Wednesday's D3 Daily Action: Oppose the Graham-Cassidy Bill (AKA TrumpCare 3.0)

TrumpCare By Another Name: “Graham-Cassidy”

Trump and the Senate Republicans have been put on a tight deadline if they have any hope of passing TrumpCare. They want to make one last push on TrumpCare—a bill known as “Graham-Cassidy”—and it should be taken seriously to make sure we defeat TrumpCare for good. 

Please call Senator Cory Gardner and Senator Michael Bennet and tell them to OPPOSE the Graham-Cassidy bill. 

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We knew we weren’t completely out of the woods on TrumpCare, but we got good news on September 1, when the Senate Parliamentarian (basically the referee on Senate rules and procedure) announced that the legislative vehicle that Republicans were trying to use for TrumpCare would expire at the end of the fiscal year. While this might seem straightforward, this was a totally open question to which no one in Washington knew the real answer. 

That decision set a new deadline of September 30. As Congress returned to Washington, that seemed like a tough deadline to meet, given Congress’s packed September agenda. The packed agenda worked in our favor—with so many deadlines to meet, Republicans would have a hard time pivoting back to health care or moving on to the Trump tax scam. The Senate had also committed to a bipartisan process with hearings—based on your work—and this process is expected to produce a bipartisan bill to improve and stabilize the ACA marketplaces. It did not seem like there was room for TrumpCare. 

Donald Trump wasted no time lighting a fire under Senate Republicans to take another stab at TrumpCare. And despite the tight timeline, some Senate Republicans are not willing to give up on a 7-year goal without one last try and are working on a last ditch effort. And that’s exactly what Republicans are doing now. Senator John McCain, who opposed TrumpCare in July, said that he would support the Graham-Cassidy bill, under certain conditions. If all other Republicans hold, that would give Mitch McConnell the 50 votes plus Vice President Pence’s tie breaker that he needs to jam TrumpCare through the Senate.


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. 


  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.

In particular, we need to make sure Senator Cory Gardner knows we 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.