反対票を表明したマケイン共和党議員  保険は、子供や高齢者といった弱い立場にある人々を最も保護する社会のセイフティ・ネットである。 ＊＊＊ トランプのオバマケア廃案とグラハム＝カッシディ案 (共和党案) の成立に向けての活動 とにかくオバマケアを何としても廃案にしたい、そしてよく読みもしないグラハム＝カッシディ案を通すために、なんでもする的姿勢で、トランプは望んでいる。 今回登場してきている案は、共和党議員もほとんど理解していない、つまり議論もしていない状況下で、「とにかく賛成票を出せばよい」的状況下におかれている。 ほとんど議論らしい議論を議会でもすることなく、９月３０日という締切期限までに通すことのみをトランプは考えている。 この法案は、主導権を政府から州におくものだが、実際には３０州以上で、巨額の削減が実現することが確実になっているものである。通常であればＣＢＯによる試算が出るのを待っての採決なのだが、９月３０日までには間に合わない。しかし、他の調査機関の試算では、もしこの法案が通れば、１５００万人が保険を喪失することが公表されている。メディケイドの大幅な削減が大きな原因となる。 この法案では、それに加え、いわゆる「既往症条件」に抵触する人が、資格を喪失することになる。 この法案にたいしては、病院関係者のほとんど、保険業界も激しい反対表明を行っている。 膨大な数の人々が保険資格を喪失し、治療を受けられなくなることが確実であるにもかかわらず、トランプおよび共和党はそうしたことには、まったく耳をふさいでいる。 トランプがこの法案の成立にこだわるのは、トランプ陣営や共和党に巨額の資金を提供している個人や組織からの激しい突き上げがあるからである。そして、この案で浮いた巨額の支出削減により、もう１つの提案である税制改革（これはビリオネア階層への大幅な減税を目指すものである）による税収減少を可能にさせる、という目算があるからである。 現時点では、共和党のマケイン、ポール、コリンズ、マーコウスキーが、それぞれの理由で、この案に反対の票を投ずることを表明している。この現状を見ると、上院での通過に必要な５０票を得るのは難しいと見られている。 共和党議員は52人、民主党議員は48人である。そして上記のとおりになれば、賛成票は48人 (52 －4）ということになり、成立しないことになる。 トランプはこの動きにたいし、早速、ツイッターで激しい個人攻撃を展開している。 (オバマケアはアメリカで成立した初めての社会保障法である。これにたいし、当初から反対者はかなり多く、その状況は、日本を含め、ヨーロッパ社会では理解しがたい社会的雰囲気をもっている。だが、ミドル・クラスが衰退し続けるなか、アメリカは１％の超富豪層と大多数のプア・クラスに分かれる社会になっている。これらの人々を救うことが、アメリカ経済自体には財政的に可能であるにもかかわらず、かれらを保険のない状況に再び追い込むことに何の責任も感じないというのは、とても理解しがたいことである。保険がなければ、多数の人々は治療を受けることができなくなるのである。いま同時に、サンダースは、シングル・ペイメント・システムによる国民皆保険制度案を対案として提示している。これが理想であるが、１５名の民主党員の賛成は得たという成果はあるが、実現にはほど遠いものがある。だが意気込みは素晴らしい。)
Latest GOP effort to
dismantle Obamacare on the brink of failure after defections
The latest Republican effort to dismantle the Affordable Care Act stood on
the brink of failure Friday after Sen. John McCain (R-Ariz.) announced his
opposition to the proposal and Sen. Susan Collins (R-Maine) said she was
leaning against it.
The intensifying resistance dealt a potentially decisive blow to the
renewed attempt to fulfill a seven-year-old GOP promise. McCain joined Sen.
Rand Paul (R-Ky.) in formally opposing the plan, leaving party leaders one
senator away from defeat.
Friday’s developments forced Senate Majority Leader Mitch McConnell
(R-Ky.) and President Trump into a difficult corner. They must now decide
whether to continue to pursue a vote that increasingly appears likely to fail,
or short-circuit the endeavor and deal with the backlash after another
unsuccessful try.
A fresh GOP failure to undo Obamacare could have a seismic impact on the
legislative dynamic in Washington and the emerging contours of the 2018 midterm
elections. Trump’s relationship with McConnell has grown sour since an earlier
attempt to repeal the law over the summer, and the current push represents a
chance to repair that relationship. If it fails, Trump could turn on
congressional Republicans more forcefully and be tempted to work with
Democrats, whom he has courted on a series of narrower issues.
Many Republicans fear that a defeat could also depress the GOP base headed
into the midterms, potentially reducing turnout next fall and creating an
environment in which GOP incumbents are ripe for primary challenges from angry
conservatives.
Play Video 2:02
What to know about the
GOP's latest
Senate Republicans are
trying to revive the momentum to overhaul the Affordable Care Act with the
Cassidy-Graham proposal. Here are five things to know about the plan and the
rush to pass it. (Jenny Starrs/The Washington Post)
One overriding obstacle for Republicans, however, is that
their efforts to roll back the ACA are deeply unpopular among the broader
public. A new Washington Post-ABC News poll released Friday showed that more than half of Americans, 56 percent, prefer the ACA
to the latest GOP plan. Only 33 percent prefer the bill that Senate Republicans
abruptly put on the table this month.
In a lengthy written statement Friday, McCain said he “cannot in good
conscience” vote for the bill authored by Sens. Bill Cassidy (R-La.) and
Lindsey O. Graham (R-S
“I would consider supporting legislation similar to that offered by my
friends Senators Graham and Cassidy were it the product of extensive hearings,
debate and amendment. But that has not been the case,” McCain said. He blamed a
looming Sept. 30 deadline to take advantage of a procedural rule allowing
Republicans to pass the bill with as few as 50 Senate votes, plus Vice
President Pence as a tiebreaker.
Senate Republicans hold a narrow 52-to-48 majority, and Democratic
senators are united against repealing or gutting President Barack Obama’s
signature
McCain also said he could not vote for a bill without a
complete snapshot of its effects from the nonpartisan Congressional Budget
Office, which said earlier this week that it could provide only a partial
picture by next week. The office said it could not determine the bill’s impact
on insurance premiums or project the change in coverage levels it would trigger
until a later date.
“I believe we could do better working together, Republicans and Democrats,
and have not yet really tried,” McCain said. He added that he took “no
pleasure” in his announcement. McCain and Graham are close friends.
In her home state Friday, Collins also signaled that she is close to
becoming a definite no. Like McCain, she voted in July against a different GOP
repeal bill that was rejected by the Senate.
“I’m leaning against the bill,” she said at an event in Portland. “I’m
just trying to do what I believe is the right thing for the people of Maine.”
Collins has said she is particularly worried that giving states wide
latitude to change the ACA’s requirements could prompt insurers to increase
rates for consumers with costly medical conditions.
“I’m reading the fine print,” she said, adding that for those with
preexisting conditions, “their premium could be so high that it would not be
affordable.”
Paul spokesman Sergio Gor reiterated his boss’s opposition to
Cassidy-Graham on Friday, after Trump threatened Paul and other senators on
Twitter.
“Rand Paul, or whoever votes against
Paul — who objects to the legislation because it does not
fully repeal the ACA — responded
Graham said Friday that he planned to continue trying to bring the measure
to a vote. McConnell’s office, which said earlier that he intended to bring the
bill to the Senate floor next week, did not respond to an inquiry about what he
plans to do next.
But some were skeptical that the rebooted effort could continue.
At a town hall in liberal Iowa City, which began an hour after McCain
announced his opposition to the bill, Sen. Joni Ernst (R-Iowa) told a cheering
crowd stacked with ACA supporters that the GOP’s repeal push was probably over
for the year.
“I’ll be honest,” Ernst said. “It seems unlikely that we’ll be voting on
this.”
Cassidy-Graham would turn funding for the ACA into block grants for states and sharply cut Medicaid spending over time. Three independent
Broadly speaking, states with
While it is difficult to calculate how the Cassidy-Graham
bill would affect the number of Americans with health insurance, an analysis published Friday by the Brookings Institution and the University of
Southern California’s Schaeffer Center for Health Policy & Economics
projected that roughly 15 million Americans would lose coverage over the next
two years if the bill was enacted.
Powerful organizations representing insurers and
physicians have come out forcefully against the bill this week. Patient advocacy groups have been mobilizing in force to
try to sway lawmakers who have yet to say how they will vote. A coalition of 20
groups is planning to hold a rally Monday at the Capitol, where the featured
speakers will include a lung cancer patient, and a mother and her 14-year-old
son who was born with congenital heart disease.
Senate Republican leaders and Trump administration officials have
continued to lobby for the measure. Pence, who hosted Maine Gov. Paul LePage
(R) at his ceremonial office Friday, said the Cassidy-Graham bill “is an idea
whose time has come.”
“President Trump and I are absolutely determined to carry this case all
across the country and to call on members of the Senate — most especially
Senator Susan Collins from the great state of Maine — to join us in giving the
people of Maine and the people of America a fresh start on
Another wild card, Sen. Lisa Murkowski (R-Alaska), was undecided late Friday, according to her communications
director, Karina Petersen. “Right now she is still focused on how the bill will
impact Alaska specifically. She’s continuing to gather data and is looking at
the details of the bill to determine what’s best for her state,” Petersen said.
Alaska officials published a preliminary analysis Thursday showing that from 2020 to 2026, the state would lose nearly a
quarter of its federal funding for Medicaid and private insurance, or $1.1
billion.
Meanwhile, Graham said on Twitter that
Senate Democrats praised McCain’s surprise announcement and called for
Republicans to resume stalled negotiations between Senate Health, Education,
Labor and Pensions Committee Chairman Lamar Alexander (R-Tenn.) and Sen. Patty
Murray (Wash.), the panel’s ranking Democrat, on legislation to strengthen
existing health insurance marketplaces.
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Murray and Alexander appeared to be nearing an agreement earlier in the
week on a deal to ensure continued payment of federal subsidies to help reduce
out-of-pocket costs and premiums for low-income people. But Alexander abruptly
ended the talks as GOP leaders intensified their efforts to win votes for
Cassidy-Graham.
David Weigel in Iowa City and Amber Phillips and Amy Goldstein in
Washington contributed to this report.
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