Saturday, March 11, 2017

Life with Chronic Conditions: Affordable Care Act-What to Know, What to Do

At the end of February, the President voiced his frustration in dealing with the campaign promise of “repeal and replace” the Affordable Care Act (ACA). "Nobody knew health care could be so complicated," he said. Really?

 On March 6, House Republicans issued a proposed replacement for the ACA. Basically this is a compromise bill, which  reflects how difficult a task it is to reverse a major welfare program, which has significant support by many in the public. Note- there is no precedent in Congress for reversing a major program of social benefits once it has taken effect and reached millions of Americans. If they are successful, what this means for other programs, such as social security and Medicare remain to be seen.

Both sides of the aisle have problems with the bill. Referred to as “Obamacare Lite,” “ Obamacare 2.0,” or “Republican Welfare” by Republican conservatives, Democrats are calling it “Trumpcare.” Four key Republican Senators said they would oppose any new plan that would leave millions of Americans uninsured. Senator Majority Leader, Charles E. Schumer state, “Trumpcare doesn’t replace the Affordable Care Act, it forces millions of Americans to pay more for less care.” ‘Trumpcare’ will make health insurance in America measurably worse in just about every way and likely leave more Americans uninsured. It does, however, greatly benefit the very wealthy and special interests.” Also coming out against the bill are various doctor, nurses and hospital associations, along with state, city and county governments.

While the President has warned the Republicans that they’d be looking at a “bloodbath” in 2018-the next major election- if they don’t repeal and replace, organizations like AARP are in strong opposition. We oppose the American Health Care Act. It would weaken Medicare and raise costs for older Americans. Tell your Member of Congress that you oppose the American Health Care Act:

The Guardian provided a succinct summary, The bill would eliminate the individual mandate, which requires Americans to have health insurance or pay a fine; cut the number of people insured under Medicaid; and allow insurance companies to charge the elderly up to five times more than the young. It would require insurers to cover so-called pre-existing conditions, but would allow them to add a 30% surcharge to premiums if people go without insurance for too long.

• Young adults-up to age 26-can remain on parents health plan
• Insurers cannot deny coverage or impose higher fees on people with pre existing conditions.
• Ends lifetime caps on coverage
• Keeps the same essential health benefits under the current law. Insurance companies would still have to cover 10 health services, including maternity coverage, prescription drugs and mental health care. State Medicaid plans, however, would not have to meet this requirement after Dec. 31, 2019.

• No penalties for American failing to have health insurance. However, for those without insurance, insurers would be allowed to impose a surcharge of 30% for those who have a gap between health plans of more than 63 days.

• Planned Parenthood would be ineligible for Medicaid reimbursements or federal family planning grants. The goal is to force Planned Parenthood to eliminate abortions from their services, which only makes up 3% of their services and receives no federal funding to start with.

• Refundable tax credits would include both age as well as earnings, meaning bigger credits for older and poorer Americans. Tax credits ranging from $2,000 per year for those under 30 to $4,000 per year for those over 60. The full credit would be available for individuals earning up to $75,000 a year and up to $150,000 for married couples filing jointly. The credits would phase out for individuals earning more — for each $1,000 in additional income, a person would be entitled to $100 less in credit, meaning a 61-year old could make up to $115,000 and still receive some credit. Compared with the ACA’s subsidies, the tax credits would go to more people but provide less financial help to lower-income people, according to Larry Levitt, senior vice president of the Kaiser Family Foundation.

•  Medicaid expansion will be phased out and be replaced with a per-person sum paid to the states.

• It delays until 2025, the “Cadillac tax” – a levy on the highest cost employer-provided plans.

• Older people will have to pay more for health insurance. Under Obamacare, insurers can charge older people up to three times more than younger people for insurance. Under the Republican plan, this limit will rise to five times more.

• While Obamacare helped millions of previously uninsured Americans obtain healthcare, the proposal would reverse that trend, leaving many without health coverage. The more market-oriented driven approach of the bill will impact the poor the worst, with the number being reduced under Medicaid.

On Thursday, the bill cleared two House committees, Ways and Means and the Energy and Commerce Committees, while Trump and others tried to deal with the backlash. It will now be heard by the Budget Committee and remains on track to land on the House floor by the end of March. Many, from both parties are questioning the lightning-fast process as well as the content of the bill, to say nothing of the fact that the nonpartisan Congressional Budget Office estimate of how the bill affects the federal deficit and the number of insured Americans has yet to be released.

The Republicans control both the House and Senator by narrow majorities. Already there are indications that more moderate Republicans think it goes too far, while more conservatives think it doesn’t go far enough. Assuming that the Democrats vote against it, just three Republican defections in the Senate would be enough to defeat the bill.

That said, anything can and will happen, so be proactive.

Congress and Elected Officials
5 Calls:  Spend 5 minutes, make calls. Calling is the most effective way to influence your representatives. 5 Calls gives you contacts and scripts so calling is quick and easy. A glance on the homepage shows you how many calls are needed per action item. Then, when you click on an item, the site offers the phone number(s), the reason why it’s important, and the script to use while on the call. The site is also personalized to your location, if you enter your address or zip code. 5 Calls is a volunteer effort and is open sourced.

Call to Action: With a simple user interface that’s accessible via the desktop or mobile web, Call To Action has a singular purpose: it makes it easy to find your representatives and place a phone call to their office. It even provides simple scripts to help you get started.

Calling Congress: Representatives and various committee members primarily respond to voters in their district. Realistically, you can’t vote for them so they don’t feel obligated to represent your viewpoint.  However, you can contact friends, family and anyone else you know that reside in states/districts where they can help influence voting. If you have unique information that helps to support a congressional viewpoint, they may take your phone call or e-mail. While it’s helpful to target who their specific representatives on a given committee might be, you can refer contacts to Senate and House member lists or to use 5Calls or Call to Action.

When You Call: It is important to let them know why you are calling and what issue you are calling about. You will sometimes be able to speak directly to your senator or representative, but more often you will speak to a staff person in the member's office. This person keeps track of how many people called and their positions on issues, and provides a summary to the member. Be assured that your call does count, even if you are not able to speak directly to your senator or representative. A good reference on the importance of calling is How to Stop the ACA Repeal-And Drive Your Congress Representative Crazy 

Indivisible Guide: Former congressional staffers reveal best practices for making Congress listen.

Connect with State and National Condition Specific Groups
• State & National Groups: Organizations like Planned Parenthood,  medical condition organizations e.g. American Lung Association, environmental groups  already have campaigns underway. Indivisible  provides a directory of groups taking action. Just plug in your zip code and how far you want to search. Joining these groups, or even just registering for free e-mail news will help you coordinate local campaigns with national efforts. Be selective in what groups you join as you can quickly be overwhelmed.

Women’s March on Washington:  Check their website as they are now posting 10 Actions 100 Days for specific ways you can make a difference. They even have a free down loadable card to make it easier for you to do that. 

Social Media
• Check Before You Post or Send: There is a lot of misinformation out there and it’s changing rapidly. Don’t be a source of “alternate news.” Get the facts not the emotion. A good site to use is 

• Facebook: Check, check, check. If you see something that you want others to see, Cut and Paste instead of “forwarding” after you’ve checked for accuracy. Don’t over post as people start ignoring you. Avoid a constant barrage of “canned” messages. Check out How to Get the Most Out of Your Personal Facebook page 

• Twitter: The Presidents favorite medium. It’s not for everyone, but if it’s for you than work it.

Introducing the American Health Care Act: Download the bill, plus see the GOP’s over view of it.  

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