Graham Cassidy: You Can’t Bake a Cake at 500 Degrees

If we have learned one thing from this Congress, it is that trying to rush the legislative process is not an effective way to get things done. No matter from what side of the aisle you look at this bill, it’s not hard to see where it went wrong, both in how it was handled and what it contained. Here’s my list:

  1. The process of making laws is, well, a process. You need to go through the steps of allowing everyone’s voice to be heard to build support and come together. There was no time to present the idea to constituents and attempt to win them over.

  2. The features of Graham Cassidy were constantly changing in an attempt to win the votes needed to pass the bill. That made it hard for senators to keep track of what they were being asked to vote on.

  3. The health care industry has a big voice and they were not a fan of the law. Many industry groups were vocal with their concerns.

  4. The bill was not popular with consumers, who organized and protested. Lessening protections for people with pre-existing conditions was met with huge resistance.

  5. The bill delegated all responsibility for Medicaid and subsidized individual coverage to the states with less funding. That was a hard sell to many Senators and most state governors were not supportive.

  6. Too many people would lose insurance coverage. Say what you want about the ACA – it has resulted in 20+ million people gaining health insurance. How do you make that kind of progress and then take it away? 

  7. It would be easier to get behind spending cuts if they came with a plan to make the dollars spent on healthcare go further. Employers have a long history of success in managing health care costs, with cost trends in the low single digits. It’s possible – but it takes work.

For employer health plan sponsors, nothing changes for now. The ACA is still the law of the land and employers must continue to comply with shared responsibility requirements, prepare for reporting in 2018, and update projections for the excise tax in 2020. Employer advocacy groups are lobbying hard for reporting simplification and repeal of the excise tax. If you’re not involved, it’s not too late. Employer-sponsored health insurance covers 178 million Americans. Our voice matters.

Tracy Watts
by Tracy Watts

Senior Partner, National Leader for U.S. Health Policy