ACA Round Up - 3/10
- Send a letter to the editor of your local paper today about the House Republican ACA repeal bill. Numerous members have already submitted LTEs to papers across the nation. We need everyone to make their voice heard in every state across the country, but it's even more important for those of us who have a Republican House member.
- Register for the 2017 National Leadership Conference for the opportunity to connect with and learn from fellow advocates across the nation who are organizing for quality, affordable healthcare.
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What has been eliminated in ACHA | New or changed by ACHA | ||
| Provision allowing children to stay on parents' insurance plans until 26 | Variety of taxes included in the ACA, effective after December 31, 2017: medical device tax; branded prescription drug tax; health insurance tax; tanning tax; 0.9% surcharge tax for high-earners (above $250,000) and 3.8% tax on investments | As a substitute to the individual mandate, allows insurers to charge a one year 30% surcharge on premiums to consumers that do not maintain continuous coverage | ||
| Requirement that insurers accept everyone regardless of pre-existing conditions | Enforcement of individual mandate | Continuous coverage penalty kicks in if individual experiences 63 or more continuous days without coverage in a 12-month look back period | ||
| 40% Cadillac tax on high value plans but implementation is delayed until 2025 | Enforcement of employer mandate | Premium rating change for older enrollees - under the ACA, older enrollees could not be required to pay more than 3X the rate of younger enrollees; under ACHA, required to pay more than 5X rate of younger enrollees | ||
| Employer tax exclusion for health coverage | Medicaid funding for Planned Parenthood and other organizations that perform abortions | Expanded tax break for health insurers; plans can write off up to $1M of executives' performance-based pay from their tax bill (previously $500,000 write-off) | ||
| Prohibition on lifetime and annual dollar limits | Use of tax credits to purchase a health plan that covers abortions | Changes to HSAs and the maximum amount an individual can contribute to his or her HSA ($6,500 for an individual; $13,100 for a family) starting in 2018 | ||
| Limit on out-of-pocket minimums | ACA-mandated Medicaid DSH cuts, slated to start in FY2018, for non-expansion states eliminated | Re-instates retiree drug deduction for employers recieving Medicare Part D prescription drug subsidy starting in 2018 | ||
| Required coverage for routine costs of clinical trials | In expansion states, DSH cuts repealed starting in FY2020 | Removes ACA prohibition on reimbursement for tax-free OTC drugs starting in 2018 | ||
| Ban on recissions | Minimum essential benefits requirement in Medicaid expansion plans at the end of 2019 | New "high-risk" pool safety net funding of $10 billion pool among non-expansion states from 2018 through 2022 | ||
| Uniform coverage of emergency room services for in-network and out-of-network visits | ACA subsidy to reduce low-income enrollees' cost-sharing in private health plans, effective at the end of 2019 | Gradual phase-out of Medicaid expansion starting in 2020; shifts Medicaid funding from current, open-ended federal matching payments to block grant model in FY2020 (per capita cap subject to income inflation) | ||
| Employer reporting regulations | Medicaid: ACA requirements that the benchmark benefit package for Medicaid expansion population be equivalent to the ACA essential health benefits eliminated as of December 31, 2019 | Current enrollees can stay in current Medicaid structure until 2020 until they leave program | ||
| Requirement to cover 10 essential health benefits (EHBs) including maternity care and preventative services (individual and small group phased out in Medicaid expansion by 2020) | ACA income-based tax creditreplaced by age-based advanceable refundable tax credit program in 2020 | |||
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Prohibition on waiting periods in excess of 90 days |
DOCTORS IN ACTION
Tell us about what you are up to! Email your updates and photos to DFAHQ@drsforamerica.org.
Arizona
Dr. Nicholas Vasquez shares that a group of emergency room doctors when to Capitol Hill to meet with Arizona leaders about the importance of keeping Medicaid expansion. They made it clear that doctors in their state, which expanded Medicaid, are not supportive of block grants.
California
Dr. Jay W. Lee, Chief Medical Officer at the Venice Family Clinic, wrote an op-ed in Medium highlighting the moral reasons for not repealing the ACA.
“Did you know as many as 45,000 preventable deaths are linked to lack of health care coverage every year? Before Obamacare, I remember the heartache of caring for patients who didn’t have health insurance or who had inadequate health coverage. People died early due to lack of access to medications or lack of access to surgeries. When Obamacare finally passed, the chief comment I heard became: “I haven’t seen a doctor in 10 years. I’m so happy to be here today.”
Illinois
First year medical student Jay Dumainian wrote a letter to the editor about cutting Public Health Funds which was published in the Chicago Tribune.
“U.S. House Speaker Paul Ryan and the Republican Party like to paint themselves as the party of fiscal responsibility. But the plan he unfurled on Monday cuts back some core health care initiatives that health care experts of all political walks agree are essential to keeping costs down and Americans healthy. In particular, the Affordable Care Act’s Prevention and Public Health Fund finds no quarter in the GOP plans, which trims the public health fund’s $1 billion budget to a big round number.”
North Carolina
Dr. Seanta Danica Clark joined the Save My Care Bus at stops in Charlotte and Greensboro, North Carolina where speakers discussed how the House Republican plan would mean fewer covered, weaker protections, higher costs and worse coverage.
Pennsylvania
Annie Liu shares that she and other medical students at the University of Pittsburgh are collecting signatures for a letter to PA lawmakers asking them to protect the ACA. They plan to deliver the letters, along with educational materials and patient stories, to city, state, and national lawmakers in Pittsburgh.
Rhode Island
Jonathan Staloff, a rising third year medical student at Brown University and founder of Brown Medical Students for the ACA shares, that he recently spoke at a ACA rally organized by Rhode Island’s Congressional delegation. Other speakers at the event included Senator Whitehouse, Senator Reed, and Congressman Langevin. You can watch the video here.
Wisconsin
Dr. Dipesh Navsaria penned an op-ed in the CAP Times about the Republican ACA repeal bill. Read more here.
“It changes Medicaid to a per capita block grant in 2020. This means a set amount of money is laid out per person to cover the cost of providing Medicaid. While this may not seem like a big problem, this is more or less what is already done in Puerto Rico. In many years, they ran out of money before the fiscal year ended. Then — Zika happened.”
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