One week ago, Sens. Lindsey Graham, R-S.C., Bill Cassidy, R-La., and Dean Heller, R-Nev., met with President Trump and top White House officials to discuss their plan to attain the 50 votes necessary in the Senate to replace the Affordable Care Act. Although the proposal isn't perfect, it could end up being the Senate's last chance to stop the seemingly inevitable Obamacare death spiral.
Since January, Congress has repeatedly tried and failed to find a formula for healthcare success. At the heart of the debate has been the fundamental philosophical differences between the conservative wing of the Republican Party and the handful of moderates unwilling to roll back significant parts of the ACA. In the House of Representatives, where Republicans enjoy a sizable advantage over Democrats, a deal was eventually struck that appeased enough members to move the bill forward, but the slim margin in the Senate has made negotiating far more difficult.
With only two votes to spare for Republicans and no help at all from Democrats, the Senate leadership has been working with conservatives and moderates on tweaks they believe could get enough votes to eventually get a bill to President Trump's desk, but with every change made in favor of the conservatives' cause, another moderate vote is lost, and vice versa.
The proposal offered by Cassidy, Heller, and Graham, who has been the most vocal proponent of the plan, seeks to take a fundamentally different approach than the one pursued by the Senate leadership. Rather than try to get people who disagree on the extent to which government should be involved in healthcare to sign on to numerous policies they view as being political liabilities, Cassidy, Heller, and Graham say Congress should simply block-grant the federal Obamacare funds to the states, empowering governors and state legislatures to decide how best to use the money.
"If we took a really principled position on healthcare, that we should send the money back home, closest to the patient, and had hearings and votes in the normal course of business, then we could get this done," Graham said on Monday during an interview with Dana Perino on "The Story with Martha MacCallum."
The benefits of the Cassidy-Heller-Graham plan are obvious: By sending federal funds to the states, the healthcare policy details wouldn't be decided at the federal level, which means Congress would only have to focus on the big-picture issues, such as determining how much funding should be given.
The plan isn't perfect or fully finalized. Most of the Obamacare taxes — the exception being the much-hated medical device tax—would be kept in place, and it's not clear exactly what, if anything, would happen to Medicaid. The pre-existing conditions requirement would also be kept, but the individual and employer mandates would be eliminated.
Putting these challenges aside, which could be much more easily negotiated than the current disputes plaguing the Senate, it's clear this plan has a much better chance of succeeding than forcing conservative or moderate senators to agree to policies they are vehemently opposed to. More importantly, it moves the country much closer to the federalist vision the Founding Fathers imagined when crafting the Constitution.
Contrary to the desires of those in both major political parties, Americans are a fundamentally diverse people living under wildly varying conditions. What works for a family in Montana is not necessarily the same as what works for a family in Texas or New York or California. Rather than compromise, thus forcing communities to live under policies they have no interest in adopting, the Cassidy-Heller-Graham model would help states across the country serve as the laboratories of liberty they were always meant to be.
Providing even greater freedom to the states would be an even more ideal model, but if the Cassidy-Heller-Graham plan were to be adopted, it would undoubtedly be a step in the right direction, allowing freedom of choice for Americans everywhere and helping Republicans in Congress to move on to other pressing issues, such as tax reform.
Justin Haskins (@JustinTHaskins) is a contributor to the Washington Examiner's Beltway Confidential blog. He is an executive editor at The Heartland Institute.
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