By SR. CAROL KEEHAN, DC CHA president and chief executive officer
We are strongly opposed to the House Republicans' efforts to "repeal and replace" the Affordable Care Act with legislation that requires the most vulnerable in our country, including those with low incomes, to bear the brunt of the cuts to our health care system. In addition to moving away from an effective coverage expansion that has provided health care to more than 20 million working people, this proposal also would take many backward steps in the continual effort to improve our health care system, including:
- Fundamentally restructuring Medicaid by capping federal financing, which will lead to major reductions in benefits and coverage for vulnerable families.
- Eliminating cost-sharing subsidies for low-income people purchasing insurance through federal or state marketplaces.
- Eliminating the income affordability adjustment for tax credits.
- Penalizing individuals with pre-existing conditions with a 30 percent monthly premium surcharge for a year, should they have a lapse in coverage.
- Creating barriers to initial and continuing Medicaid enrollment.
The proposed legislation, called the American Health Care Act, will increase substantially the number of uninsured people by taking away coverage individuals and families just obtained. It will disrupt the insurance market for the entire nation. It will drive up uncompensated care costs for safety net providers. This nation is too great to let those things happen.
The nonpartisan Congressional Budget Office "scored" the legislation March 13. Its report forecasts that the American Health Care Act would cut $880 billion out of Medicaid between 2017 and 2026 and would leave 14 million fewer individuals covered by Medicaid by 2026, as compared with the current law. The CBO anticipates that, by 2026, an estimated 52 million people would be uninsured compared with the 28 million who would lack insurance that year if we stayed under the current law.
CHA's "Vision for U.S. Health Care" calls for health care to be available and accessible to everyone, paying special attention to poor and vulnerable individuals. Radically restructuring the Medicaid program — with per capita caps or block grants — fundamentally undermines coverage for over 70 million poor and vulnerable children, pregnant women, elderly and disabled individuals in our nation. Federal Medicaid funding caps simply shift the cost burden onto local and state governments, providers and individual beneficiaries, ultimately leading to the loss of Medicaid coverage for millions of individuals.
The ACA is not a perfect law, and we have always said it should be improved where necessary. This new plan does not improve the law — instead, it undermines it and leaves behind millions of people who have obtained meaningful, affordable insurance that was not possible before the ACA.
We strongly encourage the full House to reject this replacement bill and work to craft legislation that addresses the real issues without creating unneeded chaos in the system and coverage loss for those who need health care.
While there are many opportunities to improve both the ACA and the Medicaid program by creating greater flexibility for state innovation, we believe this proposal will simply erode the safety net and jeopardize the health and economic safety of millions of Americans. We stand ready to work with all members of Congress to improve the availability, affordability, coverage and quality of our health care system in ways that do not harm those who need our help and support.
Copyright © 2017 by the Catholic Health Association
of the United States
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