Thread by @ASlavitt

In addition hurting ppl over 50, w pre-ex & on Medicaid, in practice, G-C is really bad conservative health policy.

Will explain...

1/ Graham Cassidy would hurt millions of ppl & make care unaffordable but the conservative case for the bill is also not a good one.

1a/ The natural consequence is a chintzier ACA, higher costs, taxes no lower and maybe higher & less state flexibility.

2/ A conservative case for GC would hinge on adding flexibility or choice to states & consumers, ⬇️ cost, or cutting taxes. GC does none.

3/ Far from adding flexibility to a state, GC is a nightmare 4 states. Billions are cut & states face the wind down of the program in '26.

4/ And if states want 2 build their own program, they couldn't w no certain Fed $ in 27 & reduced funds. Even red states will leave ACA.

4a/ I have designed & built these systems & worked w many states. Few states can actually do much different.

5/ Far from Federalism, states would be treated one-size-fits-all by ignoring state differences in cost & practice ACA accounts for.

6/ Far from conservative, incentives are upside down-- rewarding states who have done poorly in finding ways to cover more people.

7/ Graham Cassidy drops the ind mandate which drives up costs for consumers. Instability reduces competition. Even worse...

8/ Waivers which allow states not to cover certain services or pre-ex give insurers incentives to drop coverage 4 key svs like maternity.

9/ Insurers under GC would offer ltd services. Consistency breeds competition. Swiss cheese insurance increases OOP costs & consumer BK.

10/ More profit for insurers, increased bad debt & that means premiums for everyone, including employer coverage, would go back up.

11/ People in their 50s & 60s wld be declaring bankruptcy. Younger people wld have Swiss cheese policies. Conservative vision?

Meanwhile...

12/ Meanwhile, most states would keep ACA because too hard to replace. Others wld move to single payer & taxes largely untouched.