UPDATE MAY 25, 2017: The Congressional Budget Office (CBO) released an analysis of the American Health Care Act (AHCA) on May 24, 2017. The CBO is a nonpartisan, federal agency within the U.S. government that provides budget and economic information to Congress. Among other duties, it reviews legislation to understand how policies could impact the economy. Congress normally waits for the CBO to finish its analysis of a bill before voting on legislation. However, the House passed the AHCA on May 4, 2017, before the CBO's review was complete.
If the AHCA becomes law, the CBO indicates 23 million Americans will lose insurance coverage over the next 10 years and the government will save an estimated $119 billion in spending. The latter would primarily be due to more than $800 billion in Medicaid cuts.
The Senate has indicated it will not vote on the AHCA and will instead write its own health care bill. Senate Majority Leader Mitch McConnell (R-KY) created a working group of 13 Republican senators to begin drafting the legislation. He has suggested the Senate version will differ significantly from the AHCA.
The Foundation is closely monitoring health care reform and will keep you updated on opportunities to advocate for the Parkinson's community as the Senate's work unfolds.
On May 4, 2017, the U.S. House of Representatives voted to pass the American Health Care Act (AHCA), which, if signed into law, would make significant changes to our health care and insurance systems. Before this act can become law, though, it must go to the Senate for discussion and a vote. But the latest reports indicate the Senate may start from scratch and draft its own bill, rather than take up the AHCA. Once senators approve a new proposal, it will be sent to the House to be debated, amended and voted on again. Then, the House and Senate will need to agree on a final draft and vote on the bill one last time. Only after that point can the legislation head to the president's desk for his signature.
People with Parkinson's need for accessible, affordable, high-quality health care cannot be understated, and our community's advocacy work in this area speaks volumes. In the last two weeks alone, advocates made telephone calls, posted on social media and sent over 12,000 emails urging lawmakers to vote against the AHCA. This level of engagement is important to continue as health care reform conversations move forward in the Senate.
The AHCA contains several provisions that would negatively impact the Parkinson's community:
- Higher Costs for People with Pre-existing Conditions. The AHCA lets states apply for waivers that permit them to charge individuals higher insurance premiums if they have a pre-existing condition (e.g., Parkinson's). A separate waiver process would allow states to put people with pre-existing conditions into high-risk insurance pools where care would likely be more expensive. Although the bill does provide $8 billion over the next five years to help some people with pre-existing conditions pay for premiums, this provision only applies to a select group. This means many individuals with pre-existing conditions could still be subject to higher costs under the AHCA.
- Elimination of Essential Health Benefits. Currently, all state-approved health plans must offer minimum essential health benefits, such as prescription drugs, mental health care and lab services, among many others. The AHCA lets states waive this requirement and opt out of offering these benefits, meaning access would vary state by state.
- Increases to Senior Citizen Health Costs. Existing law stipulates that insurers can charge older Americans no more than three times what they charge younger adults. The AHCA would change this rate to five times and would allow some states to potentially raise this even higher.
- Changes to Medicaid. Under the AHCA, the amount of funding states receive from the federal government for Medicaid would be reduced beginning January 1, 2020. This could result in the loss of access for some newly eligible individuals. A significant number of people with Parkinson's are eligible for Medicaid, so our community could be particularly impacted by this change.
- Establishment of Tax Credits to Purchase Coverage. The AHCA would create tax credits for individuals and families to pay for state-approved health care coverage. These tax credits, provided as a lump sum once a year, would be adjusted by age, with older individuals receiving higher tax credits than younger recipients. However, tax credits based on age alone, rather than age in conjunction with income status, will disproportionately affect older Americans who may be on fixed or limited incomes, making health care coverage less affordable.
The Foundation is closely monitoring activities in the Senate to better understand if and when the chamber will begin crafting a new health care reform bill. News media indicate this could happen in June. Once the drafting process begins, there will numerous opportunities to make your voice heard and influence the legislation. Our passionate and engaged community can urge senators to leave out many of the AHCA's harmful provisions and instead include ones that are beneficial to people living with chronic conditions. Stay tuned to our blog for more information and the latest advocacy opportunities.