Essentially, Republicans are claiming that many people lack access to affordable healthcare because federal politicians haven’t been creative enough, and allowing the states to experiment will solve the problem.
But this is abject nonsense. The politics of healthcare reform in America are difficult because powerful actors have a vested interest in an inefficient and inequitable status quo. But the policy question is not difficult. Under a market system, many people cannot afford access to basic medical care, and all but the most affluent cannot afford expensive treatment for a serious illness. To get needy people access to healthcare requires some combination of public expenditure and cross-subsidization of the sick by the healthy. (During his brief “Kimmel” phase, Cassidy understood this.)
Though the ACA did not go far enough, it used tighter regulation and more generous subsidies to provide access to tens of millions of people. Cassidy-Graham would destroy this progress. States are no more likely to find a way to provide effective coverage to more people with less money and fewer rules than they are to discover a formula to convert urine into fine Cabernet Sauvignon. It can’t be done.
Supporters of universal healthcare in California and other states that have used the ACA to cover as many people as possible might be tempted to find a silver lining here. Couldn’t states use the increased flexibility to create a single-payer system? Almost certainly not, because the block grants aren’t generous enough. As Sarah Kliff of Vox observes, states such as California and New York would have to spend a lot more money just to retain the coverage levels of the ACA. The “flexibility” offered by Cassidy-Graham is a ruse — it would make it easy for states to cover fewer people but exceptionally difficult for states to cover more people.
And Republicans are selling this as "giving power to the states" just like reactionaries did with, you know, slavery. Jim Crow, and interracial marriage. It's weird then that so many Republican governors are against the legislation because they understand they're going to get screwed by it.
Understand that Graham-Cassidy is there for two reasons: to destroy President Obama's signature achievement by erasing him from the history books, and to brutally punish those who voted for him so that we never dare raise our voices, our hands, or our votes against the GOP ever again, and remember, the GOP doesn't get paid until they do it.
There's a significant chance that both will be successful results of this bill becoming law.