Category: Congress

The ACA: Eight Years of Increasing Access to Care

  

The landmark Affordable Care Act (ACA) recently celebrated the 8th anniversary of its enactment. Despite having extended health insurance coverage to millions of Americans and being more popular than ever (the ACA currently enjoys a favorable 54% approval rating), the Trump Administration and Congressional Republicans have repeatedly attempted to undermine and outright repeal the ACA.

The Trump Administration has additionally given states new latitude to impose work requirements, premiums and copayments on non-disabled, adult Medicaid beneficiaries. Such requirements could have a significant negative impact on enrollees; studies have shown that Medicaid coverage actually encourages work, helps individuals avoid crushing medical debt, and has kept millions of Americans out of poverty. Tightening eligibility criteria for adult Medicaid recipients also jeopardizes Medicaid coverage for their children.

In December 2017, Congress eliminated the individual mandate for Americans to purchase health insurance coverage; the Congressional Budget Office estimates that as a result, individual private market premiums will increase by 10% and 13 million Americans will lose coverage. The Trump administration has also proposed rules that would allow for the sale of plans that fail to meet essential health benefits which provide protections for individuals with preexisting conditions. As a result, healthier individuals will be attracted to sparse, less expensive plans, leaving those with more complex health conditions to purchase insurance on the Marketplace. The reliance of sicker individuals on Marketplace plans will further fuel a rise in premiums.

Despite these attempts to undermine critical aspects of the ACA, essential elements of the legislation remain intact, allowing millions more Americans to access critical preventive benefits and other healthcare services. Federal assistance toward the purchase of a Marketplace plan for those with incomes between 100% and 400% Federal Poverty Level (FPL) and federal funding for Medicaid expansion continue to increase enrollment, and essential health benefits requirements ensure that Americans receive all of their necessary care.

The continued popularity and resilience of the ACA illustrate the commitment of the American people to continue to advocate for common sense health care reform that increases the number of Americans enrolled in comprehensive health plans, and their continued resolve to reject proposals that jeopardize access to care for the most vulnerable Americans. ANA continues to oppose attempts to undermine the ACA and remains committed to supporting policies that reduce costs, provide comprehensive coverage and encourage enrollment.

Why Medicaid is More Important Than Ever

  

Too often overlooked in recent debates is the role that Medicaid plays in children’s healthcare coverage. Of the 74 million Americans covered by Medicaid, nearly 36 million are children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) – which was enacted in 1997 to ensure affordable and accessible healthcare coverage for low-income children. Roughly 38 percent of American children receive healthcare services through these two programs, and they have been critical in increasing the percentage of American children with health insurance coverage to a historic high of 95.5 percent in 2016.

Medicaid and CHIP are particularly important to some of the nation’s most vulnerable children – 76 percent of children living in poverty, 48 percent of children with special health needs, and 48.8 percent of children ages three and under are covered under Medicaid and CHIP. Furthermore, 49 percent of births are covered by Medicaid. Without these two programs, millions of children would go without crucial healthcare services, positioning them for a lower quality of life further down the road.

And yet, despite the indubitably positive impacts that these programs have for America’s youngest and most vulnerable, Congressional Republicans and the Trump Administration have repeatedly attempted to scale them back and reduce the number of Americans who receive coverage. Congress voted on several bills in 2017 – all of which failed to pass both chambers – which would have reduced Medicaid eligibility, slashed funding, and imposed caps on state Medicaid programs. Congress also chose to play political football with CHIP, which expired on September 30, 2017, and did not re-authorize the program until January 2018, a full four months after its funding had expired. The Trump Administration has also opened the door for states to impose work requirements on Medicaid recipients. These proposals have all been aimed at low-income Americans, who are burdened enough already as they work to make ends meets.

Reducing coverage to reduce poverty and encourage work is counterintuitive given that Medicaid actually encourages Americans to remain employed, and implementing such proposals would have drastically negative impacts on the nation’s low-income and vulnerable populations. Seventeen percent of American parents receive health insurance coverage through Medicaid; reducing Medicaid eligibility and funding for adults would also reduce coverage for those children whose parents receive coverage through Medicaid. Medicaid also helps to keep millions of Americans out of poverty and out of debt. The burden of this reduction in coverage, meanwhile, would fall equally, and unfairly, on parents and their children.

While CHIP has been fully re-authorized for 10 years and there are currently no legislative proposals to roll back Medicaid coverage that appear close to passage this Congress, it is important to recognize not only during this Medicaid Awareness Month, but all year, the impact the Medicaid has on such a large segment of Americans. ANA continues to support universal access to affordable and accessible healthcare coverage and continues to stress the importance of preventive services. Medicaid and CHIP are some of the most important programs toward achieving those principles, and we urge Congress and the Trump Administration not to jeopardize Medicaid coverage for any Americans.

#NeverAgain

  

For decades, the American Nurses Association has called on lawmakers to come together and pass common sense policies that prevent gun violence and protect Americans. Nurses have pushed for action to enhance our background check system, enact mandatory waiting periods, prevent potentially dangerous individuals from getting guns, and allow the Centers for Disease Control and Prevention (CDC) to research gun violence and firearm injury prevention.

These calls were strengthened and renewed at our 2016 Membership Assembly and took on new urgency in the wake of the mass shooting at Marjory Stoneman Douglas High School last month. And while it is frustrating that we made appeals after Sandy Hook, Aurora, Orlando, Las Vegas, and so many other horrific mass shootings, with nothing done to stop this violence, nurses will not stop calling for action.

ANA, along with 95 other organizations, recently called on Congress to establish a bipartisan National Commission on Mass Shootings. We are also actively supporting Congresswoman Stephanie Murphy’s Gun Violence Research Act (H.R. 1478). This bill repeals the current provision that prohibits the CDC and other federal agencies at the Department of Health and Human Services from researching gun violence and firearm injury prevention. This bipartisan bill is a first step in working toward preventing gun violence.

Nurses have a unique perspective on this issue and their input is needed now more than ever. We call on you to help lend your voice to this important issue. Please send a message to your legislators letting them know you support Congresswoman Murphy’s legislation, and be sure to include your own perspective on this critical issue. ANA is committed to working with our partners on and off Capitol Hill to bring nurses’ dedication and ideas forward to help solve this issue. We stand together in calling for meaningful gun violence prevention and increased dialogue with our communities to take action against hate and death.

Our thoughts remain with the victims, students, parents, teachers, first responders and the medical professionals in Parkland, Florida, as they work to heal. ANA is also cognizant of the impact these mass causality shootings have on survivors of gun violence and the continued challenges of recovery that they face. The Parkland community has mobilized around their grief and anger to spark a national conversation, which we have not seen in quite some time. This is a conversation that is long overdue.

Gun violence like this is far too familiar in the United States, and, like so many others, nurses are dealing with the consequences. On average, there are more than 35,000 gun deaths per year in the United States, including almost 13,000 homicides. Even more outrageous is that nearly seven children under the age of 19 are killed with guns every day in the United States. Nurses are being called to care for victims of not only mass shootings but homicides, suicides and accidental shootings in clinics and emergency departments throughout the country. It is because of this that so many nurses and their families are joining the students, parents and teachers at Stoneman Douglas by standing up and saying #NeverAgain.

“We (nurses) are on the front lines of every mass shooting, which over time has become deadlier and more frequent. We have a duty to advocate for the safety of all through stricter gun laws and research the growing trend of gun violence” said Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of ANA.