Former President Barack Obama on Sept. 20 said it was "aggravating" watching Republicans make another attempt to dismantle the Affordable Care Act.
"For those of you who live in countries that already have universal healthcare who are trying to figure out what's the controversy here, I am too," Obama said during an address at the Bill & Melinda Gates Foundation's Goalkeepers conference in New York.
He said the latest attempt to repeal the ACA — a bill introduced Sept. 13 by Republican Sens. Lindsey Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada and Ron Johnson of Wisconsin — would raise costs and reduce healthcare coverage.
"It's certainly frustrating to have to mobilize every couple of months to keep our leaders from inflicting real human suffering on our constituents," Obama said. "And all of this is being done without any demonstrable economic or actuarial or plain common sense rationale."
Obama reminded Americans that paying more for insurance or being denied coverage because a person is a woman or has a pre-existing condition is "not a thing anymore. We got rid of that."
"And people are alive today because of it, and that's progress," he said.
Obama acknowledged that the ACA — the 2010 law that is considered the 44th U.S. president's greatest legislative achievement — "was full of things that still need to be fixed."
"It wasn't perfect, but it was better," he said.
This is the first time Obama publicly weighed in on the Graham-Cassidy bill, which seeks to take the federal dollars being spent on the ACA's Medicaid expansion, tax credits, cost-sharing reduction subsidies and the basic health plan funds and turn them into block grants to be split among the 50 states and the District of Columbia.
Senate Majority Leader Mitch McConnell, R-Ky., plans to bring the bill to the chamber's floor next week for a vote, despite the legislation lacking a full analysis from the nonpartisan Congressional Budget Office.
The CBO on Sept. 18 said it was aiming to provide a preliminary assessment of the Graham-Cassidy bill by early next week. But it added that it would not be able to provide point estimates of the effects of Graham-Cassidy on the deficit, health insurance coverage or premiums for at least several weeks.
A Sept. 20 analysis from the nonpartisan Avalere Health, however, showed that if Graham-Cassidy was enacted, 34 states and the District of Columbia would lose funding — seven of them experiencing reductions of over $10 billion.
California and New York would be particularly hit hard, standing to lose $78 billion and $45 billion, respectively. The big gainer would be Texas, whose federal funding would rise by $35 billion.
Federal funding to states would be reduced by a total of $215 billion by 2026 and by more than $4 trillion by 2036, Avalere reported.
Opposition
It is unclear whether McConnell has the 50 votes he needs to pass the Graham-Cassidy bill. Republicans hold 52 seats in the Senate and at least one of them, Sen. Rand Paul of Kentucky, has repeatedly said he would vote against the legislation.
A handful of other Republicans have expressed some concerns about the bill, including Sen. Susan Collins of Maine, particularly about its impact on Medicaid — the government's insurance program for the poor — and the lack of bipartisanship.
There was a bipartisan effort underway to make short-term fixes to the ACA, but Senate Republican leaders pulled the plug on it Sept. 19.
Collins was one of three Republicans who helped bring down McConnell's final attempt in July to repeal the ACA — a failure that followed two others that week.
The other two Republicans, Sens. John McCain of Arizona and Lisa Murkowski of Alaska, have not definitively said how they would vote on Graham-Cassidy.
McCain, however, has insisted that any healthcare reform bill must go through the "regular order" process of being vetted by Senate committees.
To meet that request, Sens. Orrin Hatch, R-Utah, head of the Senate Finance Committee, and Ron Johnson, R-Wis., head of the Senate Homeland and Government Affairs Committee, scheduled hearings for Sept. 25 and 26, respectively.
McCain, however, has continued to express some skepticism that those two sessions would be adequate.
Numerous groups have also weighed in against the Graham-Cassidy bill, including the AARP, the Federation of American Hospitals, America's Health Insurance Plans and the American Medical Association.