The ACA is under attack again. This time it is the Graham-Cassidy Bill.
In order to pass with a simple 50 vote majority under budget reconciliation, the bill must be passed by the Senate no later than September 30. Currently, the Republican Senate Leadership is all in on Graham-Cassidy and launched a full scale whipping operation. Additionally, SEIU is hearing that Graham-Cassidy could come to the floor as soon as Tuesday, September 26. Neither side has the votes to pass or kill the bill at the moment, but by most accounts the Republicans are close to 50. In the rush to attempt to pass this legislation, Senate Republican Leadership will move forward with a vote without CBO coverage numbers or estimates about increased premiums and costs.
Republicans on the Hill will be making a hard push over the next ten days and it’s time for us fight back again!
WHAT WE CAN DO:
— We will be holding a NATIONAL CALL-IN DAY on MONDAY, 9/25. It’s crucial that we make these calls as this could be the final day before the vote. More details on the call in day will be sent out later this week.
— Prior to the call-in day, CALL THE ACA HOTLINE AT 866.426.2631. Your calls will be targeted at key Republican Senators and House members who can stop this bill.
ABOUT THE BILL:
On Funding, the Graham-Cassidy (G-C) Bill would:
- End the ACA’s Medicaid expansion starting in 2020. More than 14.9 million have gained coverage as a result of 31 states and the District of Columbia expanding Medicaid.
- End the ACA’s tax credits and cost-sharing subsidies that have helped more than 9 million middle-class families afford insurance.
- Eliminate the ACA’s marketplace subsidies, Medicaid expansion, and cost-sharing subsidies (CSRs) replacing them with a block grant that would run through 2026. The block grant would provide $239 billion less between 2020 and 2026 than projected federal funding under the ACA. After 2026, the funding will disappear completely.
- In 2027 alone federal health care funding will be cut by $299 billion.
- The block grants would start at $136 billion in 2020 (which would be 22% or $30 billion below what the amount would have been under the ACA) and grow at an annualized rate of 6.6%, ending at $200 billion in 2026 (which would be 20.5% or $41 billion below the amount under the ACA).
- The bill uses a complicated formula to allocate the fixed grant amount among states. This is likely to favor states that did not expand Medicaid over those which did. This means there will be an outsized cut to important CIR states like CA, FL, NY, NJ, and MA.
- This plan would also convert Medicaid’s current federal-state partnership to a per capita cap, meaning states would face additional Medicaid cuts. A vast majority of states would see net cuts in federal health coverage funding due to the combined effects of the plan’s block grant and its Medicaid per capita cap.
On Coverage, the Graham Cassidy Bill would allow states to apply for waivers that let them bypass critical ACA patient protections such as:
- Pre-existing condition protections: Insurers can charge people with pre-existing conditions higher premiums. The ACA currently prohibits that.
- Potentially charge higher rates to older people: Insurers can charge people higher premiums based on their age or other characteristics, as long as they comply with a minimum set of anti-discrimination rules.
- Essential Health Benefits requirement: States could allow plans that did not cover the current set of basic services defined under the ACA, thus allowing insurers to drop coverage for items such as maternity coverage.
Overall Impact of the Bill:
- The bill radically restructures and cuts the Medicaid program by turning into a per-capita cap structure. This will likely lead to coverage and service cuts for millions.
- It will end Medicaid expansion and ACA tax credits and subsidies and transform them into an insufficient and temporary block grant funding that will lead to hundreds of billions of dollars in federal cuts. States that expanded Medicaid and ACA coverage will be hurt the most.
- The proposal will go back to the old days where insurers could charge higher premiums to people with pre-existing conditions.
- The bill will defund Planned Parenthood for a year.
- Similar to the previous versions of the bill that were rejected, these provisions will lead to insurance coverage loss, job cuts, and premium increases for millions.
Fight Back Plan
– CIR, along with SEIU, will be holding a national call-in day on Monday September 25. It’s crucial that we make these calls as this could be the final day before the vote. More details on the call in day will be sent out later this week.
– Prior to the call in day on the 25th we are asking everyone to call the healthcare hotline at 866.426.2631. Your calls will be targeted at key Republican Senators and House members who can stop this bill.