The Republicans’ replacement bill for the Affordable Care Act (ACA), the American Health Care Act (AHCA) is garnering a chorus of groans from the nonprofit healthcare community, with organizations perturbed – in particular – by the plan’s proposed cuts to Medicaid.
Key elements of the bill, which was passed in the House of Representatives by a 217-213 vote on Thursday, include monthly tax credits to middle and low-income Americans that will range from $2,000 to $14,000 annually to help pay for healthcare premiums, with older individuals receiving more support, according to a White House breakdown. Medicaid financing will also be changed to base funding to states on population and those areas that are most vulnerable following the country’s economic downturns. States will also have the option of both block grants and work requirements for certain populations.
The legislation now goes to the U.S. Senate where it is expected to undergo changes. Nonprofit leaders will be paying close attention to what those changes might be.
Specifically, the bill does little to provide help to the 24 million Americans who would lose coverage after the ACA repeal and cuts to Medicaid would adversely impact poor, elderly, and disabled Americans, said Rick Pollack, president and CEO of the American Hospital Association (AHA), via a statement. AHA’s stance is that it is vital to protect Medicaid and members “urge the Senate to restart and reset the discussion in a manner that provides coverage to those who need it and ensures that the most vulnerable are not left behind,” the statement reads.
The Catholic Health Association (CHA), like the AHA, indicated that it was “deeply disappointed” with the House vote, according to a statement by Sister Carol Keehan, president and CEO. Keehan specifically referenced the proposed restructuring and cuts to Medicaid and said that the legislation jeopardizes protections for those with pre-existing conditions. “As this legislation moves now to the Senate, CHA will continue to work with lawmakers to address these issues,” Keehan said. “And on behalf of those we serve in Catholic health care, we will continue to advocate a health care system in which accessible and affordable health coverage is available for everyone.”
In addition to the 24 million individuals currently insured under the ACA, Nicole Lamoureux, CEO of the National Association of Free and Charitable Clinics (NAFC), said that she would like to see Senate revisions address how to provide access to healthcare to the 29 million Americans who have not received coverage since the ACA passed. Protection for those with pre-existing conditions and the protection of Medicare expansion programs are other priorities.
“We are disheartened that the House rushed through legislation rather than taking the time to work with members of the safety net and develop a plan that could actually help the American people,” Lamoureux said in an email. “It is clear that many issues still surround the health care landscape in this country, but the current legislation as written promises to do more harm than good.”
NAFC has been committed to educating policy makers, the press, and the public about the needs of uninsured and medically underserved populations in the U.S. While discouraged by the House’s vote, Lamoureux said that all eyes will be on the actions of the Senate.
Even with the ACA, free and charitable clinics have seen steady demand in recent years, with 1.8 million individuals served in 2016, up from 1.7 million in 2015. A total of 190,000 volunteers, including 94,000 medical volunteers, helped provide over 6 million patient visits in 2016, according to Lamoureux. Demand has been persistent in both in states that have expanded Medicaid and those that have not. Lamoureux said that if the Senate signs the bill into law, those that lose Medicaid coverage will no longer be able to afford healthcare and will turn to free and charitable clinics as a result.