Details Emerge on President Trump’s Health Care Agenda
President Donald Trump and his team began sharing details of their health care agenda this week. In addition to the repeal of the Affordable Care Act – also known as Obamacare – the President is said to support restructuring Medicaid into a block grant, providing a fixed amount of money to states to provide services to low-income families, children, pregnant women and senior citizens. As noted previously in the Capitol Connector, such a change would be particularly detrimental to Americans’ access to mental health and addiction care through Medicaid.
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Congress Passes Budget Bill Creating Pathway for ACA Repeal
Congress took their first step toward repealing the Affordable Care Act (ACA) last week, as both chambers passed a budget resolution that gives Congress instructions to start developing an ACA repeal package. The Senate passed the resolution first, followed by the House, and both votes split primarily along party lines. The budget resolution will permit the Congressional majority to use reconciliation, a filibuster-proof tool that would allow repeal legislation to pass with simple majorities in the House and Senate.
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CBO Estimates Dramatic Increases In Uninsured, Premiums with ACA Repeal
The Congressional Budget Office (CBO) released a report on Tuesday estimating dramatic increases in the number of uninsured people and in monthly premium costs if Congress repeals the ACA with legislation similar to last year’s repeal efforts. The report found that in the first year after repeal, the number of uninsured would increase by 18 million, premiums would increase between 20-25 percent, and that half of the nation’s population would live in an area with no insurer participation in the individual market. CBO’s estimate does not consider coverage or premiums resulting under any transitional or replacement policies that could be passed along with or soon after an ACA repeal bill.
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Governors Join Discussion on Health Care Repeal and Replace
On Thursday, Republican and Democratic governors and lieutenant governors from across the country joined the debate on plans to repeal and replace the Affordable Care Act. Republican state leaders met in a closed-door meeting with Congressional leadership to discuss potential changes to the Medicaid program including the ACA’s Medicaid expansion, program sustainability and avenues to greater flexibility. Meanwhile, Democratic governors on Thursday recirculated a letter to congressional leaders opposing the repeal of ACA provisions without a replacement.
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Growing Number of Senate Republicans Oppose ACA “Repeal and Delay” Strategy
A growing number of Senate Republicans have voiced opposition to the “repeal and delay” strategy for changing the Affordable Care Act. A group of five Senators wants to give Congress more time to formulate an ACA replacement plan, as outlined in an amendment introduced on Monday. The amendment reflects continuing disagreement within the Congressional majority on a path forward, creating an opening for more advocates to weigh in with their views.
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CMS Issues Guidance on Community First Choice for HCBS Services in Medicaid
The Centers for Medicare and Medicaid Services (CMS) recently issued a letter to State Medicaid Directors providing guidance on the implementation of the Community First Choice (CFC) State Plan Option, a home and community-based benefit package available to states to promote community stability and integration.
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Block Grants, Per Capita Caps Would Slash Medicaid
The 115th Congress is considering a potentially dramatic refinancing of Medicaid. Current proposals to block grant or institute per capita caps on Medicaid could ultimately shift costs onto states and enrollees, restrict access to care and increase the number of uninsured and underinsured. Despite promises of greater flexibility for states under a new system, the ultimate goal of these proposals is to massively cut federal spending for Medicaid, potentially leaving millions without needed care.
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