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Alert: House Could Vote on Health Care This Friday

Mental Health Task Force/ Make It Work Milwaukee Update

Efforts are continuing in Washington to repeal the Affordable Care Act and make radical changes to Medicaid, including major cuts in Medicaid funding. The Center on Budget and Policy Priorities and other sources are reporting that the House may vote on a modified health care bill as early as Friday. The conservative Freedom Caucus has announced their support for the amended bill – see the update below which includes details about the MacArthur amendment which would:

  • Roll back key pre-existing conditions protections: just like before the ACA, discrimination based on pre-existing conditions would be allowed except in states that chose to prohibit it.

  • Roll back nationwide standards that require plans to cover services like mental health and substance use treatment and maternity care, and that prohibit lifetime and annual limits.

Please read below for additional detail on the proposal and suggestions for taking action now to share your concerns with policy makers.

CBPP Health Update

Things on the health care front have taken a dire turn and we could see a vote on a modified health care proposal in the House as early as Friday.

The proposal has the support of the conservative House Republican Freedom Caucus – which heightens the chances significantly that the bill could pass. As explained below, the only way to stop this legislation is to ensure that moderate and centrist Republicans oppose the measure. So, the work those of you represented by these Members are doing is extremely important – especially in the next 24–48 hours.

Legislative Update

Over the recess, the leader of the Freedom Caucus, Rep. Meadows, negotiated a provision to add to the original House ACHA bill with Rep. MacArthur, one of the leaders of the moderate Republican “Tuesday Group.” The change is portrayed as protecting “pre-ex” coverage (meaning ensuring coverage for those with pre-existing conditions), but in fact, it makes it more likely that millions of Americans will see their premiums rise and/or lose access to their health coverage.

The modification would:

  • Roll back key pre-existing conditions protections: just like before the ACA, discrimination based on pre-existing conditions would be allowed except in states that chose to prohibit it.

  • Roll back nationwide standards that require plans to cover services like mental health and substance use treatment and maternity care, and that prohibit lifetime and annual limits.

See our paper on how this provision would make the AHCA worse here:

While the agreement was portrayed as a “deal” between moderate and conservative Republicans in the House, it turns out this change was nothing more than an agreement between Reps. Meadows and MacArthur. Unfortunately, that has now changed with the endorsement of the Freedom Caucus (which only serves to underscore concerns about the impact of the change).

Unless moderate Republicans oppose the measure, it will pass and go to the Senate which would then come under intense pressure to act. This underscores how critical your work is in the districts of moderate House Republicans since they are now getting a strong push from the Administration and Republicans to support the bill.

There are still very strong reasons for moderate Republicans to oppose this modified ACHA bill. This group has indicated consistently that they are worried about protecting the Medicaid expansion in their states, and about protecting coverage for Essential Health Benefits and pre-existing conditions. Yet the modified ACHA bill retains the elimination of the Medicaid expansion – and effectively the end of Medicaid as we know it (the per capita cap/the $880 billion cut), and only further weakens these critical consumer protections.

Specifically, the bill:

  • Still causes 24 million people to lose coverage: 1 in 10 non-elderly people who would otherwise have insurance would lose it.

  • Still effectively ends the ACA Medicaid expansion.

  • Still cuts $840 billion from Medicaid over 10 years, with most of the savings going to wealthy people and insurance, pharmaceutical, and other corporations.

  • Still increases premiums and deductibles for marketplace consumers, with total out-of-pocket costs increasing by an average of $3,600 – and far more for older people, lower-income people, and people in high-cost states.

In short, for moderate Republicans who had announced their opposition, there’s no reason for them to change their position. For those moderates who had not yet indicated their position, there is no excuse to support this bill given the harm it would do.

We know that since last week many of you have sent calls to action to your networks and have been hard at work reaching out to your representatives on this. If you need their staff contact info, please reply to this email and let us know. We are happy to provide that information. Please see the list of the most recent public statements made by legislators on this modified version of the bill below.

Considering these developments, we hope you will move quickly in the next 24–48 hours to ensure that your moderate Republican representative has heard from you and other allied state partners and activists that the modified AHCA bill would have a tremendously harmful impact in your state.

In addition, we want to urge those of you with moderate Republican senators or other Republicans who represent a state with the Medicaid expansion to contact them quickly as well.

This could prove very useful in affecting the outcome in the House: if moderate Republican senators in states with moderate Republican representatives speak out against the modified House bill, it will send a powerful signal that this legislation is not going to fly in the Senate and give House members pause about “walking the plank” for nothing. In addition, if this bill does manage to pass the House, we need to make sure key senators are well aware of the deep problems with the modified House proposal.

We strongly urge you to consider enacting (or continuing) the following steps with the key House Republicans:

  • Send a brief letter or email to your Representative in Washington (e.g. send it to the health care staffer) urging her/him to oppose the modified health plan. (If you need your Representative’s staff contact information, please let us know). Sample message points are below.

  • Post something on your Member’s Facebook page and/or tweet at them about why this bill will hurt many in his/her district – join and promote hashtag campaigns such as #ProtectOurCare

  • Let allied groups in the state/district know of these developments and urge them to communicate with the Member to urge his/her opposition

Messaging Points:

The modified Republican plan will make the underlying AHCA bill even worse. It is no compromise and it is certainly not a “deal” to the millions of Americans whose coverage will be impacted negatively:

  • People could be charged more if they had a pre-existing condition, putting affordable insurance out of reach for millions of Americans

  • Plans would no longer be required to cover services like mental health and substance use treatment, or maternity care – effectively allowing women to be charged more than men

  • People could again be subject to lifetime and annual limits on the coverage they get – meaning a medical catastrophe could once again mean bankruptcy

Ask your members to commit to opposing any bill or provision that causes millions of people to lose coverage, ends the ACA Medicaid expansion, shifts hundreds of billions of Medicaid costs to states, or makes individual market coverage less affordable.

House FY17 Continuing Resolution/ ACA cost sharing subsidies update

On a related front, we also wanted to share some apparent good news on the negotiations between President Trump’s staff and Congressional Democratic leaders over the Continuing Resolution (CR) appropriations wrap-up bill for FY17 and whether it will include language clarifying that the Administration should release the payments to cover cost sharing subsidies for moderate and middle-income Americans so they can purchase affordable coverage. The current continuing resolution – and funding for the government – expires on midnight of April 28th. The Administration just announced it will fund the cost sharing subsidies directly.

Congress may not be able to prepare the detailed conference report on this FY17 appropriations measure by the 28th, so it’s quite likely that the House and Senate will pass a one-week extension of the CR and finish this up next week.

We are available if you have questions or need help.

Thanks in advance for the work we know you will do to help ensure this harmful legislation does not pass the House this week or any time soon. While we will likely face related health care threats throughout the year, if this House bill goes down, it’s very unlikely we’ll see another run at a comprehensive bill to repeal and replace the ACA.

CBPP Resources on the House Health Care Bill

To Help Stabilize the Individual Health Insurance Market, Take ACA Repeal Off the Table

If “Essential Health Benefits” Standards Are Repealed, Health Plans Would Cover Little

House GOP Health Bill Still Cuts Tax Credits, Raises Costs by Thousands of Dollars for Millions of People

States Estimating Large Medicaid Cost Shifts, Coverage Losses Under House GOP Plan

Additional Resources

Medicaid Work Requirement Would Limit Health Care Access Without Significantly Boosting Employment

False Claim That the Medicaid Expansion is Causing Waiting Lists

Medicaid Helps Schools Help Children

Medicaid Per Capita Cap Would Shift Costs to and Risks to States and Harm Millions of Beneficiaries

Building on ACA’s Success Would Help Millions with Substance Use Disorders

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Last edited by Tyler Schuster.   Page last modified on April 26, 2017, at 09:12 PM

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