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.

Hey Capitol Hill – the nurses called, did you hear us?


Nurses will always speak out for patients

Last week, ANA held its largest Hill Day in our history, with more than 400 nurses representing 48 states descending on Capitol Hill to discuss their continued opposition to the American Health Care Act.

The day started at the Washington Hilton, where nurses heard from Reps. Ruben Gallego (D-AZ-7) and Alan Lowenthal (D-CA-47) who both emphasized the importance of advocacy. The group then headed to the Hill, where they attended more than 300 congressional meetings, educating lawmakers in both the House and the Senate and reminding them the importance of nurses in the healthcare system.

Every nurse engaged their legislators with compassion and authority — speaking not only as patient advocates, but as representatives of the nation’s most honest and ethical profession, and largest group of healthcare professionals. Our combined impact cannot be understated: healthcare is the top employer and the sixth largest industry in the United States, and you represent the largest workforce in healthcare.

The nurses in DC were supported by the actions of thousands of nurses across the country, who amplified their message through direct calls to Congress and social media — making almost a million impressions on Twitter alone.

One RNAction Hill Day tweet has even gone viral, with hundreds of likes and retweets by notable groups and allies, including Families USA and former CMS Administrator Andy Slavitt, as well as several local chapters of the group Indivisible. This outsized reach is a direct result of our engagement with the Families USA-led “Big Tent” coalition, with whom we have long worked to coordinate and amplify reform messaging.

But our work doesn’t stop at a successful Hill Day. Now we need to continue to put the pressure on the Senate! We’ve made it easy for you to call your senators by using our new click-to-call functionality. Make your call now and tell your senators that we need a transparent, patient-first approach to health care reform — we’ll connect you directly with their offices.

Another Poor Score


Today’s Congressional Budget Office (CBO) report confirms what we already suspected: despite last minute changes made prior to a misguided and party-line House vote, the American Health Care Act (AHCA) seriously threatens health coverage affordability, access, and care delivery, and would cause roughly 14 million individuals to lose coverage by 2018, and 23 million to lose coverage by 2026.

The American Nurses Association (ANA) remains opposed to the AHCA and urges the Senate to abandon the bill advanced by the House in favor of a more transparent process that truly aims to expand access to affordable quality care.

Photo: Carlos Barria, Reuters
Photo: Carlos Barria, Reuters

According to the report, the AHCA would allow for various waivers that would undermine protections for those with pre-existing conditions, and undercut access to essential health benefits for roughly one-sixth of the population. Taken together, these waivers would cause premiums to “vary significantly according to health status and the types of benefits provided, and less healthy people would face extremely high premiums,” according to the CBO. “Over time, it would become more difficult for less healthy people (including people with pre-existing medical conditions) in [states that make use of the waivers] to purchase insurance because their premiums would continue to increase rapidly.”

The bill also continues to pose a serious threat to those Americans who rely on Medicaid, a majority of whom are children. Rolling back state expansion of Medicaid would effectively cut off coverage for millions of low-income Americans and further upend the health care landscape.

Though today’s score was marginally better than the first assessment released in March, the negative consequences for those who need care most remain extreme. In particular, the CBO noted that “out-of-pocket spending on maternity care and mental health and substance abuse services could increase by thousands of dollars in a given year for” those not covered by group health insurance plans.

The ANA encourages the Senate to draft a comprehensive health care plan that protects Americans from being denied insurance coverage because of pre-existing conditions and provides access to affordable health insurance coverage plans that offer a minimum standard of benefits. These include preventative services and screenings, inpatient and outpatient services, prescription drug coverage, mental health, maternity services, and chronic disease management.