<p>With the end of this year&rsquo;s budget less than 30 days away, three Republican lawmakers are scrambling to finish another healthcare proposal. ;</p>
<p>It is the last healthcare bill left standing after the Senate rejected four separate repeal plans this summer. It&rsquo;s also the most extreme. ;</p>
<p><strong>Here are the details:</strong></p>
<p>&bull; Ends ACA Medicaid expansion</p>
<p>&bull; Ends ACA tax credits and cost-sharing subsidies ;</p>
<p>&bull; Ends the mandate to purchase coverage ;</p>
<p>&bull; Requires that all insurance plans accept applicants regardless of health condition ;</p>
<p>&bull; Gives states a lump sum to do with as they please (but states must contribute to that sum in order to access it)</p>
<p>Such a block-grant approach has wide appeal among Republicans, including Senator John McCain, who effectively killed the GOP&#8217;s repeal attempt in July with his &#8220;no&#8221; vote. ;</p>
<p>The bill, co-sponsored by Republican Senators Lindsey Graham (SC), Bill Cassidy (LA), and Dean Heller (NV), is being pushed as a compromise that would return power to the states. ;McCain&#8217;s support will be a key factor in the potential success of the bill. ;</p>
<p>McCain would &#8220;love to get money and power out of Washington,&rdquo; explains Graham. &ldquo;But we&rsquo;ve got to get formulas worked out that work for each state, including Arizona.&rdquo; ;</p>
<p>McCain has expressed support for the bill, but says he won&#8217;t say yes until he sees a finished product with support from state governors. ;&ldquo;I think it&rsquo;s a good proposal and I think we ought to support it,&rdquo; says McCain. &#8220;As I have said all along, any effort to replace Obamacare must be done through the regular order of committee hearings, open debate and amendments from both sides of the aisle.&rdquo; ;</p>
<p>Cassidy has suggested that states who like Obamacare can use their money to maintain it, but opponents argue that the bill&#8217;s funding formula would make that approach too expensive. &ldquo;We need to let states take care of themselves and give power back to patients,&rdquo; argues Cassidy. &ldquo;Let a blue state do a blue thing and a red state such as mine take a different, conservative approach.&rdquo; ;</p>
<p>The bill is facing serious opposition from activists and Democrats, not to mention lawmakers who are focused on tax reform and don&#8217;t want to revisit healthcare. ;</p>
<p><em>Graham-Cassidy</em> ;would &#8220;substitute a block grant for the funding that now provides states with resources for Medicaid expansion, premium tax credits, and cost-sharing reduction subsidies,&rdquo; argues ;Judith Solomon of the Center on Budget and Policy Priorities. &ldquo;People don&rsquo;t have a guarantee of meaningful coverage. It&rsquo;s totally different.&rdquo;</p>
<p>Opponents point out that ;<em>Graham-Cassidy</em> ;does not require states to spend money on low-income populations. This is a huge shift from Obamacare, which tried to focus on helping these populations by expanding Medicaid and doling out giant tax credits. ;</p>
<p><em>Graham-Cassidy</em> ;would also take all current Medicaid expansion spending from the 30 participating states and divide it among all 50 states. This would benefit some states and seriously disadvantage others. ;</p>
<p>Andy Slavitt, administrator for the Center for Medicare and Medicaid Services under President Obama, ;says the bill is &#8220;out of step with where the American public and many in the Senate are moving to now ;&ndash; small bipartisan steps to move us forward and make healthcare more affordable for millions of Americans.&rdquo; ;</p>
<p>Despite the pushback, Graham and Cassidy plan to head to the White House this Wednesday to discuss the plan. ;&ldquo;Stay tuned,&rdquo; Graham said. &ldquo;It&rsquo;s coming out and it&rsquo;s coming out this week.&rdquo;</p>
<p>Last week, ;White House adviser Kellyanne Conway said Trump was &ldquo;ready with pen in hand to sign healthcare reform if, say, <em>Graham-Cassidy</em> moves forward.&rdquo; ;</p>
<p>&#8212;</p>
<p>In the meantime, a bipartisan group of lawmakers is working on a package to strengthen Obamacare markets before enrollment begins on November 1st. Susan Collins (R-ME), who joined McCain in killing the GOP&rsquo;s last repeal effort, says the Senate is much more focused on this second bill. ;</p>
<p>&ldquo;The fact is we&rsquo;re going to have four hearings, and then by the end of the week, I think you&rsquo;ll see the outlines of a bill emerging from the committee,&rdquo; says Collins. ;</p>
<p>Republican lawmakers are running out of time. The 2017 budget ends at the end of the month, and if they don&rsquo;t get a healthcare bill passed before September 30th their efforts will be stymied by a Democratic filibuster.</p>
<p><strong>Editor&#8217;s note:</strong> McCain is being a pain in the ass on this, but I have every confidence that a bill will eventually be passed. There is too much riding on this for the GOP.</p>