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How the latest health care repeal bill could shake out in Missouri and Illinois

Carla has started taking classes, hoping to make her children proud by becoming fluent in English over the next few years. St. Louis Public Radio has changed Carla’s name because she is an unauthorized immigrant. May 2017.
Jenny Simeone-Cases | St. Louis Public Radio

Missouri Republicans have jumped behind the latest proposal in Congress to repeal the Affordable Care Act.

A Senate bill would gut protections for people with pre-existing conditions and redistribute health care spending in the form of block grants to states. States like Missouri, which did not expand Medicaid coverage to low-income people under the 2010 health law, would see a boost in funding; states like Illinois could lose hundreds of million dollars a year.

“This is an opportunity to say to the states, we’re going to let you be responsible for devising a system for people in your state that meets the needs of people in your state,” Republican U.S. Sen. Roy Blunt of Missouri, a co-sponsor of the bill, said this week. “And we’re going to do that in a more effective way than has been done in the past.”

The proposal, sponsored by Republican U.S. Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, is scheduled for a hearing next week. But it seems unlikely to pass after U.S. Sen. John McCain, an Arizona Republican, said he would vote ‘no’ if the bill were brought up for a vote. Several governors, including Republican Gov. Bruce Rauner  of Illinois, have made statements against the bill, while Missouri Gov. Eric Greitens, also a Republican, told reporters he supports it.

Patient and medical advocacy groups, including the American Association of Retired People and the American Medical Association, pointed out the uncertainty of a system that requires states to rebuild their health system from scratch.

The short deadline means the Congressional Budget Office will be unable to publish a full cost assessment of the bill, but two think tanks offered their own state-by-state analyses this week. 

Credit Avalere

  • Between 2020 and 2026, Missouri would receive $4 billion more in federal health spending under the Graham-Cassidy proposal compared to current law, according to an analysis by Avalere funded by the Center for American Progress. Missouri’s current funding level is lower than other states because the state legislature has repeatedly voted to reject federal funding to expand Medicaid coverage to low-income people.  

  • Between 2020 and 2026, Illinois would receive $8 billion less in federal funding under the Graham-Cassidy proposal, according to Avalere. Total federal funding loss to states would be $215 billion, the firm estimated. 

The federal money would expire in 2026.
If the Senate is going to pass the measure with only Republican votes, GOP leaders will have to do it by the end of the month. That’s when the window closes to pass laws through the budget reconciliation process, which requires 51 votes instead of 60.

Follow Durrie on Twitter: @durrieB

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