Minimal Script: Hi. I’m from [ZIP] calling to ask Senators [___] to oppose the Cassidy-Graham ACA repeal plan. Congress needs to improve the Affordable Care Act, not repeal it and leave millions of people without options. Thanks!
Senator Feinstein: DC (202) 224-3841, LA (310) 914-7300, SF (415) 393-0707, SD (619) 231-9712, Fresno (559) 485-7430
Senator Harris: DC (202) 224-3553, LA (213) 894-5000, SAC (916) 448-2787, Fresno (559) 497-5109, SF (415) 355-9041, SD (619) 239-3884
Other Senator Contacts: http://www.phoneyourrep.com
Twitter Warriors: Belt on this Tweetstorm tool kit and get started. You know what to do.
For those with GOP senators: https://www.trumpcaretoolkit.org
General Concepts of Cassidy-Graham’s little bill.
How horrible is this bill?
It cuts money for care right off the starting line.
It reduces federal funding for expanded healthcare coverage by $26 billion immediately and by $83 billion by 2026. After 2026, this bill ends block grant funding, meaning up to 32 million people could lose health coverage.
Yep, that’s going to hurt.
Oh, look! Pretty charts!
It bundles funds into block grants and cuts the federal money given to states. The proposal would take all of the money going out the door to help people afford and access insurance and bundle it into one “block grant” given to states. This “block grant” includes money for the Medicaid expansion and marketplace cost-sharing subsidies while also deeply cutting the total amount of money.
All it takes is one Hurricane Harvey or other natural disaster – than POOF! That State’s money’s all gone. Too bad.
Then, it only allows the block grants to grow at 2%.
This is a far slower growth rate than medical costs grow. And to top it all off, there is virtually no accountability for how this money is spent.
Either their grasp of basic math in real-life word problems is deficient or they are just cruel, horrible people. Pick one.
It redistributes this block grant to favor red states that did not expand access and coverage for their residents by punishing states that did.
This provision is about politics not policy. Senator Cassidy himself said: “Let a blue state do a blue thing and a red state such as mine take a different, conservative approach.”
Appalachia Residents See Doctors For Health And Dental Care At Largest Free Clinic In U.S. WISE, VA – JULY 21: People wait to enter the Remote Area Medical (RAM) mobile clinic after sleeping in their cars on July 21, 2017 in Wise, Virginia. RAM holds the three-day event annually at the Wise County Fairgrounds, one of many free weekend clinics they hold in Appalachia, providing dental, medical and vision services to thousands of uninsured and underinsured people. (Photo by John Moore/Getty Images)
We think this is actually called a “bribe” in old-person speak.
Cassidy-Graham literally takes money from states that expanded Medicaid and gives it to states that did not.
There are other factors in the Graham-Cassidy formula that tilt the limited funds toward red states (such as distributing some of the block grant based on population density) in order to try to appease states like West Virginia whose Senators are key swing votes. Any state that was doing well with the ACA model would have to kick in a lot of money to maintain it.
California will be the biggest loser of all. This is not an accident.
Yep, definitely a bribe.
Things they hope you won’t notice…
- It prohibits federal Medicaid funding for Planned parenthood clinics for one year.
What other interesting/horrible things does this bill do?
- It doesn’t require that states earmark money for high-risk conditions or low-income consumers.
- It eliminates ACA’s tax credits and cost-sharing subsidies for middle and low-income consumers, while ending Medicaid expansion in 2020. (Because no one will need Medicaid after 2020, presumably.) MILLIONS will lose coverage. This is most extreme plan the GOP has come up with yet.
It still strips health care from people with disabilities, seniors in nursing homes and other vulnerable populations.
It still could allow states to charge people with pre-existing conditions more and gut key protections.
- It ends the individual insurance mandate while requiring insurers to cover everyone, which will result in high premiums for all. An individual market premium will rise by 20% by 2018. See the discussion of insurance market “death spirals” later on…
Yes, there’s more, of course.
- Of course, the old farts exclude any plan that covers abortion services beyond those for saving the life of the woman or in cases of rape of incest, effective 2018.
- Changes age rating to 5:1 in January. Not quite old enough for Medicare – cough it up!
- States can eliminate or change “essential health benefits in the individual or small group market. 1332 waiver authority will allow states to exclude maternity care too. Because we have no interest as a society in healthy kids and moms.
- It disqualifies small employers from receiving tax credits if their plans include abortion coverage beyond the Hyde limitations.
- It allows tax favored health saving accounts (HSAs) to be used to pay premiums for qualified high-deductible health plans that do no include abortion coverage beyond the Hyde amendments. We see a trend here.
- It adds a state option to require work as a condition of eligibility for nonelderly Medicaid adults who are not disabled or pregnant. (Doesn’t create jobs though.)
- Cuts health benefits for people with opiod addiction by billions of dollars.
- Endangers rural hospitals that depend on Medicaid funding.
Is that insurance “death spiral” thing a part of this plan too?
- Yep. It includes a requirement that insurance plans accept all applicants regardless of high-cost preexisting conditions.
- It stops two policies that entice healthy people into the marketplace: mandates to buy insurance and tax subsidies to make coverage affordable.
- States wouldn’t be required to use their block grants towards affordability subsidies.
- Washington state already tried this experiment. It failed.
Are you still wanting MORE information?
Let’s go deep, shall we?
First, we know that every GOP proposal so far has tried to hurt us.
Here’s a handy chart to keep track of the differences between the various GOP offerings .
If you’ve never used the kff.org site for studying health care initiatives, now is a great time to start!
On this interactive chart, you can stack up to three health care plans side-by-side to compare and contrast.
Here’s a partial section comparing the overall approaches of ACA, Graham-Cassidy’s thing and the ACHA.
Here’s the complete section comparing Women’s Health issues… Other sections compare details regarding Medicaid, Medicare, high risk pools, etc…