Health Reform

What is Graham Cassidy?

The Republican’s latest health care bill is the Graham-Cassidy-Heller-Johnson (GCHJ) proposal or Graham Cassidy for short. Below is my super short summary of the bill.

What does it propose?

The Washington Post has a nice summary which shows that the bill would:

  • Not force you to buy insurance (repeal the individual mandate)
  • Not force employers to provide you with insurance (repeal the employer mandate)
  • Lets states decide how to help you with health insurance premiums (Remove ACA premium subsidies and replace with block grants to states)
  • Health insurers have to cover people with pre-existing conditions, but states have the option of allowing insurers to not cover all the care associated with these conditions
  • Insurers would be able to charge older customers up to five times as much as they charge younger customers (under the ACA this was 3 times as much), but, states could overrule this.
  • There are no lifetime limits but…states can waive this clause.
  • Less generous Medicaid funding (moving from an entitlement program to a block grant program)
  • Short-term reinsurance fund for 2018 and 2020
  • Decrease taxes for medical device makers.

In short, there is no mandate and although there are some protections for individuals (e.g., mandatory coverage of pre-existing, and lifetime limits) states can get around these provisions if they so choose.

The bill would also result in a transfer of funds from blue states to red states as many blue states expanded Medicaid.

What does this mean for you?  

The answer to this question likely depends a lot on what state you live in.  Some states may opt to have higher taxes and provide more generous insurance.  Other states may opt for lower taxes and less generous insurance support.  Some may increase insurance coverage of less generous coverage (e.g., a Medicaid for all plan) and others may use their block funding to support existing insurance programs (e.g., reinsurance subsidies) but not support people who don’t have access to these plans.  Thus, Graham-Cassidy is a way to reduce federal government spending, repeal individual and employer mandates, and let states decide whether or not to provide broad based coverage approaches to their residents.


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