Here’s How the Latest Attempt to Repeal Obamacare Would Work

The latest attempt to repeal the Affordable Care Act is getting a second wind as it approaches its final deadline.

With less than two weeks before a budgetary deadline that would allow the bill to pass with a simple majority, the so-called Graham-Cassidy bill is within a handful of votes from passing.

Named for its sponsors: Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, the bill would devolve the current system and let red and blue states go their own way on health care, while cutting federal support over time.

It’s a sweeping proposal. Right now, the federal government pays about $110 billion each year to fund healthcare. This funding goes chiefly to Medicaid expansion, an Obamacare linchpin that 32 states have signed up for, and federal subsidies that ease the burden of healthcare costs for lower-income Americans. Under Graham-Cassidy, these programs would be done away with.

In their place, Graham-Cassidy would introduce a “block grant” system, which would divvy up healthcare funding among the 50 states for them to spend on their own healthcare systems.

“If you like Obamacare, you can keep it,” Graham has said of the plan. “If you want to replace it, you can.”

There would be no more federal mandates for health insurance, for either individuals or employers, though states would have the power to impose them.

But the block grant system would be temporary — the bill has it set to expire by 2027 — creating a cliff of sorts that could create a crisis for individual states a decade from now, even though the bill’s proponents emphasize Graham-Cassidy as a triumph of “state’s rights.”

Critics of the bill say that the elimination of Medicaid expansion and subsidies could potentially leave tens of millions of Americans uninsured, according to a report by the Center on Budget and Policy Priorities. Larger, generally more liberal states like California and New York will be the hardest hit, since they’ve invested the most in programs offered by Obamacare; an annual parcel of funding from the government might not be enough to compensate.

Graham-Cassidy would also eradicate the Obamacare mandates for health insurance. Individuals will no longer be required to have health insurance, and employers would no longer be required to provide it to their employees. The bill would eliminate the financial penalty imposed on those that don’t oblige.

As with this summer’s failed repeal bill, Graham-Cassidy would also freeze Medicaid funding of Planned Parenthood for one year.

Correction: The original version of this story misstated the position of Bill Cassidy. He is a Republican Senator from Louisiana, not a Representative.