From Jen Hofmann’s action items for this week
Action: Stand with Americans who are poor, disabled, and/or unable to work.
Find: Your state Medicaid director’s address (look up, scroll down for address).
Write: Dear [Name], I am deeply concerned about the CMS letter on 1/12/18 allowing states to deny medical care to vulnerable citizens. With a majority of Medicaid enrollees already working, in school, or medically unable to work, compliance enforcement is an unnecessary waste of taxpayer money. We must take care of our neighbors in need. This new policy penalizes people living in poverty and with disabilities, cutting them off from a powerful poverty-reducing program. I entreat you to continue providing Medicaid to all [Staters] who need it. Thank you for your consideration. Name, town.
Here is a great resource from the Kaiser Foundation about ACA Signups and health insurance.
Understanding Health Insurance
Take action this weekend and submit your story for the Graham-Cassidy Hearing on Monday, September 25th.
Jen Hoffman’s action item for this weekend
Action: Submit public testimony for Monday’s Graham-Cassidy hearing.
Email: GCHcomments@finance.senate.gov by 1pm EST/10am PST Monday 9/25.
Script: I/my family rely/relies on quality, affordable healthcare. Because of this, I oppose the Graham-Cassidy bill. My story with [Medicaid, pre-existing conditions, disabilities, affordability, etc.] is… I would like to see a bipartisan Congressional effort to improve the ACA, not repeal it.
Virtual Phone Banks in Chicago Area
Indivisible Chicago is hosting phone banks today to fight Trumpcare. More information HERE
Keep Talking to Your Representatives
While we can all breathe a sigh of relief that BCRA won’t pass, we must remain vigilant. There are already rumblings of an attempt to cut Medicare and Social Security . The President has threatened to actively sabotage the markets to destroy the ACA. We know the Affordable Care Act needs attention to address problems in the markets. It is time to talk to our representatives about steps to strengthen and improve the ACA through bipartisan efforts.
The Center for American Progress has recommended three initial legislative steps.
- Guarantee continued payments for ACA subsidies and reduce cost sharing
- Reimburse insurers for high-cost enrollees
- Offer inducements to insurers to enter markets with a single or no insurer
Saving healthcare will take more than resisting Republicans. We need to propose solutions to the problems in our current system and encourage our representatives to fight for them.
Back to the Phones
We all had a little breather over the 4th of July break, but the Senate will be back in session tomorrow. Indications are they will pull out all the stops to pass BCRA. Mitch McConnell submitted revisions to the CBO last week, and has been offering money to flip “no” votes. He will have two weeks to pass the bill after the CBO scores it. Save My Care has TV ads in Nevada, Alaska and West Virginia. It’s time for us to go back to the phones and call everyone on the list.
|Dick Durbin (D)||IL||202-224-2152|
|Tammy Duckworth (D)||IL||202-224-2854|
|Shelley Capito (R)||WV||202-224-6472|
|Lisa Murkowski (R)||AK||202-224-6665|
|Dean Heller (R)||NV||202-224-6244|
|Dan Sullivan (R)||AK||202-224-3004|
|Jeff Flake (R)||AZ||202-224-4521|
|Susan Collins (R)||ME||202-224-2523|
|Bill Cassidy (R)||LA||202-224-5824|
|Cory Gardner (R)||CO||202-224-5941|
|Richard Shelby (R)||AL||202-224-5744|
|Luther Strange (R)||AL||202-224-4124|
|Pat Toomey (R)||PA||202-224-4254|
|Lamar Alexander (R)||TN||202-224-4944|
|Ron Johnson (R)||WI||202-224-5323|
|Rob Portman (R)||OH||202-224-3353|
On Friday, July 7th, with about 200 other people, I attended the Health Care Round Table hosted by Congressman Brad Schneider and the Lake County Health Department at Waukegan High School. The Congressman spoke about the history of the Affordable Care Act, the AHCA and the BCRA and the implications for Illinoisans of the proposed changes. He emphasized that the ACA was the result of 15 months of work, 79 public hearings, testimony by over 180 witnesses, included hundreds of amendments (many by Republicans) and eventually passed with no Republican votes. The ACHA and BCRA have been developed behind closed doors with no hearings, witnesses, amendments, or debates.
Medicaid in Illinois
- over 3 million Medicaid recipients
- covers 50% of childbirth
- covers 47% of children
- covers 18% of seniors and disabled people
Impact of the AHCA (Congressional bill)
- 24 million lose Medicaid in the first decade
- cost of insurance on the exchanges would increase, especially for older people. A 60 year old making $26,000 would see premium go from $1700 a year to $16,000 a year
Impact of BCRA (Senate bill)
- 23 million people would lose Medicaid
- provides a $800 billion tax cut for the 400 wealthiest Americans
- Medicaid would be cut 26% in the first decade
- Medicaid would be cut 35% in the second decade
- almost all premiums would go up
- “age tax” – older people would have the highest increases
- those with income at 200% of the poverty level would see a 96% increase in premiums
- those with income under the 200% poverty level would lose subsidies, premiums increase 300%
- rate of uninsured would rise again to 18% (after falling from 20% to 10% as a result of the ACA).
The Congressman stated that the ACA needs fixing, and supports a bipartisan approach. He thinks the marketplace needs adjustments, something must be done about insurance companies pulling out of the market, the Cost Sharing Reductions must be continued and a public option should be considered.
Mark Pfister, Executive Director of the Lake County Health Department, shared information about the ACA in Lake county.
- 44,436 people accessed insurance because of the ACA
- rate of uninsured went from 11% in 2013 to 3% in 2016
- 21,600 people got Medicaid in 2016 because Illinois opted for Medicaid expansion
- 40,000 patients get health care at Lake County Health Department and 60% are on Medicaid
- pre-ACA, the uninsured rate at the Health Department was 46%; it is now 34%
- ACA created the Public Health Prevention Fund, funds vaccines from CDC for disease outbreaks like Zika or the mumps. The BCRA cuts the fund by 11%
- Mental Health Parity Act (2008) required insurance to cover mental health services as they did other medical services but not implemented until the ACA provided the funds to pay for it. BCRA eliminates those funds resulting in cuts to mental health and substance abuse services
Three constituents shared their stories of how the ACA has helped them including:
- children being covered on their parents’ insurance until age 26
- coverage of pre-existing conditions
- subsidies in the exchanges
- removal of life time caps
During the question and answer period, Congressman Schneider outlined his “fixes” for the ACA
- goal is to provide quality, affordable health insurance
- need comprehensive health care policy, agencies need to be able to address issues
- promote innovation to reduce costs (repeal medical device tax)
- strengthen marketplace, pass the Common Sense Act
- bolster Cost Sharing Reduction Subsidies
- bipartisan effort
One constituent asked what is being done now, in addition to trying to block the passage of BCRA.
- Problem Solving Caucus – 23 Democrats and 21 Republicans
- Bipartisan Working Group – meets once a week
- Similar group being developed in the Senate by Senator Heitkamp
- looking at abuses in the system (Martin Shkreli)
The audience was largely supportive of the Congressman. The negative comments were about the cost of insurance in the marketplace, the lack of local providers for the marketplace plans, costs of medications and long waiting times for appointments.
Behind the Scenes Efforts to “Flip” Senate Votes
Several news sources are reporting that Senator McConnell continues to apply pressure to Senators who are resistant to vote “yes” on BCRA. The NYT provided a list on Wednesday of the current positions in the Senate (article link HERE ). According to Talking Points Memo, McConnell is focusing on ten Senators who were most vocal in their opposition in the last week ( link to article HERE ). They describe the probable “wish list” for each of these Senators. The Washington Post outlines similar behind the scenes negotiating, but sees this as an attempt to revise parts of the bill to get a new CBO score prior to voting again in mid-July (link HERE ).
Regardless of the strategy, it is clear that BRCA is not dead yet. Marches and protests continue in Washington and at the offices of Senators. If anything was learned after passage of the AHCA, it is that zombie bills can rise again.
McConnell Working Behind the Scenes to Pass BCRA
The Senate is rapidly moving toward another vote to try to pass BCRA, probably on Friday. We need to continue to make calls encouraging Senators to oppose this bill, in any form. Scroll down to previous action items for the phone numbers. Encourage anyone you know with a Republican senator to keep up the pressure.