes were needed to pass a bill via Budget Reconciliation, which Citizens Against Government Waste has discussed previously. The votes were not there beause three Repubican senators opposed the legislation: Sens. Susan Collins (R-Maine), John McCain (R-Ariz.), and Rand Paul (R-Ky.)  There was no support from Democratic senators.

Our sister organization, the Council for Citizens Against Government Waste, supported the Graham-Cassidy legislation.  Was the Graham-Cassidy bill perfect? No, but it was far better than what we have in Obamacare, where sky-high premiums and deductibles are becoming common place.

Graham-Cassidy did three major things:

• It repealed the individual and employer mandates.  No longer would a citizen be forced by the federal government to purchase health plans that they did not want or need.  Premiums are reaching a point where they have become unaffordable, unless you receive a government subsidy, and citizens are choosing to pay the fine instead of purchasing coverage.  The employer mandate has stifled the economy and caused companies to cut back employee hours.
• It returned regulatory and spending power back to the states.  Graham-Cassidy took the funds currently spent on Obamacare’s exchanges and blocked grant it to the states.  Governors and state government officials were given great leeway in how to regulate health insurance and utilize the funds.  After all, who would be more willing to listen to a citizen that has a concern, the state representative that lives a block away or a faceless bureaucrat in Washington?  If state officials liked Obamacare's mandates, they could have kept them.  Or, the states could have allowed choice to reign among health plans that have would spurred competition to lower prices and utilized the funds to help people with pre-existing conditions and people with low-incomes.
• It reformed Medicaid by putting it on a budget for the first time, blocked granted the federal funding to the states, and stopped Medicaid expansion for working-age, healthy, childless adults.  These actions would have refocused the program’s original purpose of helping poor children, seniors, and the disabled.  Governors and state officials would have had the ability to run the program in a way that is best for their state.

What is next? No one really knows.  There is some discussion of combining repeal and replace healthcare legislation with tax reform, but that is unlikely to happen.  Republicans could try again to write a bill, have hearings but, it will require 60 votes in the Senate to avoid a filibuster, which means Democratic votes are needed.  While Democrats have said they want to work in a bipartisan way with their Republican colleagues to fix healthcare, it is difficult to see how that would happen considering 17 members of their caucus, or one third, support Sen. Bernie Sanders’ (i-Vt.) single-payer, or government-run, healthcare bill.  Plus, Senate Health, Education, Labor, and Pensions Chairman, Lamar Alexander (R-Tenn.) already tried to find a bipartisan solution to fix stabilize the current healthcare market but was unable to come to agreement with his Democratic colleagues.

But the authors of the legislation remain optimistic.  Sen. Lindsey Graham said at a press conference that the Senate was on a on a pathway to pass Graham-Cassidy and "It's not if', it's only a matter of when," and reminded people that Welfare Reform adopted a similar process by sending money and power back to the states.  The authors of the legislation released a joint statement, stating, "Obamacare's problems are widespread and well known.  Forty five percent of counties or parishes in the U.S. are down to single provider.  Premiums are skyrocketing.  And families across the country are suffering under the weight of this failed law.  Unfortunately, these problems will only get worse over time."  They noted their ideas were not the problem, timing was by saying, "Due to circumstances under our control and not under our control, the process and timing of this vote did not line up this time.  However, our idea of sending the power and money to the states clearly resounded with our colleagues.  A one-size fits all approach to health care does not work.  The needs of South Carolina are different than those in Louisiana, Nevada, and Wisconsin.  Our system should be flexible to reflect this reality.  We can all say with confidence that our plan not only replaces Obamacare – it will end the march led by our Democratic friends towards single-payer health care."

Let's hope so.

Meanwhile, Congress is moving onto tax reform.  For now it seems any Republican efforts to repeal and replace Obamacare is in a coma.  It will be up to the Republicans that opposed the legislation to revive it.