Montana’s Senate delegation is picking up where it left off on repealing the Affordable Care Act as lawmakers prepare for another vote, possibly next week.

Democratic Sen. Jon Tester called the GOP’s latest attempt to appeal the ACA, a 2010 law commonly referred to as Obamacare, as a “dangerous bill that will raise rates, kick hardworking folks off their health plans and shutter rural hospitals.”

Should the latest health care bill proposed by Republican Sens. Lindsey Graham and Bill Cassidy get a vote before the end of the month, Tester will oppose it. Among other things, the bill cuts federal funding for Medicaid, ends federal funding of Medicaid expansion and allows insurers to once again increase rates on Americans with pre-existing conditions, according to Montana’s senior senator.

Republican Steve Daines said the GOP’s latest attempt at a health care re-do could be good for Montana. The Graham-Cassidy bill would replace current flow of the federal money for Medicaid and other ACA subsidies with block grants. Those block grants will be smaller than current federal ACA support levels in some states, but Daines said it looks like Montana will receive more money. Dating back to his 2013 term in the U.S. House, Daines has been a consistent yes vote for repealing the ACA.

“You look at what’s going on in Montana with the fiscal situation,” Daines said. “The governor has a train wreck going on. Under the current Obamacare legislation, Medicaid is on a glide path, down from 100 percent to 90 percent. That shift, under current law, will even add more fuel.”

Democratic Gov. Steve Bullock on Tuesday added his name to a bipartisan list of governors asking the Senate to kill the Graham-Cassidy bill and focus instead on making health care more available and affordable for Americans. The governors said they prefer a bipartisan attempt in the Senate Health, Education, Labor and Pensions Committee to stabilize market prices for individual insurance.

The HELP Committee ended its efforts Tuesday, when Chairman Lamar Alexander, R-Tenn., declared a partisan impasse. The committee was debating whether to increase federal cost-sharing reduction payments to states, which insurers say they need to stay in individual markets.

Insurers have until Sept 27 to commit to state individual market programs for another year. If they don't commit, state's will lose insurers offering subsidized policies to people on the individual market.

Tester lately has been arguing against plans by both the left and right to ditch the Affordable Care Act. On Sept 13, Sen. Bernie Sanders, I-Vt., unveiled his “Medicare for All” plan. The politically independent senator, who ran unsuccessfully as a Democrat in the 2016 presidential primary elections, is proposing that Medicare be expanded by stepping down the eligibility age every year for four years until every American qualifies.

A couple dozen Democrats, including the possible presidential candidates like Sen. Elizabeth Warren of Massachusetts, signed onto the Sanders plan. Tester didn’t sign on.

Tester told The Gazette the Senate’s focus should be on improving the Affordable Care Act, not a Medicare expansion bill with no chance of becoming law. Since January, hospitals in Montana have been telling Tester repealing ACA would damage rural health care across the state.

“What they told me is 'Fix the current health care system,'" Tester said. "Keep what’s in it that works and fix what’s in it that doesn’t. That’s how I’ve approached all of this going forward.”

The Montana Hospital Association strongly opposed Republicans' attempt in July to repeal ACA. Medicaid expansion is working, MHA argued, but the federal government wasn’t doing enough to preserve services in rural Montana. Profit margins at hospitals had fallen 40 percent since Medicaid expanded, MHA said. The association said unadjusted reimbursement rates, combined with rising drug and supply costs, were eroding profits.

The American Hospital Association announced its opposition to the Graham-Cassidy bill for not stabilizing the insurance market. AHA said the block grant program would end in 2026, cutting support for millions of people.

Daines said the block grant program pencils out until 2026 because all federal budgeting is done on 10-year cycles.

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Agriculture and Politics Reporter

Politics and agriculture reporter for The Billings Gazette.