Next week the Senate is expected to take up the ACA repeal plan introduced by Senators Graham (R-SC), Cassidy (R-LA), Heller (R-NV) and Johnson (R-WI). The plan (being referred to as Graham-Cassidy-Heller-Johnson or Graham-Cassidy) is just as harmful to patient protections as previous legislation considered in Congress this year. Graham-Cassidy would make significant changes to the individual insurance markets and the funding formula for Medicaid.
- States could redefine the essential health benefits, the ACA requirement that plans provide comprehensive coverage. This also affects the ban on lifetime and annual limits, the limit on out-of-pocket spending, and the requirement that plans not be discriminatory. The impact would be significant as nearly all private insurance plans include these policies.
- Insurers will not be allowed to deny someone coverage based on a pre-existing conditions. However, states could allow insurers to set premiums higher for people with pre-existing conditions and for older people. They could charge so much money that it makes insurance unattainable, and they can decline to cover needed services.
- The bill would terminate the ACA’s Medicaid expansions, premium tax credits, cost-sharing reduction payments, and small business tax credits. Instead, states would receive funds as a block grant from the federal government. There is a complex formula - some states would lose money (mostly states that expanded Medicaid) and some states would get increased funds (non-expansion states) until 2026. The block grant funding ends in 2027, so all states would face dramatic funding cuts then unless Congress acts at that point.
- The bill would also eliminate the individual and employer mandates, which would further destabilize the insurance market.
- The bill would change the Medicaid funding formula – instituting strict per-capita caps, significantly reducing federal funding, and encouraging states to implement work requirements for Medicaid enrollees. When included in other ACA repeal proposals, the Congressional Budget Office has estimated that these reforms would lead to millions of Americans losing coverage.
We need all CHD advocates to contact their members one more time before the Senate votes on the proposal next week. While some provisions of Graham-Cassidy differ from the other ACA repeal proposals, this bill, like those that preceded it, invalidates the patient protections important to adults with CHDs.
Congress is running short on time. The legislative process being used to pass a repeal bill with only 51 votes expires on September 30th, so advocates must weigh in now! We expect the vote will come to just a few Senators again, so every Senator’s vote counts.
It is IMPERATIVE that you contact your Senators today! Your phone calls and emails are necessary to tell Senators our concerns about the bill. We need to educate them about how the ACA’s patient protections have benefited persons with CHD and urge them not to pass legislation that will make it harder for adults with CHDs to access the comprehensive coverage and care they need.
Visit www.Senate.gov and select your state from the drop-down menu bar next to the American flag at the top of the page. This will take you to a page with phone and email contact information for your two Senators. For your convenience, we’ve drafted an email for you to send to your Senator, which you can find here. Simply copy and paste the message into the body of an email. If you would prefer to call you Senators or connect on social media, click here, where you’ll find instructions and talking points.
Let us know about your interactions! Please contact Danielle Hile at ACHA (dhile@achaheart.org) to let her know any responses or continuing dialogue you have with your Senators.