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Tyler Cowen

Last-Ditch Obamacare Repeal Is Worth Taking Seriously

Critics should compare Graham-Cassidy bill to realistic alternatives, not their ideal insurance world.
Take a look inside.

Take a look inside.

Photographer: Daniel Acker/Bloomberg

The Republicans are making yet another run at repealing Obamacare, this time with a bill sponsored by Republican senators Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana. While this legislation doesn’t seem workable in its current form, as the old saying about Richard Wagner’s music goes, the bill is in some respects “better than it sounds.”

Think of Graham-Cassidy as allowing each state to try its hand at health-care policy, backed by a federal lump sum payment. Not surprisingly, opponents fear the states could waive essential components of Obamacare, such as the individual mandate, required coverage for pre-existing conditions or the regulations for “essential” health benefits. Alternatively, states could use the money to help develop their own single payer systems or pursue other innovations. The bill would also replace the federal-state partnership on Medicaid with capped per capita aid to each state, a formula that would induce many states to spend less on the health program for the poor.