Federal Health Care Bill --By Julie Reiskin
Dear CCDC Members:
You likely have heard in the news that a new bill came out last night on a federal level to “repeal and replace” Obamacare/Affordable Care Act. There is a lot of information in the proposed bill and it covers both Medicaid and the insurance subsidy programs. Here are a couple things to keep in mind:
1) CCDC opposes this bill.
2) It is going to move VERY fast so there will be new reports daily or several times daily for the next month.
3) You will likely be overwhelmed with information and urgent emails. You do not need to be an expert on every aspect of this proposal. You DO need to act. This communication will provide some guidelines and talking points.
4) Some things can happen quickly and some things cannot. While the bill will move quickly, the implementation is set for a couple years out. However, once something is in law, it is harder to change it.
5) CCDC is part of some coalitions and you can use these resources as places to get ACCURATE information. If you have ANY questions please contact a member of the CCDC staff before sharing information that may or may not be accurate. These are credible places to get information: http://www.protectourcareco.org/ www.cclponline.org, www.nhelp.org
What would this proposed bill do?
1) It will change how Medicaid is funded and use a method called Per Capita Caps. Right now the state gets a match (either 50% or more) for all Medicaid costs. So if more people are sick and need high-cost treatment, the federal government pays more. The main purpose of this bill is TO REDUCE FEDERAL SPENDING.Per Capita Caps also mean when the state can find matching money like through the hospital provider fee, they can get extra federal match. The Adult and Children’s Medicaid Buy-In Programs (that allow adults with disabilities and parents of children with disabilities to be employed) are funded through these mechanisms.
2) It will make it harder to get Medicaid. States are encouraged to do redeterminations every 6 months. After 2020, it will get even harder for some people to get Medicaid.
3) The people who would no longer be able to get Medicaid (mostly those covered by the expansion) will be shifted to a refundable tax credit program to buy insurance. The tax credits will not come close to covering the out of pocket costs. It makes it harder for older and sicker people.
4) Repeals the part of the Affordable Care Act that allowed Community First Choice –this is what we have been working on in Colorado for years and is a way to make consumer-controlled, community based services more available to everyone by improving the personal care benefit.
Questions to ask:
1) Proponents say this will give the states more flexibility to serve the most in need but there are no requirements that states do so. Who determines the most in need?
a. Will the federal government require states to serve people with disabilities including those who are very expensive to keep alive?
b. Will the federal government allow a state to decide to only serve the healthy because it is easier and cheaper to serve them?
c. There is nothing about long-term services and supports (LTSS). How will these costs be covered? This is currently the biggest part of the budget. Will you as our representative protect the most vulnerable who rely on these services for daily support??
2) Will you as our Colorado representative address the programs that are currently funded through a match on fees (like the Medicaid buy-in program)?
3) The materials about the bill says they keep patient protections and mention no discrimination by insurance companies based on pre-existing conditions and that kids can stay on parents health insurance until age 26, but does NOT mention if they will allow insurance companies to impose lifetime caps. Will lifetime caps still be banned?
When calling or emailing and using social media:
1) Say your name, zip code and tell your personal story.
2) Be polite—even though this is terrifying, we need to communicate respectfully.
3) Use multiple methods—call, email, Tweet and put on Facebook.
4) Always contact both Senators and YOUR U.S. Congressperson
What else can I do?
ü Fill out our Medicaid Story Banking survey so CCDC can coordinate telling our important stories—and send this to your friends and anyone else who is affected by Medicaid.
ü No matter what, our state will have to make decisions. If you have not met with your state representative, do so now. If you need help figuring out who it is or need someone to go with you, please contact Dawn Howard at email@example.com . She can help you do this. Let your legislator know how you and your family rely on Medicaid and why we must be part of any discussion about Medicaid changes.
ü Tell us please when you have contacted our Senators and your congressperson—and when you have met with your state legislator. Just send an email to firstname.lastname@example.org
We can sit at home and freak out or we can act---and our history tells us that only action will accomplish our goals. Justin Dart used to say “get involved as if your life depends on it.. because it does” and this has never been more true.
CCDC will do our best to keep you informed without being overwhelming.