ALERT: Senate about to pass bad health care bill!

This is FYI.  Please pass it on to anyone…….family members, colleagues, clients, patients…….with an interest in what is happening to the people we serve with disabilities.  Thanks.

From: Ellen Pinnes <epinnes@aol.com>
Sent: Friday, June 23, 2017 4:41 PM
Subject: ALERT: Senate about to pass bad health care bill!

This message is from Ellen Pinnes for The Disability Coalition.

Please do not respond to this email address.  You can contact Ellen at EPinnes@msn.com.

The United States Senate is getting ready to pass a health care bill that will be extremely harmful to people with disabilities and many other Americans.  After weeks of secrecy about how the Senate would change the health care bill passed by the House of Representatives last month, Majority Leader McConnell released the Senate bill yesterday (Thursday) and plans to bring it to the Senate floor for a vote next week, before senators go home for the July 4th recess.

Remember:  although these bills have mostly been talked about as repealing and replacing the Affordable Care Act, they go much further than that and also make radical changes to Medicaid that go far beyond the ACA.

Public opinion polls by respected organizations have consistently shown that the majority of the American people oppose the Republican health care bills.  And virtually every stakeholder group has come out against them, including providers like doctors and hospitals, patient advocacy groups like the American Cancer Society, advocates for seniors like AARP, and a wide array of groups representing people with disabilities at both the state and national levels, with The Disability Coalition among them.

Here’s what the Senate bill will do:

* It slashes federal Medicaid funding even more drastically than the House bill’s cut of nearly $840 billion.  To make up for that huge loss of funding, states will have to either pick up the additional cost (which they’re unlikely to be able to do) or cut the program by reducing eligibility, benefits and/or provider payment rates (which is what they’re almost certain to do).

* The bill drastically changes the funding structure for Medicaid for the first time since the program was created more than 50 years ago.  Instead of a partnership in which federal funding grows as needed by having the federal government pay its share of Medicaid expenditures through federal “match” (i.e., a set percentage of cost), each state will get a fixed allotment of funding each year.  If actual costs are higher due to factors such as rising drug prices, epidemics or other public health emergencies, natural disasters, or any other cause, the entire added cost would fall to the state with no additional federal funds.  (Note that the bill delays these extreme funding cuts for a few years so they won’t be so obvious when incumbent senators who vote for them run for re-election.)

* Services for people with disabilities will be in danger.  Many of the services that people with disabilities rely on to live independently in their communities are optional in the Medicaid program – federal law doesn’t require states to cover them, as it does for nursing facility care.  And they’re expensive.  So they’re among the things most likely to be reduced or eliminated in the face of a massive funding shortfall.  Of course, many of these services are important to frail seniors as well, and they too will be harmed by this bill.

* The expansion of Medicaid under the Affordable Care Act, which has allowed states like New Mexico to cover low-income adults to 138% of the federal poverty figure, will end.  The Senate calls for a slightly longer phase-out of the overall expansion but reduces some federal funding even more quickly than the House bill would.  And under either bill, the ultimate impact is that the expansion – and the generous federal funding provided for it under the ACA – will end.  In New Mexico alone, hundreds of thousands of people will lose their health insurance.  Nationwide, many millions will lose coverage.  Remember, the Congressional Budget Office projected that the House bill would mean 23 million more uninsured people, with most of those due to loss of Medicaid coverage.

In addition to Medicaid changes, the Senate bill changes the law for private health insurance.  The short version is that people will have to pay more for worse insurance.  Here are some of the details:

* Subsidies that help pay monthly premiums to buy insurance will generally be reduced from those available under the ACA.  As a result, the cost will go down slightly for younger people but rise significantly for older folks.  Also, the subsidies will be completely eliminated for people with incomes between 350% and 400% of the federal poverty level.  Republicans who oppose the ACA have complained for years that premiums are too high for people just above 400% because the subsidies end there, creating a “cliff” effect where people just slightly over that level get no help at all.  But instead of fixing the “cliff”, they’ve made more people subject to it.

* Out-of-pocket costs to actually obtain health care (co-pays and deductibles) will rise.  Another complaint about the ACA is that out-of-pocket costs are too high.  But the Republican plan RAISES them instead of lowering them.  Plus, the Senate bill ends the ACA cost-sharing reductions that help people with low-incomes (up to 250% of the poverty level) pay for out-of-pocket costs.

* Consumer protections will be withdrawn.  The Senate leadership claims that their bill, unlike the one from the House, will keep protections for people with “pre-existing conditions” (i.e., health care needs).  But there are two parts to protecting people with health conditions:  one is requiring insurance companies to charge the same premium regardless of a person’s health status, and the other is ensuring that needed benefits are covered.  The Senate bill apparently keeps the former set of protections, but it won’t require that insurers cover a meaningful set of benefits, as the ACA does now.  That means that insurance companies can simply design insurance plans in such a way that the services people with health conditions need aren’t covered, or they’d be covered only at a much higher cost.  Healthy people will buy skimpy policies and people who need services will have to pay a lot more or not be able to buy insurance at all.  It’s estimated that more than half the people in America have such pre-existing conditions.

* Eliminating requirements to cover a package of “essential” benefits.  This means that insurance companies can go back to the pre-ACA days when insurance routinely failed to cover important benefits like mental health, substance use treatment and maternity care, and many plans didn’t even cover prescription drugs.

* Insurance companies will once again be allowed to cap the amount of benefits they’ll cover annually or over a lifetime.  The ACA ban on capping coverage applies to the package of “essential health benefits” that are required to be part of insurance under current law.  Removing those coverage requirements and letting insurers offer skimpier packages that cover fewer benefits means that people with high-cost health conditions will no longer be protected.  For example, a baby born with a serious medical condition could use up her entire lifetime’s benefits in the first few months of her life.

Other problems with the bill:

* The United States is in the midst of an unprecedented opioid addiction epidemic.  The Senate bill will end the Medicaid expansion and the access it provides to substance use treatment.  And private insurance will no longer be required to cover these services.  Access to treatment for addiction will be lost at a time of national crisis.

* By cutting both Medicaid and help to pay insurance premiums, the Senate bill will increase the number of uninsured Americans, reversing the ACA’s historic progress in reducing the uninsured rate.

* Meanwhile, the massive cuts harming people with low or moderate incomes will be used to pay for big tax cuts for the rich.  It’s estimated that people with incomes over $1 million will each get a tax cut of $50,000 a year.

* Beyond the loss of health care, economic impacts will be harsh.  A recent study from George Washington University found that more than 900,000 jobs would be lost by 2026 under the Republican House bill, and that there would be reduced business activity and economic growth nationwide.

New Mexico’s Senators Udall and Heinrich are solid in their opposition to the harmful Senate bill, but their party is in the minority and has little power as the majority leadership plans to force the bill through on a party-line vote.  If you have family or friends in states with Republican senators, we encourage you to 1) make them aware of how dangerous the Senate bill is, and 2) ask them to contact their senators and urge them to vote No.

The Disability Coalition is administered by Disability Rights New Mexico and is funded in part by the New Mexico DD Planning Council through Federal Program funding, with additional funding provided by The Arc of NM, the Independent Living Resource Center, New Vistas and DRNM.

 

Fritzi  Hardy, BS, MA, NLP

Chair of the New Mexico Association of Family Living Providers

The only association focused entirely on Family Living within the DD Waiver

553 Mission Ave., NE
Albuquerque, NM  87107-4905
ph: 505-345-1709

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