Affordable Care Act Resources
On this page we provide regular updates on this ongoing debate, what it means for cancer survivors, and how survivors and advocates can make their voices heard.
We cannot afford to go back to the days when cancer survivors were at the mercy of the health care system, often forced to pay exorbitant premiums for plans that don’t cover critical services. Use our tip sheet for reaching out to your Members of Congress and tell them to oppose the Graham-Cassidy bill. Call your Senator today (844) 257-6227 and ask them to say NO to the Graham-Cassidy repeal bill. Please keep calling and ask your friends and family to call.
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ACA Status Updates
Nearly every patient group, the American Medical Association, AARP, all 50 state Medicaid directors (NAMD), and insurers agree that this bill would be bad for Americans. “Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history,” NAMD’s board of directors wrote in a statement Thursday. Friday afternoon, Sen. John McCain (R-AZ) issued a statement saying, “I cannot in good conscience vote for the Graham-Cassidy proposal.” This is a very encouraging development, but we must remain vigilant until Graham-Cassidy is defeated and there no longer exists a threat to repeal the ACA.
— Kaiser Family Found (@KaiserFamFound) September 21, 2017
Not only would this legislation dismantle significant parts of the ACA, but it would also drastically cut health care leaving already money-strapped states to pick up the tab. The block grants are estimated to be $107 billion less than what the federal government would have spent over the period 2020-2026 for ACA coverage. As Kaiser Family Foundation reports, there are winners and losers with the funding formula for the states, and the 31 states that expanded Medicaid will lose significant funding to provide health care to their constituents.
Another concerning aspect of the bill is the fact that the already insufficient block grant funding disappears after 2026. There are so many unknowns about this bill, but one thing is for sure: it would be terrible for patients. Additionally, because Republican leaders are pushing this bill through before the September 30th deadline, the Congressional Budget Office (CBO) will not have enough time for a full score to determine the impacts of this legislation. Senators will likely be voting on this bill without a full picture of its impacts on our nation’s economy, and they will not know how many millions of Americans will be left without insurance if this bill becomes law.
Because cancer survivors would lose critical patient protections and access to comprehensive and affordable coverage, we strongly oppose the bill. Please contact your Senators at (844) 257-6227 to tell them to vote NO on the Graham-Cassidy bill as it would be harmful to cancer patients and survivors. We need a bipartisan and transparent process to strengthen the ACA and help provide critical long-term stability.
Follow NCCS on Twitter to stay updated on developments: @CancerAdvocacy.
In the video, NCCS CEO Shelley Fuld Nasso and Policy Manager Lindsay Houff go over the details of this disastrous legislation that would cause millions of Americans to lose insurance coverage and access to affordable care, and would eliminate vital patient protections guaranteed by the ACA. Shelley and Lindsay also go over some ideas for what you can do to stop this bill in its tracks.
Follow NCCS on Twitter to stay updated on developments: @CancerAdvocacy.
The bill not only gets rid of the ACA exchanges and block grants the law’s funding, but it also eliminates the Medicaid expansion and key patient protections, all of which have been critical for cancer survivors across the U.S. and is necessary for their access to affordable and comprehensive health care. We cannot let the Senate pass this terrible bill that would leave millions without health insurance. The Senate has started to work in a bipartisan fashion to stabilize the ACA markets, and this bill undermines those productive efforts. Senator McCain (R-AZ), whose dramatic vote against so-called “skinny” repeal killed the crusade in July, has spoken positively about the bill, giving supporters of the bill further hope that repeal can be achieved. Vox reports that while it will be difficult to get the 50 votes necessary for this bill, it is certainly possible.
Cassidy-Graham: the last Obamacare repeal plan left standing.https://t.co/JgD65IISqn
— Sarah Kliff (@sarahkliff) September 13, 2017
As the Center for Budget and Policy Priorities reports, the bill would permit states to access waivers that would allow insurers to charge people with cancer more for their health care, a discriminatory practice that was made illegal under the ACA. Cancer survivors cannot go back to the days when insurers could deny or charge exorbitant premiums to those who have pre-existing conditions. Another concerning piece to the Cassidy-Graham bill is the fact that the funding for the health care block grants face a cliff in year 2026, meaning every dollar disappears thereafter.
— Center on Budget (@CenterOnBudget) September 15, 2017
This legislation is not only dangerous and irresponsible, but it would be devastating for patients who would be left with expensive health plans that did not cover prescription drugs, chemo therapy, or other critical services. This is unacceptable and NOW is the time to call the NCCS hotline at (844) 257-6227 and ask your Senators to say NO to the Cassidy-Graham repeal bill. We need a bipartisan and transparent process to strengthen the ACA and help provide critical long-term stability.
Follow NCCS on Twitter to stay updated on developments: @CancerAdvocacy.
But while many are focused on stabilizing the ACA market, several Republicans are still focused on gutting the law, specifically Senators Graham and Cassidy. The two Senators have proposed a bill that would cut ACA funding by a third and gut the Medicaid program, with the most drastic cuts to states that expanded Medicaid. The Graham-Cassidy proposal would be more severe than any other ACA repeal bills that were considered and failed earlier this year. On Wednesday, Senator McCain told a reporter that he would support the Graham-Cassidy plan to repeal the ACA, but then later clarified by saying that he supports the bill in concept, but hasn’t seen a final product.
Today, at a bipartisan event hosted by the American Enterprise Institute and the Center for American Progress , Governors Hickenlooper and Kasich discussed their joint plan to stabilize the country’s health insurance markets. The plan was created from a set of principles the two men wrote about in a Washington Post op-ed, in which they said another one-party health care plan is “doomed to fail,” just like the Republican plans considered this year. In the op-ed, they asserted that the best place to start reform efforts is “to restore stability to our nation’s health insurance system.” A major concern of this proposal is its openness to eliminate ACA guardrails and essential health benefits. During the event today, Governor Kasich said that states should have more flexibility with benefit design because young, health Americans don’t need as comprehensive coverage as others in the market. As cancer survivors know all too well, no one plans on being diagnosed with cancer and having comprehensive health insurance is critical for the more than 1.5 million Americans who were diagnosed in 2017.
NCCS will continues to analyze these proposals and others and provide further updates as necessary. It’s important to remember that not only has the ACA provided cancer survivors with unprecedented patient protections and has provided millions of Americans with quality and affordable health care, but it is also growing in popularity and most Americans want to work to improve the law, not repeal it.
However, Senators Graham, Cassidy, and Heller are still actively pursuing their plan to repeal the ACA. As the Center on Budget and Policy Priorities reported, “The Cassidy-Graham plan would have much the same damaging consequences as other Senate and House Republican repeal and replace bills. It would cause many millions of people to lose coverage, radically restructure and deeply cut Medicaid, increase out-of-pocket costs for individual market consumers, and weaken or eliminate protections for people with pre-existing conditions.”
As we welcome the bipartisan approach and committee hearings, we cannot overlook this dangerous Cassidy-Graham effort to essentially block grant and shrink Medicaid and the ACA. Several of our CPAT advocates are meeting with Senators in their home states this week to express concern over the Graham-Cassidy approach and support for a bipartisan effort to enhance the ACA and its patient protections. You can help amplify their voices by calling your Members of Congress at (844) 257-6227 and telling them to support a bipartisan approach to health care.
On Thursday, CareSource announced that it would cover the only remaining county without an ACA insurer, leaving zero counties without ACA plans. ACA critics have long used the argument of bare counties to exaggerate a narrative that the law is “collapsing” or in a “death spiral.” Yet now with all counties covered and the ACA functioning in all parts of the United States provides further evidence that such a narrative is simply not true. Larry Levitt, senior vice president at the Kaiser Family Foundation said, “It shows how resilient the market is. The open-ended premium subsidies are an enormous carrot for insurers to go into underserved areas, even in the face of significant uncertainty. It’s not a great outcome to have monopoly insurers, but it’s a whole lot better than having no insurers.”
With the fate of the ACA in the hands of an administration who wants to repeal the law, it is critical that cancer survivors and those who have benefited from the ACA share their stories, ask their Members of Congress to work to stabilize the marketplace, and make a commitment to pay the CSRs long-term to avoid uncertainty in the marketplace. This uncertainty is causing insurers to preemptively raise rates and will hurt patients across the U.S.
If you are interested in meeting with your Members of Congress over recess, please email Lindsay Houff at email@example.com.
August recess is typically a quiet time in Washington, but that is not the case this year. Earlier this week, the Congressional Budget Office released an analysis that found that ending cost-sharing reduction (CSR) payments, as President Trump has repeatedly threatened, would increase the deficit by $194 billion over 10 years. Cutting the cost-sharing payments would end up costing the government more because insurance companies will raise rates in response. The report predicted that premiums for benchmark plans sold on the ACA exchanges will rise about 20 percent next year and about 25 percent by 2020. In the long-term, the number of uninsured will not change significantly, as plans realign to make up for the loss of the CSR payments.
On Wednesday, the White House said it would make the CSR payments to insurers for another month, buying the president some time to decide whether he’ll continue the payments long-term or cut them off altogether. This uncertainty is causing insurers to preemptively raise rates. In meetings with Congressional offices, NCCS has learned that Senators Alexander (R-TN) and Murray (D-WA) are working on a bipartisan stabilization package that would fund the CSR payments long-term. This is where advocacy can be extremely helpful on this issue. Call your Senator today (844) 257-6227 and ask that Congress and the Administration do the right thing and fund cost-sharing reduction payments that help families afford health insurance. CSR payments are not a bailout for insurers, but rather a win-win for patients and the government.
It is also critical to highlight that efforts to repeal the ACA are not completely off the table as the Graham/Cassidy/Heller bill gains traction. Senator Cassidy (R-LA) said he’s meeting with the Trump administration “two or three times per week” on a plan to repeal and replace Obamacare. Cassidy has teamed up with Senators Graham (R-SC) and Heller (R-NV) on a new proposal that would essentially block-grant Obamacare funding to the states while repealing the law’s individual and employer mandates. This proposal would be devastating for cancer survivors as it would lead to the largest cuts to Medicaid of any Republican replacement proposal so far. Allowing states to opt out of patient protections would leave Americans with skimpy or unaffordable coverage.
In positive news, the problem of “bare counties” with no insurer offering plans in 2018 has been largely resolved. According to Margot Sanger-Katz in the New York Times, “A few months ago, it looked as if large swaths of the country might end up without any insurers willing to sell Obamacare insurance in 2018. But in the last few weeks, the ‘bare county’ problem, which President Trump had cited as a sign the markets were failing, has nearly solved itself.” Only two counties, with less than 500 enrollees combined, have no insurer at this point.
NCCS has urged Congress to work in a bipartisan fashion to fund CSR payments to help stabilize insurance markets and to strengthen the ACA so health care is improved for those living with cancer. Recess is a great time to meet with your Members of Congress in your districts and states to make your voice heard. Please contact Lindsay Houff at firstname.lastname@example.org if you would like to set up a meeting with your Members.
On Wednesday, a bipartisan health policy coalition announced a plan that they will be presenting to Members of Congress to strengthen and stabilize the ACA, pay all the federal subsidies provided under the ACA, and to encourage enrollment in coverage. In addition to making cost-sharing reduction (CSR) payments, the coalition also says that states should have more flexibility, specifically allowing ways to “combine private and public coverage to provide greater freedom and work opportunities for disabled Americans.”
The ACA currently allows some state flexibility through a waiver process, and while more flexibility is being encouraged by the bipartisan coalition, NCCS is urging Members of Congress to ensure that critical patient protections are secure and that any state flexibility would not lead to worse coverage than is currently available.
It is important to note the role uncertainty is playing with rising insurance premiums. A recent New York Times article references a recent analysis done by the Kaiser Family Foundation saying, “…insurers are being quite explicit about citing the Trump administration’s hostile policy messages as a substantial reason for the higher prices.”
Health insurers price uncertainty into their proposed Obamacare premiums for next year. https://t.co/9ZV0SVhGDW
— The Upshot (@UpshotNYT) August 10, 2017
Finally, a Kaiser Health Tracking Poll released this week provides further evidence of where the American people are on health care. The poll shows that a majority of the public (60 percent) “say it is a ‘good thing’ that the Senate did not pass” the ACA repeal and replace bill. A majority (57 percent) also believes that there should now be a bipartisan approach in Congress to make improvements to the ACA.
Recess is the perfect time to make your voice heard by attending district meetings and local town hall events. Tell your Members of Congress to do the right thing by honoring the CSR payments and working in a bipartisan fashion to stabilize the ACA marketplace as soon as possible. NCCS is here to help you in these advocacy efforts.
If you are interested in scheduling a meeting in your district or state Congressional office during the next month, please email our Public Policy Manager, Lindsay Houff, at email@example.com. We have an informative tip sheet online to help you prepare for calls, meetings and town hall events. Another important way you can make your voice heard is through op-eds in local newspapers. NCCS would love to help you draft an op-ed and provide instructions on getting the article published.
While the future of the ACA is still uncertain, one thing is for sure: Your advocacy efforts played a critical role in derailing terrible legislation that threatened millions of cancer survivors. We won’t stop now – join us during this month’s recess to put pressure on Congress to make health care better for ALL Americans.