Last week, there was flurry of activity and chatter on Capitol Hill surrounding the ACA’s repeal-and-replace. Much of the focus surrounded Congressional Republican’s three-day retreat in Philadelphia, where House and Senate Republicans were expected to plot their legislative agenda for the 115th Congress.
Congressional leaders held a special session on Thursday morning to try to reach a consensus on how to move forward on an ACA repeal and replacement strategy; unfortunately, no consensus was reached, which seemed to suggest that House and Senate Republicans were more divided on how to move forward than previously thought.
In the House, Speaker Ryan (R-WI) suggested on Thursday a more piecemeal approach towards health reform that’s focused on a “repeal and repair” of the system. Chairman Greg Walden (R-OR), a close Ryan ally, later this week will consider four separate bills that affect changes to the individual market in the House Energy and Commerce Committee. The changes would permit insurers to tighten enrollment periods, an attempt to try to ensure coverage for pre-existing conditions, and consideration on a measure to allow insurers to charge seniors higher rates. The committee will also examine potential reforms to the Medicaid program.
In the Senate, Senators Cassidy (R-LA) and Collins (R-ME) introduced the Patient Freedom Act. Hoping to chart a path that gives states options for reform, the bill would allow states to either 1) keep the ACA as is, 2) switch to a different insurance expansion plan that auto-enrolls individuals into a subsidized catastrophic plan, or 3) move forward with a repeal and no coverage expansion (meaning states would lose federal Medicaid expansion funds).
Senator Rand Paul (R-KY), also introduced his own bill. His legislation primarily focused on repealing the ACA’s employer and individual mandates, which includes a repeal of the ban on pre-existing conditions. The plan includes a two-year open enrollment period in which individuals with pre-existing conditions cannot be denied, but by and large the bill emphasizes tax credits and a more deregulated health market as an alternative to the ACA.
Stay tuned for more activity on Capitol Hill this week on the healthcare reform front.
Anxiety among both the public and lawmakers continues to rise as House and Senate Republicans last week took the first step toward their ultimate goal of repealing the Affordable Care Act. At least 5 Republican Senators have stated their support for having a replacement plan to go along with any repeal legislation. Several Republican governors who have expanded Medicaid under the ACA have also expressed their concern over a model that does not include replacement legislation. Governors John Kasich and Rick Snyder of Ohio and Michigan, respectively, have been particularly vocal; their states stand to lose a combined $86 billion in federal funding if the ACA is repealed.
Efforts to repeal the ACA were further muddied on January 17th, when the Congressional Budget Office released its report which details the impact of repealing the ACA without replacement legislation. The CBO is the non-partisan Congressional office tasked with providing independent analyses of budgetary and economic issues to support the Congressional budget process. Highlights of the report include:
- 18 million people could lose their health insurance coverage within the first year, and 32 million could lose coverage within ten years, between Medicaid and the individual insurance market
- Destabilization of the individual insurance market due to the elimination of the individual mandate and premium subsidies for low-income individuals resulting in a “death spiral”
- Half of the country would be living in areas with no insurer in the individual market in the first year, and three-fourths would live in such areas by 2026
- Premiums for health insurance coverage purchased on the individual market would be 20 percent to 25 percent higher in the first year
Congress has a daunting landscape as it moves ahead with its plans to repeal and replace the ACA. It is a near certainty that the Affordable Care Act will be altered in some way. It is less certain what those alterations might look like. ANA stands by its core principles and demands that any replacement legislation reflect our principles: 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.
Nurses have the power to change the conversation on health care – starting with your senators, right now.
Can you speak out for your patients today? A two-minute phone call could make all the difference for patients who are on the brink of losing their health insurance.
Just dial 1-202-224-3121 to reach the Capitol Switchboard and an operator will connect you to your senator’s office.
When you’re connected, here are some pointers to guide your conversation:
- Share your name and your town or city so they’ll know you’re a constituent.
- Tell the staffer that you are a nurse, and you’re concerned that patients like yours could lose access to health care if the Affordable Care Act is repealed.
- Remind them that insurance costs were skyrocketing before the ACA went into effect, and that without it, millions of people would have simply been priced out of healthcare already.1
- Explain that, as a nurse, you want to share your personal story of how you experience the healthcare system. Share your vision for what is working and what is not, and what Washington can do to fix those problems.
- Finally, thank them for their time. If you have another minute, call the switchboard again and ask to speak to your other senator’s office.
Once you’re done, let us know you’ve made your call so we can keep track of which senators are hearing from nurses and hold them accountable here in Washington.
Yes, I called my senator’s office and spoke with a staffer.
Yes, I called both my senators’ offices and spoke with their staff.
No, I wasn’t able to get through, but I’ll try again later!
Thank you for taking care of your patients every day, and thank you for speaking out today. Nurses like you truly are making a difference in Washington!