The Reasons Behind the Senate Vote on Banning Abortion.
The Senate has scheduled a vote on a bill, already passed by the House, that bans abortions after 20 weeks, and the Trump Administration has signaled its support of this bill. While some websites are raising the alarm, The Hill asserts that the bill has little chance of passing in the Senate with the narrow Republican majority. According to The Hill, the purpose of scheduling this vote is to get Senators on record with their votes for or against the bill. Anti-abortion activists are hoping that Democrats up for re-election in battleground states will suffer the consequences of their vote, while Democrats characterize the bill as an extreme assault on a woman’s right to make decisions about her health care. This bill, titled “Pain-Capable Unborn Child Protection Act” is based on faulty “science” mis-representing fetal development as outlined by Dr Daniel Grossman on Twitter (@DrDGrossman). When politicians insert themselves into medical decisions best made between doctors and their patients, decisions that should be based on the patient’s individual circumstances and unique needs, unintended consequences and unforeseen harm often follow.
The key to the electoral impact of the bill may be how issues-influenced voting weighs against voting based on economic factors. As always, who shows up to vote in an election can be critical – in 2017 special elections were sometimes decided by a strong showing of voters who have previously not been active at the voting booth. As The New York Times points out in their editorial post this evening, having Democrats take back control of either house of Congress will guard against future actions to restrict reproductive freedoms. Voting in local elections is important, as are actions supporting progressive voters in red states. Don’t forget, primaries in Illinois are March 20 and election day is November 6th – cast your vote and make your voice heard!
Initial Numbers for ACA Enrollment – Over 600,000 Sign Up in the First Four Days!
The Washington Post reports that more than one in five of these are new enrollees. The increase in numbers is despite the Trump Administration undercutting the process by shortening the enrollment period by half, slashing the TV and radio advertising budget and cutting navigator funding. State run exchanges are also reporting brisk business as the enrollment period begins according to CNN Money
However, this trend doesn’t predict overall ACA success as the numbers tend to fall off during the latter part of the enrollment period. The sickest people who need insurance the most tend to sign up first, but the success of the ACA marketplace also depends on healthier people signing up to balance the risk pool. It is important for all of us to keep spreading the word about the enrollment period and where to find help with the process (see below).
Additional Information About ACA Enrollment
From Protect Our Care IL Newsletter:
|Here are the top 5 things you need to know about Open Enrollment:|
- Open enrollment is only half as long this year (Nov 1 – Dec 15).
- Discounts on health coverage (through tax credits and cost sharing reductions) are STILL available to those who qualify.
- It’s important to shop around – the pricing of premiums is very different this year. In Illinois, you can go to HealthCare.gov or GetCoveredIllinois.gov. Eighty percent of people can get a plan for $75 or less and many in Illinois can get a bronze plan for free.
- You may qualify for 2018 tax credits even if you didn’t in 2017. If you aren’t eligible for tax credits (check this calculator to make sure), go to GetCoveredIllinois.gov and see if you can find a cheaper plan off marketplace.
- Free help is available! If you have questions about signing up or want to talk through your options with a trained professional, you can make an appointment with a trained navigator here or call Get Covered Illinois at 866-311-1119.
Another Opportunity to Get Your ACA Questions Answered
The POP (People Over Party) Workshop will bring Miranda Wilgus of ACA Consumer Advocacy in to update you with the latest information on the ACA sign-ups, Medicare and Medicaid, and answer your questions on health care coverage.
Health Care Workshop information:
Sunday, November 11, 2017 1-3pm
St. Peter United Church of Christ
47 Church Street, Lake Zurich, IL
Here is a great resource from the Kaiser Foundation about ACA Signups and health insurance.
Understanding Health Insurance
What Is the Latest on the Rollercoaster Also Known As the ACA?
At the North Shore Indivisible meeting today, Miranda Wilgus of the ACA Consumer Advocacy group updated us on some of what has been happening with the Affordable Care Act (ACA).
Regarding ACA Enrollment:
The first item to know and to publicize among your friends and relatives is that the ACA enrollment period is shorter this year, down to 45 days instead of last year’s 3 months! ACA enrollment starts Nov 1st and runs only through December 15.
- In addition to shortening the enrollment period, the budget for publicizing information about the ACA has been radically slashed, leaving it to advocacy groups and service providers to spread the word.
- Another obstacle to sign-up : the website will be down for “maintenance” every Sunday for 12 hours (!).
- If you need help finding a navigator (someone who can help guide you through the enrollment process), visit Get Covered Illinois for assistance.
- After much flip-flopping, Trump signed an executive order to stop the Cost Sharing Reduction (CSR) payments. These are payments for the silver level of ACA policies that reimburse insurance companies for the extra discounts they must give so people pay less for deductibles, co-pay and co-incurance. The Attorneys General of 19 states (including IL) are suing the administration to reinstate these payments as they required by the law (The Affordable Care Act).
- In the meantime, the cost of silver policies are expected to skyrocket. Consumers should look at all levels of the policies on the ACA marketplace. In some cases, gold policies (which offer more coverage) may even cost less than the silver level.
- Do not let “auto-enroll” re-sign you for the silver level until you have checked out the alternatives.
- Pay attention to details! Sometimes prescription plans will not go into effect until medical deductibles have been met.
- Consumer Alert! Some disreputable insurance brokers have been cold-calling customers to sell them cheap health care policies, claiming they are part of the ACA marketplace and that they are “qualified” although they are not actually qualified. Qualified policies provided coverage for the Essential Health Benefits mandated by the ACA. If you buy an unqualified plan, you will be liable for the tax penalty when you file your taxes (see below).
- Trump signed an executive order that the IRS not enforce the ACA tax penalty mandate. This is non-binding and the IRS will still be enforcing the tax penalty!
- Other recent executive orders: allowing associations to offer health insurance policies that do not have to follow ACA mandates and allowing businesses to not offer contraceptive coverage on the basis of moral objections as well as previously allowed religious objections.
For more information about getting covered, or if you would like to get involved, visit ACASignUpProject.com . Downloadable fliers to publicize enrollment information are available in English and Spanish at Indivisible ACA Signup Project Gallery.
There is a bipartisan bill in the Senate put forward by Lamar Alexander (R-Tenn.) and Patty Murray,(D-Wash) which would restore the CSR payments and help stabilize the ACA marketplace. However, Mitch McConnell, Majority Leader of the Senate, will only bring the bill forward for a vote if Trump will promise to sign it. As of now, Trump has expressed support for it, withdrawn support for it, called CSR’s “pay-offs to insurance companies” (false) and has made other demands. The status of this bill changes by the day, occasionally by the hour, so stay tuned for further updates!
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.
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.
A Brief Summary of the Health Care Forum
Palatine Public Library
During an information-packed health care forum hosted by NWSOFA (North West Suburbs Organizing For America) and Protect Our Care IL, presenters painted a clear picture of what the healthcare insurance landscape looked like before the Affordable Care Act (ACA) went into effect. Of the non-elderly population who lacked employee coverage and had to look for an individually purchased insurance plan, 17% had no insurance at all. premiums were sky-rocketing. Of those insured by individually purchased plans, 75% had no maternity care, no addiction treatment, no preventative care and a multitude of loopholes where insurance companies could deny you coverage if your care became too expensive. Medicaid was only available to those below a certain income level and additionally they had to be disabled, be a child or care-giving parent of a covered child or pregnant. Those battling chronic health conditions and the “working poor” were not eligible, despite not earning enough to afford health insurance.
When the ACA was passed, during the first year, the uninsured rate dropped from 17% to 7% and the insurance plans covered the 10 Essential Health Benefits, giving robust coverage, and banning denial of coverage for pre-existing conditions and banning life-time caps on the cost of certain coverage. Medicaid was expanded to include the “working poor” where eligibility was based on income and not a checklist of other qualifiers. Though the ACA (like most programs when they are newly launched) needed some tweaks to correct problems, it was working in providing more Americans better access to quality health care coverage.
The current health care plans being proposed by the House (AHCA) and Senate (BCRA), would roll back all progress made in providing Americans with health insurance, to the conditions found prior to the ACA. Medicaid cutbacks would devastate many hospitals, particularly those in rural areas. Loss of those hospitals would also result in loss of jobs both directly in those affected hospitals and jobs in areas that support the hospitals, further hurting those communities. Loss of coverage for many Americans would result in more people dying from preventable conditions.
The unpopularity of the recent Senate plan has resulted in some Republican Senators refusing to support the BRCA and a delay in the planned Senate vote. Although this is a temporary victory, the battle has just begun. Senate leaders will modify their plan – not necessarily for the better – and use all means to persuade enough Senators to vote and pass the BCRA
Now is the time to maintain pressure on the Senators and turn up the volume of your protest! This will be a long battle. Call your Senators, call wavering Republican Senators, join rallies, write letters to the editor, call Gov. Rauner. Do whatever you can. See our action items list for suggestions and events as they are updated. Click here (or the link in the first paragraph) for the link to all of the information sheets covered at the forum.
Comparison of the ACA, AHCA and BCRA Health Care Bills
Confused by what is in the ACA (Affordable Care Act) vs. AHCA (American Health Care Act – House version) vs. BCRA (Better Care Reconciliation Act – Senate version)? Click here to see a Huffington Post article that clearly shows the differences in an easy to understand, side-by-side comparison.