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For Better, or Worse? The New Health Care Act

The Better Care Reconciliation Act 2017 – the Senate Republican version of the American Health Care Act – was released last week.  It is largely not good news.

  • The passage of this bill would eliminate Medicaid expansion and all but end Medicaid as we know it, cutting off health care for tens of millions of people and enacting even deeper cuts than the House bill. People living with HIV can expect a drastic rollback to a pre-ACA world. States that use AIDS Drug Assistance Program (ADAP) to purchase insurance will have fewer marketplace options, and individuals will likely become more reliant on the Ryan White Program than ever before. The Williams Institute estimates that 984,000 LGBTQ Americans may become uninsured by 2026 as a result of proposed changes to the ACA.
  • The Senate version of the AHCA also maintains the House bill’s provisions allowing states to circumvent the Essential Health Benefits put in place under the ACA through the use of a waiver system, which would allow insurers to no longer cover services like mental health or maternity care. Because states would no longer be required to cover certain pre-existing conditions, people with opioid, mental health, and substance use disorders would be hit especially hard.
  • Additionally, the proposed bill hurts New York. New York’s Essential Plan, which enrolls nearly 700,000 New Yorkers in low-cost health insurance plans, likely would not survive because it relies on federal funding that would disappear.
  • The Senate bill includes an amendment sponsored by Reps. John Faso and Chris Collins that would effectively prohibit the state from using county taxes to pay for the Medicaid program, costing the state millions.
  • The more severe Medicaid cuts would hit between 2020 and 2024, according to the Senate bill, which phases out the enhanced federal match states such as New York received from the federal government because of Obamacare. In its place, there would be a per-capita cap assigned to each state. The per-capita cap would be based on what a state spent between 2014 and 2017, but high-cost states such as New York would see their per capita reduced by the secretary of Health and Human Services by as much as 2 percent.
  • To make matters worse, shoppers on the individual insurance market would see the value of their subsidies decrease.

To move this legislation, Senate Majority Leader Mitch McConnell needs 50 Republicans willing to vote for it. They don’t have to like it. Once the Congressional Budget Office (CBO) score on the Senate version of the AHCA comes back, which is expected imminently, McConnell can move the bill to the floor for a vote after a scant 20 hours of debate.

Call Senators Schumer and Gillibrand! We know that our own New York State Senators were not part of the secretive drafting process and are against the repeal of the ACA. However, they need to hear from us about how this legislation will impact the LGBTQ communities and people living with HIV/AIDS. From personal stories, to words of encouragement to keep fighting for us, let them know your voice counts.  Call toll free at (866) 426-2631.