Chuck Grassley: Fulfilling campaign promise just as important as 'substance' of health bill

Despite many evident shortcomings in a bill to repeal the Affordable Care Act health care law, Republicans have a responsibility to pass it, U.S. Sen. Chuck Grassley said Wednesday.

In a conference call with Iowa reporters, Grassley expressed support for the Graham-Cassidy health care reform proposal currently before the Senate, arguing that the GOP has pledged to repeal the law known as Obamacare and must seize any opportunity to do so.

“You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Grassley said. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”

Grassley also expressed doubt, however, that the bill would pass in the Senate, in which the GOP holds a narrow majority. To move on to the House, Graham-Cassidy must win 50 of 52 Republican votes.

“No, I think we’re one or two votes short and I don’t see those other one or two votes coming,” he said when asked if the votes were there. “I hope I’m wrong.”

The Graham-Cassidy proposal would make over major parts of the American health care system, directing funding for the Medicaid health care program and other federal health care dollars into block grants handed over to the states on a per-capita basis.

States would have wide latitude in shaping health care benefits for residents, and could allow insurers to charge higher rates for sick patients and stop covering benefits currently required under federal law.

“This is a deregulation bill from Washington, D.C. … to basically provide the resources so each state can run their health care system to fit their state, to meet the needs of their people as they see it, not as Washington sees it,” Grassley said at one point during the call.

Allowing states to shape health care benefits and regulations to match their populations will better account for the geographic and economic diversity of the country.

“What might fit Massachusetts and New York and Maryland doesn’t fit Iowa very well,” Grassley said. “The upside of it is, we’re going to give states the opportunity to deliver health care more efficiently and effectively, and in a more affordable manner than Obamacare has in the past.”

But Grassley also acknowledged that Graham-Cassidy would not affect the most pressing Obamacare shortcoming facing Iowa: rising premiums and limited choices on the state’s individual health insurance market.

Instead, he said, that’ll have to be addressed first with a “stop-gap” plan now under consideration and ultimately with a separate legislation.

“What you want to do long-term is going to be done in the Alexander bill,” Grassley said, referring to a bipartisan bill to stabilize individual premiums nationwide that reportedly fell apart this week.