Minneapolis Star Tribune

Minnesota has a huge stake in the congressional obsession with repealing the Affordable Care Act finally coming to an end. Even the last-gasp, supposedly improved health reform package now pushed by leading Republicans — a measure that would have to pass by Sept. 30 — would threaten many Minnesota families’ health coverage and create a big budget hole for state taxpayers to fill.

It’s unfortunate that Republican efforts to scrap former President Barack Obama’s health reform law didn’t sputter out in late July. Alternative legislation known as “Graham-Cassidy” for its lead authors — Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana — remains a viable, though long-shot, option.

Because of procedural rules, Senate Republicans have until the month’s end to pass it with 50 votes instead of the traditional 60 a bill needs to clear the upper chamber.

Repeated analyses by the Congressional Budget Office showed that the various GOP plans would all result in millions of Americans losing coverage. Graham-Cassidy contains the same warmed-over toxic stew that would lead to coverage losses — reduced subsidies to buy private insurance, weakened consumer protections and radical federal funding cuts for the Medicaid program. Generally, the only thing new is it would shift federal dollars from states with bigger populations to smaller, more rural states — a sneaky maneuver that could pick up more congressional votes.

Minnesota would take a unique hit. The state took advantage of a provision within the ACA to boost federal funding for its popular MinnesotaCare program for working families. But Graham-Cassidy would shut down this new flow of federal support.

That would leave the state with a major budget headache, which in turn could undermine the coverage 90,000 Minnesotans depend on. In 2015, that new flow of federal dollars to MinnesotaCare amounted to $91.2 million. The program’s total cost that year: $510 million, according to the Minnesota House Research Office. This federal support was estimated to reach $328.6 million in 2016.

Graham-Cassidy would cut federal dollars as well for the Medicaid program, which serves the poor and elderly, leading the Minnesota Department of Human Services to sound the alarm Thursday about the legislation. Officials warned of $30 billion in lost revenue over 10 years and lost health coverage for thousands of Minnesotans if it passes.