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FEDERAL | Cassidy & Graham Unveil the Final Repeal/Replace Effort

Sens. Lindsey Graham (R-SC), Bill Cassidy, MD (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) unveiled legislation to repeal and replace key components of the Affordable Care Act (ACA). The proposal would convert $1.18 trillion in federal funding for Obamacare over the next seven years into block grants to states, while repealing the individual and employer mandates as well as the medical device tax. States would have the flexibility to waive some insurance regulations as a part of the block grant program, such as rules mandating coverage of essential health benefits.

While the White House has confirmed that the President will sign this bill, the chances of passing the measure before September 30 remain slim, with Republican leadership hesitant to endorse the plan and eager to move on to tax reform. However, according to Sen. Graham, the bill is only three or four votes shy of the 51 votes required for passage, and the sponsors are currently working to win over Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK), critical "no" votes in the earlier attempt to repeal Obamacare. Sen. John McCain (R-AZ), whose opposition doomed the Senate's last Obamacare repeal effort, has said that he supports the concept of the Cassidy/Graham legislation. Sen. Rand Paul (R-Ky.) has come out in opposition to the proposal, arguing that the measure does not go far enough to repeal the 2010 health care law.

Senate Finance Committee Chairman Orrin Hatch (R-UT) has scheduled a hearing for this legislation on September 25, although he has expressed concern that the bill may not have enough support to warrant a vote on the floor. GOP leadership has also asked the Congressional Budget Office (CBO) to prioritize a score of the legislation, which is necessary before consideration by the full Senate.

Both houses must move quickly. After September 30, the Senate may no longer utilize the fast-track budget reconciliation process, at which point Republicans will need a super majority of 60 votes to pass Obamacare repeal.

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