Late Monday March 6, Congress introduced two bills that make up the American Health Care Act (AHCA) that will restructure Medicaid and reform the Affordable Care Act. Congress is on the fast track to repeal major portions of the Obama Affordable Care Act. It is moving swiftly!!! The US House of Representatives hopes to quickly move the repeal bill through Committee and vote by the end of March. The Senate has indicated that it would like to vote on the House bill before the mid-April recess.Sponsors of the bills say it offers more choice; however disability rights advocates believe the American Health Care Act offers less protection. There is serious concern about the caps on Medicaid and the future of disability services in home and community-based settings, resulting in cuts to the Medicaid program. The level of cuts over time would decimate the Medicaid program. In Maryland, Medicaid pays for supported employment, day habilitation, residential services, and personal supports.
Below are critical areas points:
- These bills will repeal individual and employer mandates retroactively.
- Provides huge tax breaks, primarily to wealthy households and business interests.
- This means eliminating tax on high earners and surcharge on investment income will benefit the wealthy.
- Lower earning households fare far worse under this plan.
- The proposals increase inequality, reducing taxes on the wealthy and making healthcare less affordable for others.
- There will be higher premiums and out of pocket costs.
- With the exception of the youngest people the bills will increase costs, making insurance out of reach for millions.
- Tax credits will be available for people with higher incomes than under the Affordable Care Act (Obamacare).
- If there is a break in coverage (e.g. someone missed enrollment) the cost would increase by 30%.
- The proposal will eliminate Medicaid expansion as of 1/2020.
- Community First Choice will lose its federal enhancement match.
- There are proposed per capita caps on Medicaid using the FY16 baseline. (Huge shift of cost and responsibility to the state.)
- Controls the growth rate of Medicaid spending at lower levels than Medicaid’s historical growth rate (anticipates states’ responsibility will increase over time, requiring states to manage healthcare with less money).
- Will result in cuts, waitlists, less community based services for people with disabilities.
- Services that people with disabilities need to live in the community are generally optional. With less funding there will be more focus on Medicaid entitlements (required or mandatory services) with potential cuts to optional services such as home and community-based supports.
- The Congressional Budget Office will probably score the bill as covering 20 million fewer people.
- The bill sponsors are using budget reconciliation process to eliminate procedure hurdles and pass the bill quickly.
- Next week there will be mark-ups in House Budget & Rules Committees.
- GOP wants the bills on House Floor by 3/20 because 3/23 is the anniversary of the ACA passage.
- The bill will go immediately to the Senate.
- There is talk about foregoing the committee process and going straight to the floor.
- Could pass as early as the second week of April.
What can you do?
Visit The Arc US website for action you can take.