When Senator John McCain of Arizona announced on Friday that he would not vote for Graham-Cassidy, the latest Republican attempt to repeal the Affordable Care Act, it seemed like the bill was dead on arrival. But on Sunday night, the bill’s authors Senators Lindsay Graham of South Carolina and Bill Cassidy of Louisiana made revisions to the legislation that were quite transparently tailored to undecided senators.
The revisions raise federal funding for Arizona, Kentucky, Alaska, and Maine according to a copy of the bill obtained by Politico. Senators Rand Paul of Kentucky, Susan Collins of Maine, and Lisa Murkowski of Alaska had previously said they would withhold their votes as the original version of Graham-Cassidy decreased funding for their states.
Federal funding would be increased by 14% in Arizona, 4% in Kentucky, and 3% in Alaska. Maine would see a 43% increase in funding between 202o and 2026. Yet, other senators expressed doubt about Graham-Cassidy over the weekend and the revised bill doesn’t account for their opposition. On Sunday, Senator Ted Cruz of Texas said he wouldn’t sign Graham-Cassidy as is after amendments he proposed weren’t adopted — Cruz indicated that Senator Mike Lee of Utah would also withhold his vote if those amendments weren’t adopted.
On Sunday night President Trump suggested Graham-Cassidy’s revisions would appease Republican holdouts before its amendments were announced:
Murkowski’s vote hasn’t been easy for Republicans to attain, but the new version of Graham-Cassidy is especially favorable for Alaska. As Politico reported, one section allows the state with the highest separate poverty guideline, which is Alaska, to obtain a 25% increase in federal matching funds for Medicaid.
It’s unclear whether Senator Rand Paul’s vote will remain a “no” despite the revisions. Paul, in particular, sought to cut the ACA’s spending dramatically — not increase it or reallocate federal funding as the bill’s revisions propose. He would also prefer that states “opt in” to ACA regulations rather than apply for waivers. The Washington Post reported that Collins’ vote will likely remain a “no” even with the revisions.
Republicans have until Sept. 30 to pass Graham-Cassidy as a part of the budget reconciliation process, which allows a simple majority vote instead of the usual 60.