On Sept. 13, Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC) introduced another “repeal and replace” bill aimed at deconstructing many of the major programs created by the Affordable Care Act (ACA). Known as Graham-Cassidy, the bill initially attracted little attention, but has gathered steam in recent days and may come up for a vote in the Senate within the week.

Graham-Cassidy would eliminate both the subsidies that help individuals buy individual health insurance policies and the reimbursements to insurance companies for offering price breaks on copayments and deductibles to the lowest-income customers. It would also roll back the ACA Medicaid expansion that was adopted by 31 states and Washington, D.C. The funding that currently goes to those initiatives would instead be distributed to the states as block grants.

Graham and Cassidy say their plan restores fairness to a system where currently more than a third of the money spent on the ACA goes to just four states: Massachusetts, Maryland, New York and California. Opponents argue that those states get a larger share of federal money now because they have large populations, have expanded Medicaid, and have high health care costs in general.

Passing this legislation will be difficult. If three senators vote no, it can't proceed. Further, this vote has to happen before Sept. 30, when the bill authorizing Senate Republicans to work on ACA repeal expires.

Impact on General Dentistry: As Congress moves forward with its deliberation of ACA replacement legislation, the AGD will continue to urge lawmakers not to lose sight of the key role oral health plays in the overall health of both children and adults and to thus protect the expansion of dental coverage gained under the ACA.