The U.S. Senate is, once again, considering legislation that would repeal critical parts of the Affordable Care Act and the Medicaid program. This is a "last ditch" effort to revive similar repeal legislation that failed to pass earlier this summer. The majority has been working under a budget resolution for FY 2017 that allows the legislation to pass by majority vote rather than the normal 60 vote super-majority, which would require bi-partisan support, but the Parliamentarian has ruled that this budget resolution expires at the close of the fiscal year, September 30, 2017, hence the revived interest in repeal.

The bill under consideration, introduced by Sens. Graham (R-SC) and Cassidy (R-LA), ends the federal commitment to finance the traditional Medicaid program (HCBS for the poor and older persons, nursing home care, health care for children with disabilities and poor children, etc.) and replaces the mandatory program with funding through a per capita cap formula (PCC). We note that this effort to eliminate mandatory funding for Medicaid long term care is not part of the ACA, but has been added to both House and Senate ACA repeal efforts. LeadingAge has opposed this fundamental restructuring of Medicaid from the beginning of the debate over repeal of the ACA. The Medicaid program is the primary source of funding other than private pay for long term services and supports and the federal commitment is essential to providing care and services to older Americans and persons with disabilities. PCC not only cuts the federal commitment by hundreds of billions of dollars, but also caps the way the program is funded, so that eligibility is no longer based on meeting certain criteria but rather on an artificial formula that does not take into account economic disasters, increasing health care and service needs as persons age, the devastating effects of dementia, and so forth. Your state will bear that burden, whether it is financially able to or not. Please call your Senators today and urge them to reject this bill and any other legislation that cuts and caps Medicaid. 

Steps for Making a Call

  1. Dial into this toll-free number: 877-413-2313.
  2. You will be prompted to enter your zip code to get connected to your lawmaker and leave a brief message urging co-sponsorship of H.R. 1661 / S. 548.
  3. After leaving your message, allow the staff person to hang up and the automated system will then connect you to your senators.

Call TODAY and urge your Representative and Senators to co-sponsor the Housing Credit bills: 877-413-2313

As you know, for over a decade LeadingAge has been at the forefront of efforts to create a better financing system for long-term services and supports. Rather than decimating the Medicaid program and providing no alternatives, LeadingAge strongly believes that it is time for Congress to seriously address how we pay for long term services and supports and how we deliver those programs. Here is our most recent analysis and recommendations, which we will be educating Congress and the public about in the coming months.

In addition to the impact on Medicaid, the Graham-Cassidy bill affects the ability of older persons to get health insurance in the individual market and repeals the Medicaid expansion, where older persons and low income individuals were able to obtain health insurance through the Medicaid program. It effectively ends both the exchanges and the expansion, which is considerably more drastic than the bill passed by the House and defeated in the Senate. Graham-Cassidy combines the Medicaid expansion and funding for the state exchanges into a 5-year block grant, reducing the dollars available and allowing the states to waive a variety of consumer protections in the ACA. Over the 5 year life of the block grant, some states that chose not to expand their Medicaid program will get more money, while most states will get less. Older persons can be charged more, and it looks like insurance companies could also charge more for persons with pre-existing conditions effectively pricing out people with lower incomes. For more information and an in-depth analysis of Graham-Cassidy and its likely impact on each state, we recommend this article from the Center on Budget and Policy Priorities

To squeeze into the current budget resolution, Congress must pass this bill by Saturday the 30th. You rose to the occasion each time we asked you to contact your member of congress to defeat each iteration of this bill, and we need you one more time! We can't guarantee that the Medicaid provisions won't come back in other legislation -- we believe this battle to preserve Medicaid will continue in other forms -- but each time we need your voice to defeat these provisions. Call your Senator now, please let them know how important Medicaid is to the people we serve.

For more information, contact Marsha Greenfield.