Affordable Care Act Resources

We have been monitoring and reporting on the proposed Cassidy-Graham repeal bill for several weeks, and now its threat is imminent. Yesterday, Senators Cassidy (R-LA) and Graham (R-SC) unveiled their health care plan at a press conference on Capitol Hill. Indications are that the sponsors of the bill are only a couple of votes away and this has moved up on the priority list for Senate Republican leadership to get done in September.

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.

New explainer!

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.

Cuts in the Cassidy-Graham bill are bad every year. Then in 2027 they go off a cliff. Coverage for millions at risk: https://t.co/kVl2LcvbLo pic.twitter.com/qT3uXXgUAN

— 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.

For more information on how you can get involved, check out our #ProtectOurCare page »

Follow NCCS on Twitter to stay updated on developments: @CancerAdvocacy.

During two Senate HELP committee hearings this week on stabilizing the ACA market, two panels of insurance commissioners and governors agreed that funding cost-sharing reduction payments were critical in keeping insurers in the marketplace and avoiding premium increases of 20% or more. As we reported previously, CSR payments compensate insurers for the discounts they are mandated under Obamacare to provide on out-of-pocket costs for lower-income customers. Both panels also suggested that reinsurance—payments to insurers to help pay claims for high-cost enrollees—would be a necessary component to stabilizing the market and making health care affordable. NCCS applauds Senators Alexander and Murray for convening these bipartisan hearings and encouraging an insightful dialogue about ways to move forward. At the moment, however, Republicans and Democrats have yet to agree on specifics, and it remains uncertain whether even a narrow stabilization bill will pass.

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.

For more information on how you can get involved, check out our #ProtectOurCare page »

With only one week left of August congressional recess, NCCS is preparing for a busy September. Senators Alexander and Murray are working on bipartisan health care legislation with the goal of helping stabilize the ACA marketplace and ensuring the law’s cost-sharing reductions (CSR) payments.

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 lhouff@canceradvocacy.org.

For more information on how you can get involved, check out our #ProtectOurCare page »

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.

Take Action

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 lhouff@canceradvocacy.org if you would like to set up a meeting with your Members.

For more information on how you can get involved, check out our #ProtectOurCare page »

It has been a relatively quiet week on Capitol Hill with Members of Congress on recess and back in their home states and districts.

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.

Take Action

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 lhouff@canceradvocacy.org. 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.

For more information on how you can get involved, check out our #ProtectOurCare page »

Since the “skinny repeal” bill’s dramatic failure in the Senate last week, all eyes have been on critical cost-sharing payments (CSR’s) and market stabilization.

The Senate HELP Committee, led by Chairman Lamar Alexander (R-LA) and Ranking Member Patty Murray (D-WA), have only weeks to address these issues, before insurance companies make their final decisions on premium rates for 2018 Obamacare plans. In a long-awaited turnaround from the past several months, they announced that committee hearings would take place to look into these issues beginning the week of September 4th.

Sen. Alexander said he supports funding CSR payments, but adds “it also should include greater flexibility for states in approving health insurance policies. Any solution that Congress passes for a 2018 stabilization package would need to be small, bipartisan and balanced.” However, reports also mention that Sen. Alexander “has proposed expanding state innovation waivers to allow states to waive ACA insurance requirements such as minimum essential health benefits.” This will undoubtedly be something to keep a close eye moving forward.

That said, as Politico reports, should Alexander and Murray get a bill through committee, it would have a strong shot at passage in the full Senate.

President Donald Trump has repeatedly threatened to cut off CSR’s, a move experts say could cause Obamacare markets to explode. But early this week, a federal court ruled that state attorneys general would be allowed to intervene by arguing that pulling the payments would endanger the health insurance of millions of people on the exchanges. Sarah Kliff of Vox explains the details of the CSR’s and the impact of refusing to make good on these payments.

The CSR payments help reimburse insurers for providing plans with low deductibles and low out-of-pocket costs for poorer Americans on the exchanges. These payments are not a “bailout” of insurance companies, as the president has stated. These payments reduce out-of-pocket costs for families and insurers don’t make any profit off these payments.

Over the past few months, a slew of insurers and state insurance commissions reported that without the payments, premiums on the exchanges would increase substantially in 2018, by as much as 20 percent. “The Administration has the opportunity to stabilize the health insurance market across our nation and ensure that our residents can continue to access affordable health care coverage,” the statement from the Health and Human Services Committee of the National Governors Association said.

NCCS has urged Congress to work in a bipartisan fashion to improve the ACA and health care for those living with cancer and to fund the essential CSR payments to avoid destabilizing the ACA insurance market.

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.