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Coffee CAHC policy round-up: September 22, 2017

Coffee CAHC is a twice-weekly newsletter where we round up and comment on the latest health coverage policy developments both nationally and here in Maine. We hope you find these updates helpful!

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Coffee CAHC

115th Congress, 1st session

128th Maine Legislature, adjourned


Friday, September 22, 2017


It’s the Common Ground Fair this weekend, and we’ll be there! If you plan to be among the, what, 60,000 or 70,000 people who attend the fair every year, make sure to swing through the “social justice” tents to find our table and say hi. I’ll be staffing our table there on Sunday morning!


National level

Well, I can’t say there’s a lot that’s “new” since Wednesday, at least not “new” in the sense of “major policy differences”. Graham-Cassidy is still barreling ahead as the Senate GOP faces down the looming September 30th drop-dead date for their preposterous rush to annihilate the ACA at any cost (whether that cost is measured in state budgets hemorrhaging the loss of billions of federal dollars, or 32 million people losing coverage, or the thousands of lives that will inevitably be cut short because of that loss of coverage, or the millions of new dollars people are going to have to spend when their state pops lifetime caps back in place and charges them more for pre-existing conditions…).

We now know that the CBO will be releasing some sort of truncated, partial, extraordinarily basic analysis of the bill next week – juuuuuuuuust enough to satisfy the Senate’s rules without actually being in a position to tell anybody the worst parts of the bill. A thumbs-up-or-down on the impact to the federal budget, without having to get into how many millions are going to lose coverage and how crappy the coverage will be that anybody is left with, if they’re lucky enough to be left with it at all.

From there, expect to see the Senate vote by the end of the week – again, because they have to.

There was one quote that emerged since Wednesday that is, to me, the single most elegant summation of what a farce this repeal attempt really is, and that comes courtesy of Republican Iowa Senator Chuck Grassley, who said this in a conference call with reporters:

“You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Grassley said. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”

I want to make sure you really, and I mean really, understand what is happening here. (FYI, all of the quotes from Senators below link to the same article where Vox rounded up responses from the 9 GOP Senators they asked to explain the bill to them).

These Senators do not understand what is in this bill (Senator Luther Strange, R-AL: “That’s the kind of detail I haven’t seen on how it would affect our state.”)


They cannot explain it. (Senator Johnny Isakson, R-GA: “Policy explanation? I’m not into policy, so I don’t really know.”)

Some of them seem stunningly more concerned about saving their own jobs than about saving American lives (Senator Pat Roberts, R-KS: “If we do nothing, I think it has a tremendous impact on the 2018 elections. And whether or not Republicans still maintain control and we have the gavel.”)

And it’s that point – about elections – that I want to focus on here for a second.

I’m not naïve or dumb enough to think that policy is ever going to be free from “politics”, and I’m also smart enough about history to know that there have been plenty of times when either party has risked a bad idea in the interest of an electoral benefit.

What I do have a problem with is when those public officials are absolutely willing to declare who gets federal investment and who doesn’t – who comes out ahead, and who falls behind – even who lives and who dies, in America, in 2017, based on whether they live in a red state or a blue state (Senator Richard Shelby, R-AL, when it was pointed out to him that the bill would cut federal funding to states by 34 percent: “But it wouldn’t cut Alabama, though…you see some of our states, four of our states, are getting a disproportionate amount of money from health care now. You know which ones.”)

And I do have a problem with it when Congress abdicates its basic responsibility to consider legislation through an at least somewhat deliberative process because one party has spent so many years faithfully parroting a bumper sticker slogan that they’ve convinced themselves of a false truth.

The bumper sticker slogan was “repeal and replace.” The false truth is that the ACA is failing, or somehow made things worse than the dog-eat-dog health system we had before.

Which has meant that a lot of us have spent most of this year doing what Jimmy Kimmel has had to do all week. I think he nailed it in one of his monologues when he called out his critics for trying to suggest that he’s unqualified to speak on the issue because he’s not a health care expert – he threw that back in their faces by playing up their own ignorance on the bill, and for blatantly ignoring all of the many, many, many experts and organizations who are health care wonks who are basically universal in their condemnation of this travesty.

But my favorite line was when he addressed those who are criticizing him for “politicizing” his son’s heart condition: he said “I want you to know that I am politicizing my son’s health problems, because I have to.”

We have to do what we have to do, which is why my ask today is that you submit comments to the Finance Committee in advance of their dog-and-pony-show I mean health care hearing on Monday. Here’s how:

  • At the committee’s request, be sure to submit comments with the following formatting instructions: a typewritten, single-spaced statement, not exceeding 10 pages in length, with title and date of the hearing and the full name and address of the individual or organization on the first page of the statement.
  • Email to by 1pm EDT on Sept. 25.
  • We recommend that you also provide a copy of the letter to your own Senators.


State level

Honestly, at the state level, everybody we work with is focused on Graham-Cassidy. Because I gotta tell you, if that bill passed, then this “state level” section of these newsletters is going to explode with information over how, exactly, Maine’s state budget is being burned to the ground as federal dollars dry up and leave us in the lurch.


Would you like to know more?

Center on Budget and Policy Priorities unpacks that “you know which four states” argument, pointing out that they account for 37 percent of the funding because they enroll 32 percent of the people.


Until next time, friends, I remain,


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