Thursday, May 4, 2017

ACA repeal passed the House. Now what?

  1. Thank your representative for voting against the American Health Care Act (AHCA)
  2. Start educating your Senator on why the AHCA is so harmful

The U.S. House passed the American Health Care Act on May 4 on a close vote, with 20 moderate Republicans voting against the bill.  All the King County Congressional delegation voted against.The bill now moves to the U.S. Senate.
While the vote is tremendously disappointing to advocates concerned about cuts to Medicaid and access to affordable, quality care for people with disabilities and other pre-existing conditions, in a sense, it also represents a small victory. For years, House Republicans have been voting unanimously to repeal the Affordable Care Act. In January, we faced an uphill battle to help Congress understand the implications for people with intellectual and developmental disabilities.In King County, at least, some of the message got through and Representatives DelBene, Jayapal, Reichert and Smith all voted against passage of the AHCA.

The specific ways this bill affects the developmental community, however, are still not well understood, and advocates need to stay engaged to help leaders and community members alike understand the nature of home and community-based supports that enable people to live, learn, work and play in the community, as well as the importance of essential benefits such as habilitative services that help people with developmental disabilities keep, learn, or improve skills and functioning needed for daily living.

So, what is at stake?

From the governor’s office:
“The AHCA would result in approximately 72,000-100,000 Washingtonians losing their current private health care insurance, and over 600,000 individuals losing their coverage under our state’s Medicaid program unless our state can find $1.4 billion in new revenue each year. It would also undermine care for children and take hundreds of millions out of long-term care and services for individuals with developmental disabilities.”
The governor’s letter
The governor’s fact sheet on impact
DSHS Impact on Seniors and Adults with Disabilities
From The Arc of Washington:

“Medicaid, which is part of the health care bill, funds nearly all supports and services for children and adults with intellectual and developmental disabilities, including employment services, personal care in the home, respite, environmental modifications, therapies, and assistive technology. These services allow people to exercise their choice, remain healthy, and live meaningful and productive lives at home and in the community.

People with disabilities nationally make up 15 percent of Medicaid enrollment, but account for 42 percent of program spending. A variety of Medicaid funded programs, such as Apple Health, the Children’s Health Insurance Program (CHIP), Community First Choice (which includes personal care), and Home and Community Based Services Waivers from the Developmental Disabilities Administration (DDA) provide a spectrum of services. Many individuals with intellectual and developmental disabilities are enrolled in more than one Medicaid program.”
So, now the action moves to the Senate … and your voice is just as important. Some contact information and statements that you might find helpful:

You can find your U.S. House representative here. Our two U.S. Senators represent all people in Washington  
  • Senator Murrary - Seattle office: (206) 553-5545; DC office: (202) 224-2621
  • Senator Cantwell - Seattle office: (206) 220-6400; DC office: (202) 224-3441

Major components of the American Health Care Act (AHCA) include:

A decimated Medicaid program: The federal government would no longer share in the costs of providing health care services and community living supports beyond the capped amount. Home and community based services such as employment support, community access, crisis stabilization, respite and positive behavior therapies are optional. Only institutional care is required. The AHCS also weakens Medicaid by ending the Medicaid expansion earlier, offering Medicaid block grants to states, and promoting work requirements that can complicate access to other supports.

No more protections for pre-existing conditions: States could waive the requirement for community rating - this would allow the insurance companies to charge people with pre-existing conditions whatever they wanted, essentially making the pre-existing condition protections meaningless. A recent amendment to add $8 billion to create high risk pools to address this would do little to fix this flawed legislation.

Loss of essential health benefits: States would have the option to waive important consumer protections in the Affordable Care Act. For example, states could choose to ignore the essential health benefits requirement which ensures that health plans cover basic needs such as prescription drugs, mental health services, and rehabilitative and habilitative services and devices that have been critically important to people with disabilities and chronic health conditions

A list of how representatives voted