ACA and Medicaid Update 3/3/17

No plan yet…: In his first congressional address, President Trump delivered a vague, five-point summary of health care positions related to repealing and replacing the ACA. When he mentioned giving governors the “flexibility they need with Medicaid” he was alluding to efforts long pursued by Republicans to restructure Medicaid’s financing structure (read “cut”) using per capita caps and/or block grants. It is now clear that Congress is considering this approach as part of budget reconciliation, to slash funding and shift costs to states, leading to cuts in coverage for low-income people and disproportionately affecting communities of color. This would effectively end the Medicaid program as we know it. See the NoHLA Q&A on the impact of these Medicaid proposals in Washington State. Congress has also discussed shifting away from income-based tax credits towards fixed age-based tax credits, which will have adverse effects on low-income people. On the other hand, some Republican governors have begun speaking out against repealing the Medicaid expansion. According to reports, Congress is still far from coming to consensus on a plan, especially after the recent town hall meetings (see below) and polls showing the rising popularity of the ACA.

…But one could come soon – NEWS FLASH!: Yesterday we learned that Republicans have a secret plan that they will only let House Republican members and staffers view in a “dedicated reading room.” A Bloomberg article – Republicans Hide New Obamacare Draft Under Shroud of Secrecy – sheds light on this information. There are reports that two House committees – Ways and Means and Energy and Commerce – will begin marking up this secret language next week. We need to emphasize the need to provide an open and transparent process so that there is an opportunity for input, hearings, and a financial “score” from the Congressional Budget Office (CBO) before the first vote is cast. See below for action steps related to the secret plan.

Town Halls (or not) are having an impact: During last week’s congressional recess, Republican representatives returned to their home states to face scared and angry constituents at local town halls. In Washington, Rep. Dave Reichert refused to hold an in-person town hall and instead held a Facebook Live event and asked citizens to contact his office directly to set up a meeting. Rep. Cathy McMorris Rodgers did not show up at a town hall set up by Fuse Washington but sent her staff to take notes; large numbers went to her office to protest. She did hold a telephone town hall. Rep. Dan Newhouse did not hold a meeting, so 140 Okanogan County residents went to “office hours” with Newhouse’s staff in Omak to request a meeting with him and express their positions. Rep. Jamie Herrera Beutler held a town hall meeting and was faced with intense questioning, especially on health care.

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