The latest Republican attempt to repeal and replace the ACA looks a lot like what they were trying to do in May, June and July—and failed to do.
But actually, the framing of the current effort—the Graham-Cassidy bill—is much more deeply grounded in the perennial debate over where political power resides in the U.S.: the federal government or the states. Graham-Cassidy also more starkly reflects what many conservatives are trying to achieve in health care policy. And what they are trying to achieve is, to put it euphemistically, not nice.
On both counts, this renewed debate resonates politically beyond health care. It’s no coincidence that the two Senators behind this new push, Lindsey Graham and Bill Cassidy, are from southern states—South Carolina and Louisiana, respectively. Before the Civil War, during the Civil War, and up to the present day, southern conservatives like Graham and Cassidy—more passionately than their northern counterparts—have pushed to devolve power to the states and weaken the federal government.