Senate Republicans Resort to Outright Bribery In Hopes of Overhauling Obamacare

A new draft of the Graham-Cassidy bill includes big handouts for the home state of a key holdout vote.


Ron Sachs/SIPA/Newscom

With less than one full week to go before a key procedural deadline, Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) have resorted to outright legislative bribery in hopes of winning enough votes to pass a bill that would overhaul Obamacare.

A new version of the legislation, which would convert Obamacare into a system of state-managed block grants, began circulating yesterday. The revision includes increased $500 million in extra funding for states that have already implemented an Obamacare waiver program—which would include Alaska. The legislation also includes additional Medicaid funding for low-density states, and for states deemed high poverty, which would boost funding for Alaska too. Alaska Sen. Lisa Murkowski, who was one of three GOP senators to vote against a previous Obamacare overhaul in July, is considered a key target for Graham and Cassidy.

These add-ons don't quite amount to the wholesale exemption for Alaska that was rumored last week. But at this point, it's hard to see them as anything but blatant legislative bribes. This is an attempt to win over Murkowski—not by making an argument for the legislation on the merits, but by topping up federal funding for her state in order to bring her on board.

Alaska isn't the only state that would receive boosted funding under the new legislation. Hawaii would also benefit from the increased federal funding to high poverty states.

There's also a somewhat curious addition in the form of an additional $750 million between 2023 and 2026 for states that were late to expand Medicaid under Obamacare. The very last state to expand Medicaid was Louisiana—home of Sen. Bill Cassidy. One of the sponsors of the legislation, in other words, appears to be padding his own state's budget. He's practically bribing himself.

There's nothing new about hiding bribes and handouts in major legislation. The version of Obamacare that passed in the Senate included hundreds of millions in funding boosts for states represented by holdout legislators, including Louisiana. Critics of Obamacare complained bitterly about these bribes. Now Graham and Cassidy are attempting to use similar tactics—arguably in even more blatant form—in order to overhaul Obamacare.

Graham and Cassidy aren't trying to win the argument. Indeed, with a legislative timeline this rushed, there is barely time to have an argument. GOP senators, when asked, do not demonstrate a strong grasp of how the bill would work, and speaking about the bill, a White House official admitted to Politico last week, "we aren't really sure what the impact will be." Early analyses have found what appear to be inconsistencies and contradictions in the revised draft. This is not exactly a sign of thoughtfully crafted, well designed legislation.

Even with the newly added bribes, however, it's unclear whether Graham and Cassidy can find the necessary votes for passage. The reconciliation rules that would allow Senate Republicans to pass the bill with a simple majority expire at the end of the month, so there isn't a lot of time. In theory, Republicans could write new reconciliation instructions allowing them to take up health care again, but that's a step they haven't taken yet, and it could complicate the tax reform push.

If anything, at this point, support for the legislation seems to be dwindling. Last week, Sen. John McCain (R-Ariz.) said he could not support the plan because it could not be debated and passed under regular order—which isn't going to happen between now and September 30. Sen. Rand Paul (R-Ky.) has been the most outspoken Republican opponent of the plan, and he signaled this morning that the revision still doesn't satisfy him.

Meanwhile, Sen. Ted Cruz (R-Tx.), who many had assumed was a yes, said this weekend that the legislation did not yet have his vote—and may not have Sen. Mike Lee's (R-Utah) vote either. In addition, Sen. Susan Collins (R-Maine), who voted against the last GOP plan in July, has consistently said she is also leaning no. It is "very difficult for me to envision a scenario" where she would vote yes, she said.

For the plan to pass, Senate Republicans can only lose two votes. It probably doesn't help that new polling shows that the plan, like previous versions of GOP health care legislation, is incredibly unpopular.

This has been the primary difficulty from the very beginning. Assuming unified Democratic opposition, Senate Republicans need 50 votes to pass an Obamacare overhaul. But each iteration of the GOP's health care legislation has had the support of somewhere between 45 and 49 Republican senators. Even with today's bribe-packed update, it's not clear that this has changed.

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  1. That picture is pretty gross. There’s no way either of those guys had pants on when it was taken.

    1. I’m assuming everything else was photoshopped onto them by staffers.

      1. We all make those faces while orgasming. Do not shame them.

        1. I’m making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life.

          This is what I do… http://www.netcash10.com

    2. That’s some caption contest material right there.

      1. The Preacharound.

  2. The lesson here is to follow no principles so you can always be the key holdout vote.

  3. We call that politics, McSuderman.

  4. Now Graham and Cassidy are attempting to use similar tactics?arguably in even more blatant form?in order to overhaul Obamacare.

    I guess arguably, anything can be argued. But probably it’s as blatant as anything else.

  5. AH!! Zombies!!

  6. Yep, I don’t think anyone thought that Murkowski was ‘standing on principle’ on this one so ‘just buy her off’ seems about right for modern Republicans who have no foundational principles left and are, in fact, comprised of many progressives themselves. They, perhaps, believe in ‘slightly cheaper’ central government but even that is doubtful.

    That’s politics, disgusting and ugly as always. Still, I prefer it out in the open rather than hidden into a bill so long that no one human has ever read the whole thing.

    1. Yeah – it seems to me like the only real difference between Team Blue and Team Red is whether you think the mega-government should be funded through taxation or debt.

  7. additional Medicaid funding for low-density states

    a/k/a Republican states

    Agree that the pandering is refreshingly transparent.

  8. So there is no shortage of whining Peter Suderman articles on how the Republicans have no plan to repeal Obamacare.

    Does Peter Suderman have ANY plan on how to repeal, replace or even mitigate Obamacare?

    Serious question.

    1. Nah. This bill is actually pretty good. It block grants Medicaid funds to states based upon the number of people that qualify for the system (and not based upon the relative wealth of the state, as it currently functions). It’s the same scheme that was used in the 90’s to reform welfare. And it would ensure that there would be no way to implement single payer, since Medicaid would become a more state-by-state managed system.

      Not a perfect bill, but definitely a good incremental step. Suderman isn’t interested in repealing Obamacare. Never was.

      1. This was my take on the Graham bill as well. I am no fan of Graham himself, but the plan seemed like a decent and incremental improvement. It might even offer me the chance to reduce my $11,000 / year Unaffordable Care Act premiums.

        Not enough for Suderman to stop whining apparently, even for a moment.

      2. Canada has a single-payer system. It is block-granted.

    2. Obamacare is a red herring. People keep forgetting that Obamacare is about insurance, not about healthcare.

      Deregulate medicine. Accomplish that, and Obamacare is superfluous. Don’t accomplish that, and you will never change the topic of conversation from “how is the government going to fix the health insurance market?”

      1. Agreed, but do you have a plan?

        1. “All Federal laws and regulations concerning healthcare are hereby repealed.”

          1. ^ Couldn’t-a said it better myself.

            1. So incrementalism sometimes, but when it is unpopular no?

          2. ACA, HIPAA, EMTALA, ERISA (self-insured employer plans, which is most of them), Medicaid, Medicare and McCarran-Ferguson. If you can do that you could probably repeal the 16th Amendment while you were at it.

  9. “Not by making an argument for the legislation on the merits, but by topping up federal funding for her state in order to bring her on board.”

    Jesus H. Christ, were we just born yesterday?!

    Horse trading to get support?

    A Senator leveraging her position to get funding for her state?

    If we don’t put a stop to this pretty soon, they’ll start acting like Congress!

    Oh, we’re talking about Congress?

    Well, what’d you expect? Legislatures everywhere have been acting like this since the days of the Roman senate. Libertarians have been arguing that the power of politicians should be circumscribed because of this kind of behavior–and replaced with markets instead. Do you imagine that getting different politicians is the solution to our problems?

    A libertarian being someone who doesn’t think politicians are the solution to our problems is as good a definition of the mythical real libertarian as any. Horsetrading to get the Alaskan senator on board is about as surprising as the sunrise.

    P.S. An argument might be made that leveraging her position to benefit her state makes her a good senator. My senators suck in no small part because they’re all about forcing Californians to make sacrifices for people–not just out of state but in other countries, as well. How dare she fight for the interests of her state when I have to suffer the likes of Diane Feinstein and Kamala Harris!

  10. I don’t know if you remember, but bribery is how the ACA was passed in the first place. I forget which midwest Senator got the goodies for his state, but it did happen.

    1. It was Nelson. The bribe was rescinded in the reconciliation bill (HERCA) after he voted for the PPACA, which included it.

  11. RE: Senate Republicans Resort to Outright Bribery In Hopes of Overhauling Obamacare
    A new draft of the Graham-Cassidy bill includes big handouts for the home state of a key holdout vote.

    Gee, more big government programs and incentives to create and keep them, only from the republicans this time.
    What’s the difference between the republicans and democrats again?

  12. John McCain: Riding that Hanoi Hilton shit right into the grave.

    Guy was probably a hack pilot.

  13. Can anyone deny how corrupt and self serving our Federal Representatives are. The whole lot should be thrown in prison and throw a way the key. I don’t care which side of the issue you are this is disgusting.

  14. wiki-Murkowski opposed President Barack Obama’s health reform legislation; she voted against the Patient Protection and Affordable Care Act in December 2009,[45] and she voted against the Health Care and Education Reconciliation Act of 2010. Murkowski has stated numerous times that she would like to repeal the Patient Protection and Affordable Care Act. Murkowski voted for H.R. 976, which called for the expansion of the State Children’s Health Insurance Program (SCHIP) to provide coverage for additional uninsured children. That bill passed both the House and the Senate, but was vetoed by President George W. Bush. She supports health care reforms in her native state, as well, largely because health care costs for Alaskans are up to 70% higher than costs in the contiguous United States. In 2017, Lisa Murkowski announced that she was opposed to repealing the Affordable Care Act without a replacement plan. She voted against starting debates in the Senate. On July 27, 2017, Murkowski voted ‘No’ on the Health Care Freedom Act commonly referred to as the ‘Skinny’ repeal of the ACA. She said the defeated bill did not adequately replace the ACA, and that her constituents had expressed concerns about its impact on their health coverage. Murkowski called for “a more open process” in writing a replacement bill. Her vote was criticized by some Alaska Republicans, while 200 people rallied in Anchorage and marched to Murkowski’s office to thank her for her role in protecting the ACA.

  15. Hell, at this point I’m rooting for Obamacare. I expect this kind of horse trading but for what? Some convoluted, mutated form of Obamacare? At least I know what I’m dealing with now. Don’t really feel like another round of winners and losers.

    And to think, at one time I actually believed the GOP wanted to repeal the ACA. Ha!

  16. Bribery? Isn’t that how Obamacare was enacted in the first place. What a bunch sniping asswipes we have for senators and congressmen.

  17. This odd fandance has two components. First is to preserve the new congressional perk of subsidies for their health insurance by whatever method preserves the language of “…as the secretary shall determine”. Block grants to states don’t remove that, do they? So we see a very unusual amalgam of nays torpedoing Graham’s ruse. The second thing is that all of this is supposed to “fail” first so they can “move on” to tax reform – most of which now won’t happen on account of their engineering the planned failure to deal with the ACA first before wrangling simultaneously with the budget in October and tax reform. With the ACA unmolested, OMB analysis of proposed law will work against any real tax reform. It’s a first for this session: they will actually be doing something in parallel. No way this turns out well from the ‘can’t walk and chew gum at the same time’ crowd.
    This is… the worst congress ever assembled, as it adheres to the [undeclared] uniparty in DC: the Cocktail Party.
    Our two party system died in slow motion over the past decade, much like patients poisoned by chronic exposure to heavy metals. These guys are engaged in a last ditch looting before they let the dollar and the rule of law burn down. Can Trump stop them? I don’t know…

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