CBO Score Proves “Better” Care Act is Bad for Patients

  

Today, The Congressional Budget Office(CBO) released a report on the financial implications of the Senate Republican health-care bill. According to the CBO the Better Care Reconciliation Act would increase the number of people who are uninsured by 22 million in 2026, with 15 million uninsured by 2018. cbo_22-million

The CBO reports also suggests the effects of the Senate bill would be particularly hard on millions of low- and middle-income Americans, as well as older Americans ages 55-64. It forces states to scale back their safety nets and prompts insurers to pare down benefits and raise deductibles in response to weakened regulations. The legislation would decrease federal deficits by a total of $321 billion over a decade. However, this could be largely due to the proposed $772-billion cuts in Medicaid spending over the next decade.

Prior to the CBO score being released Senate Republicans leadership released an amended version of the Senate Better Care Reconciliation Act. Which includes two changes:

1. Amends provisions of the stability and innovation funds section to allow both short and long-term funds to be used to purchase health insurance benefits.

2. Would allow an insurer in the individual market to impose a waiting period of six months on an enrollee who had had a gap in coverage of 63 days or more during the preceding 12 months. This is a significant change with respect to individual market requirements. The original Senate bill repealed the individual mandate but left nothing in its place to encourage healthy people to enroll in the individual market.

Again, we continue to ask and remind you to call your Senators and tell them to #ProtectOurCare and #ProtectOurPatients!

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GOP Senate Led “Better” Care Act forgets to Provide Better Care

  

Today, Senate Republicans revealed their answer to health care reform by introducing legislation entitled the Better Care Reconciliation Act of 2017 (BCRA). This is the Senate’s response to the House passed American Health Care Act (AHCA). The 142 page proposal, drafted by 13 Republican Senators under a veil of secrecy, would dismantle the Affordable Care Act and result in a loss of health care coverage for millions of Americans. Republicans and Democrats have already expressed opposition to the bill.

Sens. Rand Paul (R-KY), Ted Cruz(R-TX), Ron Johnson(R-WI), and Mike Lee (R-UT) said in a joint statement that they are “not ready” to vote for the GOP health-care bill, but are open to negotiations. Former President Barack Obama also weighed in, calling the bill a “massive transfer of wealth from middle-class and poor families to the richest people in America.” President Trump promised a healthcare bill with “heart” calling the House bill “mean.”

At a press event held with Sens. Debbie Stabenow(D-MI), Maggie Hassan (D-NH) and Jeff Merkley(D-OR) American Nurses Association(ANA) President Pam Cipriano, PhD, RN, NEA-BC, FAAN stated ”The Senate’s health care proposal would be disastrous for our nation’s most vulnerable. We will not be fooled. This is not a promise kept. This is a promise broken. This proposal is heartless. We are nurses and we are worried about our patients. We will not stop fighting for them. We can—and must—do better.”

The response from providers, consumers, and industry was swift. While the Senate made changes to woo moderate Republicans within the caucus, they amounted to little more than window dressing.

Under the bill:
• Tens of millions of Americans would lose health insurance coverage, while millions more would see their premiums and out-of-pocket costs rise.
• Access to affordable coverage on the individual market would be further compromised with cuts to subsidies and a lower qualifying threshold for eligibility (Individuals at 400% of poverty eligible for subsidies under ACA, Senate bill lowers to 350%)
• Medicaid expansion would be rolled back over a 3 year phase-out period for expansion states between 2020-2023.
• The Medicaid program would be fundamentally restructured to a per-capita or block grant funding structure – shifting costs to already overburden state budgets.
• The Medicaid inflation rate would tied to the Consumer Price Index after 2025, an even lower growth rate than the House-passed bill.
• States could waive Essential Health Benefits, putting a critical set of health coverage protections at risk
• Waivers would allow states to undermine protection against discrimination for those with pre-existing conditions.
• And more than 2.4 million women getting care at Planned Parenthood clinics across the country would see their access to services disrupted. The bill defunds Planned Parenthood for a year.

For a more detailed summary and a side-by-side comparison of the Senate and House bills read our Health Policy one pager. As the Senate prepares to vote on this legislation next week, ANA will continue to fight for a better solution for health care, one that matches ANA’s core principles for health system transformation.

Lastly, it’s more important than ever for the Senate to hear from nurses. We’ve made it easy for you to call now! If we don’t make the phones ring off the hook, this bill will become law. And your patients will pay the price.

New Study Highlights Positive Experiences of Medicaid Enrollees

  

A newly published Commonwealth Fund study sheds light on the health care experiences of Medicaid enrollees when compared with privately insured and uninsured individuals. Accessibility and quality outcomes for Medicaid enrollees have long been subjects of heated debate. Proponents of Medicaid expansion note that access to and use of health care services – particularly preventive care – through Medicaid reduces emergency department utilization and the cost to hospitals of uncompensated care. The Trump Administration recently reversed an Obama Administration policy of withholding federal funds to states to fill in financial holes for hospitals’ uncompensated care costs, which was meant to encourage states to expand Medicaid. This policy reversal comes in spite of evidence that Medicaid expansion has significantly reduced uncompensated care costs and improved hospitals’ financial stability. These arguments also ignore the fact that Medicaid provides access to comprehensive health care services for vulnerable populations including children, the elderly, and the disabled. Medicaid also provides critical services such as maternal care, mental health and substance use disorder services, and long-term services and supports like nursing home care.

The results of the Commonwealth study demonstrate the value of the Medicaid program from an access standpoint.  This study surveyed adults with Medicaid for the full year, adults with private insurance for the full year, and adults with no coverage either at the time of the survey or at some point in the past year. The study found that Medicaid enrollees generally have access to care at rates comparable to those experienced by the privately insured population. Medicaid enrollees reported better care experiences than those without insurance and similar experiences to those with private insurance. Medicaid enrollees also received preventive care at a rate similar to that of individuals with private insurance and at a much higher rate than those without insurance. Medicaid enrollees also had fewer issues paying medical bills and had fewer instances of cost-related access issues than both the privately insured and uninsured populations.

The results of this study demonstrate that Medicaid provides access to crucial health care coverage for low-income and vulnerable populations. This is yet another piece of evidence that Medicaid expansion has moved the U.S. health care system toward achieving the American Nurses’ Association’s principles for health care reform: universal access to a standard package of essential health benefits for all citizens and residents; utilization of primary, community-based and preventative services while supporting the cost-effective use of innovative, technology-driven, acute, hospital-based services; the economical use of health care services with support for those who do not have the means to share in costs; and a sufficient supply of a skilled workforce dedicated to providing high quality health care services.