Tags Posts tagged with "ACA repeal"

ACA repeal

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ALERT – Act Now to Stop Irreparable Medicaid Cuts!
Latest Available data on Graham/Cassidy

The next few days are critical!
Call Congress at (202) 224 3121 and
click here to send your Senators an email to VOTE NO.

The process by which Senate Republicans can pass an Affordable Care Act (ACA) repeal/replace bill by a simple majority budget process called reconciliation (and thus not requiring Democratic support of any kind) ends next week, at the end of September.

The Graham/Cassidy bill is now presenting a major threat to Medicaid – it replicates cuts presented in previous health proposals (using exact language from the Better Care Reconciliation Act – BCRA). According to earlier Congressional Budget Office (CBO) estimates, it will cut Medicaid (outside of expansion) by $175 billion between 2020-2026, and $39 billion will be cut from the Medicaid program in 2026 alone.

The situation has gotten worse. Last night, Chairman Alexander (R-TN) of the Senate HELP Committee who was leading bipartisan ACA fix efforts announced that the bipartisan deal is dead. That leaves the door wide open for Graham/Cassidy passage. Republican Senators are being told that the bill will benefit their state – that is false. This is a bill that seeks to save billions of federal dollars, not make policy improvements to health care programs.

The ACA will be replaced by block grants with likely less funding to states than they currently receive. and all of that money stops flowing completely to states in 10 years. The Medicaid program will be cut significantly and states will be expected to either pick up the bill or make tough decisions about whose lives are most at stake.

So here’s the timeline:

There are two Jewish holidays in the next two weeks that shorten the Senate session calendar. Today, Senators leave to observe Rosh Hashanah and will return Monday. They will have to pass a bill by Wednesday or Thursday because Yom Kippur (also observed by the Senate) begins at sundown next Thursday.

We will soon see a new Congressional Budget Office summary on the impact of Graham/Cassidy, and we expect the bill to be pushed hard next week to get to passage. We need three Republican Senators to oppose the bill in order for it to fail. Key Senators that could stop the bill are the same champions that ANCOR has awarded Congressional Leadership Awards to this year for defending our programs – Senator McCain (R-AZ), Senator Collins (R-ME), and Senator Murkowski (R-AK). Please make sure that if you are a constituent, or have connections in their states, that they hear from you!



Capitol  Switchboard: (202) 224-3121

Graham/Cassidy Text

  • Medicaid per capita cap section begins Section 124, page 65
  • Provider tax reduction is Section 123, page 64
  • Penalization to states that overspend, page 66
  • Per capita formula base period, page 68
  • Per capita formula inflation rate (CPI-M+1% until 2026 then CPI-M), page 76

Limited HCBS demo (we have intel this is for fear that per capita caps will end some state HCBS programs and need demo money to survive), page 96

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Until today, it was hard to imagine a bill could be worse for Americans living with addiction and mental illness than the AHCA bill passed last month by the House of Representatives.

The Senate version of the American Health Care Act purports to be a “repeal and replace” of the Affordable Care Act, but is really a draconian restructuring and gutting of Medicaid, the program that covers 20% of Americans and is one of the primary payers of addiction and mental health treatment in the U.S.

Instead of “repeal and replace,” it is “wreck and wreak havoc.”

The bill’s supporters have said that their newest proposal would “soften the landing” for Americans who will lose Medicaid coverage. In reality, the landing would be catastrophic. There is nothing “soft” about ripping health care away from the 11 million Americans enrolled in the Medicaid expansion. The new bill also shifts hundreds of billions of dollars in costs to states—leaving them with a Sophie’s Choice of which populations and benefits to cut in order to close their budget shortfalls. Seniors? Pregnant woman? People with a preexisting condition, like cancer or a heart attack? Who do we help, and who do we turn our back on?

The Senate bill also slices and dices Medicaid enrollees into the deserving and the undeserving, exempting some populations with disabilities from the caps while leaving other vulnerable individuals—like people with addictions—out in the cold. Lawmakers must remember that people with addictions do not qualify as “disabled” under a Gingrich-era change that excluded them from Social Security Disability. The proposed cuts to Medicaid would disproportionately harm those who rely on Medicaid for lifesaving opioid addiction treatment, at a time when mortality from the opioid epidemic is growing at devastating speed each year. We are facing a national emergency on opioids – now is hardly the time to reduce our efforts.

The bill’s feeble attempts to bolster psychiatric treatment while stripping health care away from millions are paltry at best. While the outdated law prohibiting Medicaid funding for services provided in residential or inpatient treatment settings deserves to be changed, the small tweak to this payment exclusion that is included in the bill will do nothing to mitigate the loss of Medicaid coverage for millions—nor does it provide for important outpatient care serving people in their own communities. The proposed one-year grant fund for mental health and addiction treatment in 2018 doesn’t come close to meeting the real—and growing—need for care. Grants are not a substitute for health coverage. We don’t rely on grants for the treatment of heart disease or cancer, and addiction and mental health should be no different.

Congress has made incredible strides in advancing access to care for mental illness and addiction in recent years. It is shocking that members of Congress – many of whom have family members who would be affected and all of whom represent constituencies who would be gravely harmed – would even consider a bill that would obliterate these gains, returning us to the days when people with mental illness or addiction couldn’t access treatment.

This is not our vision for America. Slashing billions of Medicaid dollars from state budgets would cost hundreds of thousands of lives. The National Council urges the Senate to vote down this reprehensible bill.


The National Council for Behavioral Health is the unifying voice of America’s community mental health and addictions treatment organizations. Together with 2,800 member organizations, it serves more than eight million adults and children living with mental illnesses and addiction disorders. The organization is committed to ensuring all Americans have access to comprehensive, high-quality care that affords every opportunity for recovery and full participation in community life. The National Council, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health pioneered Mental Health First Aid in the U.S. and has trained more than 1 million individuals to connect youth and adults in need to mental health and addictions care in their communities. To learn more about the National Council, visit the official website.

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Call Congress to Protect Medicaid TODAY!

The Senate looks primed to introduce and vote on health care legislation by the end of this month that would repeal Medicaid expansion and fundamentally restructure the Medicaid program. Call your Senators TODAY and urge them to oppose these changes!

Remind your Senators of the critical role Medicaid plays in providing access to lifesaving treatment services to millions of Americans living with mental illness and addiction.  Dedicating a few minutes of your time today can help save Medicaid access for millions of Americans in need.



Instructions for Call-In Day

  1. Dial this number: 202-224-3121
  2. Ask for your Senators.
  3. Share with them this message:
  • Your message: “I am calling about the American Health Care Act. I urge you to oppose any proposal that results in cuts or rollbacks of Medicaid. Medicaid is the single largest payer of mental health and addiction treatment services in the country. Any proposals that rollback Medicaid coverage or restrict people’s access to treatment will have a significant impact on this vulnerable population. The House-passed bill directly targets important health care protections like the essential health benefits, protections for those with pre-existing conditions and hurts efforts to achieve parity in health care. I’m calling from [city, state, and zip] and my name is [first and last name].” 

Chuck Ingoglia
Senior Vice President, Public Policy and Practice Improvement
National Council for Behavioral Health

Questions, contact Jack Phillips.