- Tuesday, September 26, 2017

The Republican effort to repeal and replace Obamacare was dead and buried. The eulogies, such as they were, were over and the Health Care Freedom Act of 2017 was dispatched to a forgettable corner of the graveyard. But when a couple of senators noticed a twitch and heard a groan they pulled it out of its coffin and called the medics.

The Graham-Cassidy bill was a simplified substitute, and soon it was on the way to Capitol Hill as one last Republican attempt to save the nation’s health care system from a collapse that would likely trigger a government takeover. With a few roguish Republicans joining the Democratic opposition, the bill died Tuesday. Back to the graveyard, where this time it will stay dead.

The measure, drafted by Sen. Lindsey Graham of South Carolina and Sen. Bill Cassidy of Louisiana, would have enabled the states to establish their own systems, funded with federal block grants, empowering the 50 states to operate as the “laboratories of democracy” they were meant to be. President Trump held out optimism that the legislative act he had expected to shake Washington with post-Inaugural shock and awe was about to finally arrive. “I hope Republican Senators will vote for Graham-Cassidy and fulfill their promise to Repeal & Replace ObamaCare. Money direct to States!” the president tweeted, and signaled that he would sign the bill.

The knock on the plan by Democrats was that the size of the grants would be insufficient, eventually leaving some Americans without health insurance. The biggest losers would be blue states like California and New York, which used Obamacare’s Medicaid expansion to collect more than their fair share of federal dollars. The net winners would be the more frugal red states, whose leaders know that trouble starts when federal largesse evaporates.

Not every dissenting senator was a Democrat. John McCain, who has never been comfortable as a Republican despite the party having given him its highest honor, vowed to oppose a law written in haste. Rand Paul, the party scold, said that block-granting Obamacare by the states is still Obamacare, and free-marketers Mike Lee of Utah and Ted Cruz of Texas threatened to join him. Susan Collins of Maine and Lisa Murkowski of Alaska declared that the ladies had to be heard. With only two votes to lose and a Sept. 30 deadline to repeal and replace by a simple majority, the once-Grand Old Party, staring at an epic fail, threw in the tattered towel. The fourth time was not the charm.

The Congressional Budget Office forecast Monday that the Graham-Cassidy measure would reduce the budget deficit by $133 billion over a decade, but “the number of people with comprehensive health insurance that covers high-cost medical events would be reduced by millions.” This killed it for the Democrats, who would have been against it if it were the perfect solution. Reductions in subsidies for Medicaid and individual policies would account for some of the loss, and many healthy, young adults would have cheerfully dropped out of government-enforced coverage.

The bill for Obamacare’s unworkable financial scheme is already overdue, with health care companies fleeing the marketplace and that will leave 40 percent of the nation’s counties with only a single Obamacare-compliant insurer in 2018. Waiting in the wings for the moment of national health-care crisis is Bernie Sanders with Medicare for All, his euphemism for socialized medicine. At an estimated cost of $32 trillion over a decade, Bernie’s remedy would attempt to cure cancer with a draught of hemlock.

A free marketplace produces the best products at the most competitive prices, but Congress prefers to write its own reality. Graham-Cassidy may have been Obamacare-lite, but the alternative left in place will devour the nation’s treasure, and eventually its future.

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