The Graham-Cassidy bill to undo the Affordable Care Act will be devastating in Arkansas — an overall reduction in Medicaid spending by billions and  a pathway to gutting of premium protection for people already sick are certain to dramatically reduce access to health coverage.

But wait, there’s more, including an acceleration of the assault on reproductive rights and critical health services provided by Planned Parenthood. Writes Vox;


A new element in this bill is that its program of block grants would create new ways for the federal government to restrict abortion coverage. Republican-led state legislatures have been working to curtail abortion access and pull funds away from Planned Parenthood for years now; Cassidy-Graham would accomplish both goals on a national scale.

Cassidy-Graham includes a lot of familiar abortion restrictions
The bill includes a provision, similar to those in previous repeal bills, that would effectively bar the use of federal Medicaid funds to pay for care at Planned Parenthood clinics. This would mean low-income patients who rely on Medicaid wouldn’t be able to get care at Planned Parenthood. Backers of such provisions have often claimed that community health centers would be able to fill in the gaps left by Planned Parenthood, but many reproductive health experts say this is unrealistic, since those centers would have to double or even triple the number of patients they saw for certain services. In order to replace Planned Parenthood’s contraceptive services, one of the many services they offer, health centers would have to see 2 million extra patients nationwide, according to the Guttmacher Institute.

What’s more, Planned Parenthood is a trusted and familiar provider for many patients, who may not necessarily know anything about their local community health center. As Dan Ramos, a state representative from Ohio, told the New York Times last year, “If someone doesn’t know where to turn, they know that Planned Parenthood provides a service that they might need.”

Like its forebears, Cassidy-Graham also includes restrictions on abortion coverage. Patients who got a tax credit to buy insurance on the individual market wouldn’t be able to use it to purchase insurance with abortion coverage, and small businesses that received a tax credit for providing insurance to their employees wouldn’t be able to offer plans covering abortion. Over time, this would mean fewer people would be able to buy individual plans that covered abortion, and so fewer insurers would offer them. Patients who can’t get insurance coverage for abortion are sometimes forced to forgo food or other necessities to pay for the procedure and may try to self-induce an abortion, which can be dangerous.

Cassidy-Graham would let states cut requirements that insurers cover essential health benefits, meaning insurance companies could stop offering maternal care or prescription drug benefits. Thirteen million women could lose access to maternal care.

This will sit well with many Arkansas politicians of course. Twitter coverage yesterday of a public appearance by Sen. Jason Rapert yesterday, for example, quoted him as saying men shouldn’t have to subsidize maternity costs through their health insurance premiums. This is a popular belief among certain (conservative, male) politicians.

Ernest Dumas writes about the impact on Arkansas this week.


Arkansas, including Governor Hutchinson and the Republican legislature, would get a severe strapping from Graham-Cassidy. It would take away the billions of federal dollars that has overmatched Arkansas’s puny contribution since 2013 and paid for income tax cuts and spread that money among states that did not cover poor adults. Arkansas would be back to 2013 but without billions of federal help and with more than 300,000 poor people still expecting medical assistance.