Just gonna make America great again here

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Outside Congressional Republicans and the hardline wingnut portion of their voter base, nobody wants the last-gasp Republican plan to kill the Affordable Care Act. A group of 10 state governors -- Republicans and Democrats both -- yesterday sent a letter to Mitch McConnell saying "Seriously. Don't do this." Virtually all the major groups with a stake in healthcare have issued statements opposing it, from the AMA and American Hospital Association to the AARP and the American Heart Association. And Jimmy Kimmel devoted his monologue Tuesday night to why the bill would be terrible for families.

Needless to say, Donald Trump thinks it's the greatest thing since hairspray:

Let's just review why Graham-Cassidy is such a terrible bill (for details, check these 'splainers at Wapo and Vox) once more: The Rs are selling it as giving states control over their own healthcare systems by converting federal aid for Obamacare and Medicaid into block grants that states can use to set up their own healthcare systems. That sounds awfully nice and local-controllish, but it's a bait and switch: The bill would actually sharply reduce the amount of federal money going into those block grants, which would get smaller every year. And in 2026, the block grants covering what used to be the ACA would vanish altogether unless Congress reauthorizes them. Medicaid -- also converted to a block grant -- would be slashed by a third over 10 years. And in the most cynical move in the bill, the shrinking pool of Medicaid funding would be redistributed from blue states that expanded Medicaid to red states that didn't, to win the votes of Republicans who had qualms about Medicaid cuts. It's easily the worst of the Republican kill-Obamacare bills yet.

How much do the Rs want this? Oh, they want it so bad that they're putting major time and effort into it. Mike Pence has been lobbying Republican senators to get on board, and even Donald Trump has been persuaded to make a few phone calls, almost like a real president might. Worse, the prospect of killing the ACA has some collateral damage: Republicans have strangled the tentative bipartisan effort to actually do something worth doing on healthcare: Tennessee Republican Lamar Alexander was instructed to stop working with Washington Democrat Patty Murray on a promising bill to stabilize the individual healthcare markets, because wouldn't it be cool to strip coverage for tens of millions over the next decade instead? Alexander, of course, knows that it was really crazies on both sides who made it impossible for cooler heads to prevail:

“I know how to get bipartisan results but I’m not a magician. To get a bipartisan result on this before the end of September would mean I’d have to persuade 10 or 15 of my Republican colleagues, persuade Senator McConnell to put it on the floor, the House to pass it and the president to sign it.”

“A week ago, I think that was possible,” Alexander added wistfully, arguing that both Democrats’ decision to introduce a “Medicare-for-All” bill and Republicans’ 11th hour repeal push “obviously makes achieving a bipartisan consensus more difficult.”

Mind you, there is no September 30 deadline for stabilizing the ACA -- it could certainly be done through regular order, not reconciliation. But hey, nice diversion!

Also, let's consider some of the fun procedural fuckery the Republicans will have to engage in to push this thing through. For it to meet the requirements to pass under reconciliation -- that is, with 50 Republican votes plus a tie-breaker by Mike Pence -- it has to be scored by the Congressional Budget Office. The CBO announced Monday that, thanks to the Republican rush job, it will only be able to partially score the bill by next week, determining only whether Graham-Cassidy would affect the federal budget deficit more or less than the House's "American Health care Act" from earlier this year. The CBO score won't include a detailed financial analysis, any examination of how the bill would affect insurance markets overall, and -- most importantly -- it won't provide an estimate of how many people would lose coverage. Still, that partial score might be enough for the Senate parliamentarian to decide it counts as a "CBO score."

Another delightful detail of how the reconciliation rules work: Since the rules apply to all work on reconciling what the Senate wants with the House bill this whole mess would replace, there's a limit to total debate time, and that time (a whopping two hours) was almost entirely eaten up back in July when McConnell tried to shove through the "skinny repeal" and John McCain took what might have been the last honorable vote in his life. As a result, how much time will the Senate have to "debate" Graham Cassidy? About 90 seconds, maybe two minutes at the outside. That's not 90 seconds per Senator, that's a total of 90 seconds, as Hawaii Dem Brian Schatz explained Monday on MSNBC:

Dem Senator blasts Republicans for allowing just 90 seconds of debate on #GrahamCassidy pic.twitter.com/48k2Ey2bo3

— Sean Colarossi (@SeanColarossi) September 19, 2017

We'll have a lot more to say about Graham-Cassidy today (mostly it will be "Call your senator and tell them it's terrible, and here's why), but for now, let's close with Jimmy Kimmel being a healthcare-for-all hero yet again. As you'll recall, back in May, Kimmel delivered a powerful, moving monologue about how his newborn son was born with a heart defect, which was repaired by excellent doctors, after which he pointed out that before the ACA, kids like his son would regularly blow through the lifetime cap on their insurance coverage and would have trouble getting insurance because they'd been born with a preexisting condition. After Kimmel called for all children -- and all Americans -- to get the care they need regardless of whether they have a parent who hosts a talk show, Louisiana Senator Bill Cassidy appeared on Kimmel's show and said any healthcare reform should pass what Cassidy called "the Jimmy Kimmel test." Needless to say, the bill Cassidy is sponsoring falls very short of that, and will allow states to reimpose annual and lifetime caps on coverage, and to charge hundreds of times more (literally) for preexisting conditions. So Kimmel's monologue Tuesday tore into Cassidy and his hypocrisy. It's worth watching the whole thing:

Cassidy, said Kimmel, "just lied right to my face." He went on to explain why exactly Graham-Cassidy fails to even come close to covering everyone or being more affordable, pointed out the huge number of healthcare organizations that have taken a stand against the bill, and encouraged his viewers -- a far bigger audience than anyone in the Senate has -- to call their representatives and senators:

So, listen, health care is complicated. It’s boring. I don’t want to talk about it. The details are confusing, and that’s what these guys are relying on. They’re counting on you to be so overwhelmed with all the information you just trust them to take care of you, but they’re not taking care of you. They’re taking care of the people who give them money, like insurance companies. And we’re all just looking at our Instagram accounts and liking things while they’re voting on whether people can afford to keep their children alive or not.

Most of the congresspeople who vote on this bill probably won’t even read it. And they want us to do the same thing, they want us to treat it like an iTunes service agreement.

As for people who'll complain that Jimmy Kimmel is politicizing his son's heart defect, Jimmy Kimmel said, YOU'RE DAMN RIGHT I CALLED THE CODE RED:

Before you post a nasty Facebook message saying I’m politicizing my son’s health problems, I want you to know: I am politicizing my son’s health problems because I have to. My family has health insurance, we don’t have to worry about this. But other people do, so you can shove your disgusting comments where your doctor won’t be giving you a prostate exam once they take your health-care benefits away.

Just to be clear, Kimmel said clicking "like" on his video wasn't enough: You've got to call Congress. And while he's at it, he wants Bill Cassidy to stop mentioning his name (we're pretty sure Cassidy already did, long ago): "There’s a new Jimmy Kimmel test for you, it’s called the lie detector test. You’re welcome to stop by the studio and take it anytime."

By the way: Jimmy Kimmel's son Billy is doing great:

ALL BABIES should be doing great. Get on the phone, hit the email, call your senator -- and if your senators are Democrats, call to tell them to use every parliamentary trick possible to run out the clock.

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[TPM / WaPo / Business Insider / CNBC / Vox / Politicus USA / WaPo / People]