ACHA Moves to Senate- Action Needed
On Thursday, May 4, the U.S. House of Representatives voted to pass legislation, the American Health Care Act (AHCA), to repeal the Affordable Care Act (ACA). After analyzing the AHCA and the proposed amendments, the Alliance for Strong Families and Communities holds firm in its position that any changes to existing law must result in gains, not losses, for the babies, children, families, and seniors served by the network. As the bill moves to the Senate, it is critical that the Alliance strategic action network is actively communicating with U.S. Senators. Action steps are provided in this blog post. You are urged to begin taking these action steps right away. The Alliance will help support and coordinate collective action using shared messaging.
In summary, the House version of the AHCA will cause 24 million people to lose their health insurance. It will also cut $880 billion from Medicaid through the state’s choice of per capita caps or block grants. Further, it begins to roll back the Medicaid expansion. If the bill becomes law, it will end the Medicaid program in its current form.
The bill that passed the House yesterday is very similar to the bill that almost made it for a House floor vote in March, except for the addition of two amendments, which could lead to even more losses for Americans. Specifically, the MacArthur Amendment would allow states to waive the essential benefits package and would allow health plans to charge people with pre-existing conditions more for health insurance. Many constituents and the administration have voiced their opposition to reinstating higher premiums for pre-existing conditions, so the Meadows Amendment was also added to provide funding to offset premiums for that population. According to the Center on Budget and Policy Priorities (CBPP), the addition of $8 billion will not make a dent in the nearly $1 trillion that the House bill cuts from programs that help people afford coverage, This could leave as many as 15 million people with pre-existing conditions without support.
Those with pre-existing conditions are not the only ones negatively impacted by the bill. Seniors, disabled Americans, states hit by the opioid crisis, and pregnant women and new mothers, will all see disproportionate losses.
The biggest winners are households making $250,000 a year or more, which would benefit from the repeal of two different taxes that currently impact them. Households with millions in investment income would come out particularly far ahead.
While we are deeply concerned by the passage of this bill in the House, it is time to focus in on what we know and what may happen next.
- The House bill still needs to be scored by the Congressional Budget Office (CBO) before the Senate can take up the bill. This score provides information on the fiscal and coverage impact of this bill. The score is expected sometime in the next two weeks.
- The Senate is not expected to pass a health bill as quickly as the House. In fact, Sen. Lamar Alexander (R-Tenn.), who chairs the Senate health committee, has gone on record saying that the Senate will write their own bill.
- While this timeline could very well change, preliminary reports are that the Senate may not take this bill up until June.
- That said, it is very important to note that Senate conversations around this bill are well underway, meaning key decisions could start being made as early as the next week or two.
- While the Republicans have a much smaller margin to contend with than in the House (they only need 51 votes to pass it), we must assume that Senate Majority Leader Mitch McConnell will put together a package that can garner those 51 votes.
Action is required. As the bill moves to the Senate, here the steps the Alliance strategic action network can begin to take:
- Build or deepen Senate relationships. If you do not already have direct relationships to your state’s two U.S. senators, begin work to make those connections now. Contact the Alliance if we can be helpful in your relationship-building efforts.
- Schedule meetings with senators. Reach out as soon as possible to schedule two things with your senators during the Memorial Day Recess (May 26-June 4). The Alliance will provide talking points in support of your meeting.
- You can meet with them while they’re in-state. Reach out to your senators’ offices to schedule an in-state meeting with them to position your organization as a resource and to help them understand the negative impacts of the House version of the bill.
- You can also schedule a phone call or virtual meeting with their Washington, D.C.-based health staff. It’s important to speak with their D.C. staff about policy matters.
- Prepare a story. Stories from constituents are so important to helping policymakers understand the impact on their district. Share how the House version of the AHCA would impact the population or an individual/family you serve. You will find an outline of a personal impact story on page 23 of the Alliance Advocacy Toolkit. Weave into the story specific impacts that may result if the bill becomes law, such as:
- The AHCA could result in higher premiums for people with pre-existing conditions or eliminate that coverage altogether, depending on the state.
- The AHCA could no longer provide coverage for "essential benefits," which, under current law, includes mental health and substance abuse disorder services, preventive and wellness services, and pediatric services. As proposed, "essential benefits" would be defined by each state.
- The AHCA would cut $880 billion from the Medicaid program, significantly impacting individuals, communities, and the social services sector.
The Alliance will continue to keep you up to date, as the bill advances to the Senate. We will be providing more detailed actions to take in lifting our message that any changes to current health care law must create gains and not losses in coverage and affordability. If you have a representative who voted NO on the AHCA, the Alliance will be equipping you to say thank you.