Graham health care

Sen. Lindsey Graham, R-S.C., discusses his block grant health care proposal from his Columbia office on Tuesday, August 15, 2017. Jamie Lovegrove/Staff

COLUMBIA — Sen. Lindsey Graham is continuing to ramp up his campaign to sell his new health care proposal that would use block grants to hand more money and control to states.

The South Carolina Republican said Tuesday he hopes at least 25 governors will be on board for the block grant approach by the end of this month. His strategy for building enough congressional support relies on winning over governors with the expectation that senators would be hard-pressed to rebuff their state government's wishes.

The plan, developed with Republican Sens. Bill Cassidy of Florida and Dean Heller of Nevada, would send federal dollars currently spent on Obamacare — $121 billion in 2016 — back to the states to use on their own health care approach. 

The group is working to complete a formula by next week to determine how much each state gets so that governors can judge the potential impact.

West Virginia Gov. Jim Justice, who flipped his party affiliation from Democratic to Republican this month, told Graham he will come on board if his state's Medicaid director decides to back the proposal after running the numbers.

After the Senate's last effort came apart, Majority Leader Mitch McConnell said he was moving on from health care. But Graham said if his proposal gains momentum, he expects McConnell will have a change of heart. 

Graham met with President Donald Trump at the White House the day after the failed Senate vote and said the president liked his idea.

"If I can get a group of governors with President Trump supporting the Graham-Cassidy-Heller block grant approach, I believe it would be impossible for the Republican leadership not to take this idea up," Graham said.

Sen. John McCain, who cast the deciding vote to kill the Senate’s previous health care reform attempt, is interested in the approach because of the impact on Arizona, Graham said. Arizona Gov. Doug Ducey is involved in writing the formula.

Unlike the last Senate try, Graham wants to hold hearings on his bill and then allow for amendments on the floor. 

Meanwhile, he and his supporters are reaching out to the Senate parliamentarian to try to get “as much flexibility under reconciliation as possible” to pass the bill. The "reconciliation" process allows legislation to pass with 50 votes, as opposed to the 60 normally required, but the parliamentarian must rule that it has a direct impact on the budget.

The bill would compel the states to spend the money on health care while maintaining two popular Obamacare provisions: enforcing coverage of pre-existing conditions and allowing children to stay on their parents' plan until they are 26. 

Graham said he was frustrated his idea did not gain traction in the Senate earlier, but he argued GOP leaders were "too invested" in the earlier "skinny repeal" plan to remove the individual mandate and were not listening to other ideas.

"Well, they're listening now," Graham said.

Follow Jamie Lovegrove on Twitter @jslovegrove.

Jamie Lovegrove is a political reporter covering the South Carolina statehouse and congressional delegation. He previously covered Texas politics in Washington for The Dallas Morning News and in Austin for the Texas Tribune.