Nevada

Graham-Cassidy is strikingly similar to earlier TrumpCare bills. While we have not seen final details, we know it still destroys Medicaid as we know it by fundamentally and permanently transforming the program into a per-capita cap.

Remember, limiting how much federal money states have to spend on Medicaid limits coverage, access, and states’ options when more people need coverage. For example, if we had a per-capita cap system now and Hurricane Harvey hit, Texas might be out of federal Medicaid money for the year. And they’d be out of luck if more people need Medicaid because of the hurricane damages.

The bill also still undermines protections for people with pre-existing conditions and people who need treatment for opioid abuse by allowing states to waive essential health benefits.

TWO NEW BUT DAMAGING APPROACHES THIS BILL WOULD TAKE:

1. Block Grants and Cuts the Federal Money Given to States
   The proposal would take all of the money going out the door to help people afford and access insurance and bundle it into one “block grant” given to states. This “block grant” includes money for the Medicaid expansion and marketplace subsidies while also deeply cutting the total amount of money. Then, it only allows the block grants to grow at 2%, a far slower growth rate than medical costs grow. And to top it all off, there is virtually no accountability for how this money is spent.
2. Redistributes this block grant to favor red states that did not expand access and coverage for their residents by punishing states that did:
   This provision is about politics not policy. Senator Cassidy himself said: “Let a blue state do a blue thing and a red state such as mine take a different, conservative approach.” This is not what would happen under his bill. Graham-Cassidy literally takes money from states that expanded Medicaid and gives it to states that did not. There are other factors in the Graham-Cassidy formula that then tilt the limited funds toward red states (such as distributing some of the block grant based on population density) in order to try to appease states like West Virginia whose Senators are key swing votes.

Make sure your Senators know you are paying attention and that TrumpCare 3.0 is not acceptable. Tell them you want them to commit to following “regular order” and working through the committee process as some Senators have started to do. And find out how much your state will lose in federal funding here.

SAMPLE CALL SCRIPT

Caller: Hello! My name is [ ] and I’m calling from [part of state]. Can you tell me how Senator [ ] will vote on the Graham-Cassidy health care bill if it comes up for a vote?

Staffer: The Senator hasn’t reviewed the text of the bill yet and hasn’t taken a position on it. There is no vote scheduled on that bill though.

Caller: I want Senator [ ] to oppose Graham-Cassidy. The bill is just like other TrumpCare bills in that it destroys Medicaid as we know it by turning Medicaid into a capped system. This hurts children with disabilities, seniors, and even victims of natural disasters like Harvey and Irma. It also takes away funding to help people afford health insurance through the marketplace, and it hurts states that have expanded Medicaid.

Staffer: Obamacare is a failure. The Senator believes we must stabilize the market and lower premiums.

Caller: If that’s what the Senator wants to do, then supporting the bipartisan, transparent process that Senators Alexander and Murray are leading through regular order would be a better option than supporting the Graham-Cassidy bill. I expect Senator [ ] to respect regular order and reject the Graham-Cassidy bill if it comes to a vote.

Staffer: I’ll let the Senator know your thoughts.

Caller: Yes, please do. I will be watching this vote closely and I expect Senator [ ] to oppose. Please take down my contact information so you can let me know what Senator [ ] decides to do.

This is not a drill—Republicans are once again close to passing their awful TrumpCare bill. (Take a minute to scream, we did.) This time they’re calling it the Graham-Cassidy bill, but it’s as bad as all of their previous attempts. If you have a Democratic Senator, then it means they’ve publicly committed to voting against TrumpCare. That’s great—but it’s not nearly good enough. This is a do-or-die moment on the ACA and your Democratic Senator should be doing everything they can to stop this bill from getting through the Senate. Here’s how they can really play hardball to defeat TrumpCare.

The window for Republicans to get TrumpCare through is closing. The Senate parliamentarian has ruled that Republicans must pass their TrumpCare by September 30, meaning that Democrats can use hardball tactics to try to run out the clock. We need to slow Republicans way down in order to keep Republicans from jamming this through the Senate.

Democrats aren’t in control, but they can still resist. They need to slow down Senate business in order to run out the clock on TrumpCare. Here’s how:

Resist through procedure. Your Democratic Senator can slow down Senate business through a combination of filibustering and  “withholding consent.” The rules of the Senate are so complicated that Senators have to regularly consent to waiving some of them so that they can actually get work done. That includes shortening time for debates, expediting consideration of amendments, and scheduling committees. Your Senator can slow the Senate down to a crawl and focus attention to TrumpCare by withholding his or her consent on legislative business.

Your Senator might act like they can’t do this out of some unspoken rule of Senate courtesy. But this is no ordinary time in the Senate—we have to pull out all the stops to stop TrumpCare.

SAMPLE CALL DIALOGUE: WITHHOLD CONSENT

Caller: Hello! My name is [name] and I’m calling from [place in state]. Am I correct that [Senator] opposes TrumpCare, the American Health Care Act?

Staffer: Yes! [Senator] is totally opposed.

Caller: I’m glad to hear that. Can you tell me what [Senator] has done so far to oppose it?

Staffer: Sure. [Senator] gave a speech on the floor recently that talked about the bill’s impact in our state. She’s listened to many constituents and heard their personal stories. She’s encouraged her colleagues to let us read the bill or have hearings on it. And yesterday she did an epic tweet storm.

Caller: I’m afraid it’s going to take more than talk and tweet storms to stop this terrible bill. We have to slow this process way down and call attention to the terrible bill Republicans are trying to jam through in total darkness. We have to use every tool available. Does [Senator] intend to withhold her consent on all Senate business until this bill dead?

Staffer: Withholding consent doesn’t actually buy us that much time. It would only delay things by 30 hours.

Caller: I’m not just talking about refusing to agree on shortening debate time on TrumpCare or other bills. I’m talking about withholding consent on amendments, placing holds on nominations, and objecting to all unanimous consent requests until the reconciliation instructions expire?. Will the [Senator] do that?

Staffer: Well, [Senator] thinks that could backfire. We’re trying to work together with Republicans on other important issues, like investigating Russian interference in our democracy. Withholding consent could make that more difficult.

Caller: Of course we want to know more about the Trump campaign’s ties to Russia. But millions of Americans’ healthcare, including [coverage loss in state, find here] is important too. That’s what’s at stake. This is the most important thing right now and the issue the Senator needs to be focusing on. I don’t think anything else is worth healthcare getting ripped away from millions of Americans.

Staffer: I’ll let [Senator] know your thoughts.

Caller: Please do. I expect her to use every tool she has. That also includes offering as many amendments as it takes to draw out Senate debate on this bill during vote-a-rama.