What you need to know about the bill that could kill Obamacare

Republican senators in the US are making a last-ditch attempt to pass legislation which would largely repeal the Affordable Care Act and replace it with a smaller and more state-led alternative.

As of Thursday, the Senate has nine days to find the votes to get a bill through.

President Donald Trump ran on a promise of repealing and replacing the Act, so can the Republican Senate do it for him?

What is the bill and who supports it?

This most recent attempt to repeal former president Barack Obama’s Affordable Care Act was authored by Republican senators Lindsey Graham, Bill Cassidy, Dean Heller and Ron Johnson.

The bill strips federal funds for healthcare, instead issuing block grants for individual states to spend as they wish. This could mean states choose to end provisions in the Act which ensure insurance companies cannot charge higher premiums for pre-existing conditions. It could also mean yearly or lifetime spending caps on people’s insurance.

Why is there such a rush to pass the Graham-Cassidy bill in the Senate?

The US Senate is in a period called budget reconciliation until September 30. During this period, politicians can pass legislation with budget implications with only 50 votes, instead of the usual 60 votes, as long as the bill originated in Congress.

Republican Senate leader Mitch McConnell is hoping to gather the votes needed after a previous attempt to pass a repeal was stymied by John McCain, who voted against it in July.

The rush to get this new bill passed means there will not be time for the independent Congressional Budget Office to give the bill a score and an estimate of how many will lose their healthcare before the vote may take place.

Who is against it?

Critics of the bill say it will create a postcode lottery and potentially result in millions losing their insurance coverage. It could also restrict women’s access to reproductive care and abortion, and severely cut Medicaid, the programme which helps provide healthcare to low-income Americans.

The American Medical Association has spoken out against the bill, saying it “violates the precept of ‘first do no harm'”. It joins a host of other medical organisations in condemning the proposed legislation, including the American Hospital Association.

One of the bill’s most prominent critics is American comedian and chat show host Jimmy Kimmel, whose son had open-heart surgery after he was born. After his son’s illness, Kimmel took preserving and improving healthcare for Americans on as a personal mission, regularly highlighting the case on his nightly show.

Kimmel and others encouraged those who feel strongly about the bill to call their senators to register their opposition to it, whether Republican or Democrat.


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