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FORCE advocates for families facing hereditary breast and ovarian cancer in areas such as access to care, research funding, insurance, and privacy.

Advocacy > Issues > Senate Drops ACA Repeal Effort

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11/8/17
FORCE, along with 60 other patient groups, is asking the Senate to preserve medical expense deductions in any forthcoming tax reform legislation.  

10/25/17
We joined over 100 Defense Health Research Consortium orgs in supporting DoD research funding. Learn more...

9/22/17
Check out this new video w/FORCE & 15 other cancer orgs representing patients, physicians, nurses, & social workers. Oppose Graham-Cassidy! See Video...

9/14/17
FORCE reps were in St. Louis today for an ICER hearing on the value and cost of PARP inhibitors for ovarian cancer patients.

Senate Drops ACA Repeal Effort

Insurance Coverage & Barriers

Overview

September 25, 2017 - A bill introduced by Senators Graham (R-SC), Cassidy (R-LA), Heller (R-NV), and Johnson (R-WI)—referred to as the Graham-Cassidy plan—briefly gained momentum but was dropped when it couldn't garner enough support for passage. Facing a deadline of September 30th to pass legislation with a simple majority vote, the controversial bill drew criticism from patient advocacy groups, medical societies, and others. The revised ACA repeal plan would have given states broad waiver authority to eliminate the ACA’s core protections for people with preexisting health conditions. These waivers would have come on top of the proposal’s elimination of the ACA’s marketplace subsidies and Medicaid expansion, radical restructuring of the rest of the Medicaid program, and large cuts to total federal funding for health insurance coverage.

The plan would have allowed states to obtain waivers of ACA preexisting conditions protections and benefit standards for any insurance plan subsidized by block grant funding. Specifically, states could waive the ACA’s:

Prohibitions against insurance companies charging people higher premiums based on their health status. While insurers would still be required to offer coverage to people with preexisting conditions, the legislation permitted them to offer plans with high, unaffordable premiums. For consumers, this is no different than a coverage denial.

Requirements that plans cover “essential health benefits.” Before the ACA introduced the requirement that all plans cover a defined set of basic services, 75% of the individual market plans excluded maternity coverage, 45% excluded substance use treatment, and 38% excluded mental health care, according to analyses by the Kaiser Family Foundation. Under the Cassidy-Graham proposal, states could let insurers restore these exclusions, leaving many people—especially those with preexisting conditions—without access to the health services they need.

The waiver authority included in the Cassidy-Graham plan is similar to the so-called “MacArthur amendment” waivers that were included in the ACA repeal bill passed by the House. Analyzing those waivers, the Congressional Budget Office concluded:

States accounting for one-sixth of the nation’s population would allow insurers charge higher premiums based on health status. In those states, “less healthy individuals (including those with preexisting or newly acquired medical conditions) would be unable to purchase comprehensive coverage with premiums close to those under current law and might not be able to purchase coverage at all.”

States accounting for half of the nation’s population would allow insurers to exclude essential health benefits. In those states, “services or benefits likely to be excluded … include maternity care, mental health and substance abuse benefits, rehabilitative and habilitative services, and pediatric dental benefits.” People needing these services “would face increases in their out-of-pocket costs. Some people would have increases of thousands of dollars in a year.”

Announcing their revised plan, Senators Cassidy and Graham explained that they sought to revise their prior legislation to accomplish the goal of letting states waive the ACA’s core consumer protections. If their bill had been adopted, millions of Americans with preexisting conditions would have lost access to these protections, and, as a result, would lose access to crucial coverage and care.

Information Source/Credit: Aviva Aron-Dine, Center on Budget and Policy Priorities

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On Friday, July 27, the U.S. Senate failed to pass the Health Care Freedom Act (also known as "skinny" repeal), a last-ditch effort to repeal the Affordable Care Act (ACA). Earlier that day, two more robust bills--the Better Care Reconciliation Act and the Obamacare Repeal Reconciliation Act--failed to pass as well.

With so many speaking out against the fast-track procedures used to drive these legislative efforts, it is anticipated that future health care reform initiatives will go through the committees, where bipartisanship deliberation is more likely. Check back here for updates on "need to know" information regarding health care reform and its impact on the high-risk cancer community.

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With Vice President Mike Pence casting the tie-breaking vote, the Senate moved forward on repealing the Affordable Care Act today (July 25, 2017) as it successfully passed a key motion to proceed to debate on the House version of the health care reform bill. 

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The U.S. Senate was poised to vote on Tuesday, July 25 to begin debate on repealing the Affordable Care Act (ACA), but senators still don't know what legislation they will be debating. The rush to repeal ACA without a viable replacement is untenable. If the Senators don’t know what they are voting on, they shouldn't be voting. Tell your Senators to vote NO on this misdirected effort. A new U.S. health system needs careful, measured debate. Let the Senate know what’s important to you!

Senate majority leader Mitch McConnell is expected to move ahead with a procedural vote to take up the health care bill that narrowly passed the House of Representatives in May. That legislation allows states to seek a waiver from ACA's current requirement that insurers charge people the same for coverage regardless of whether they have a preexisting condition. It also eliminates mandatory coverage of essential health benefits such as maternity care, mental health, and preventive screenings.

If the majority leader can secure 50 votes to begin debate on the House bill, he could move to replace it with an entirely new bill. Essentially, this effort would result in the repeal the ACA without a definitive replacement. If that amendment vote fails, as is being predicted, he could move to replace the House bill with a new piece of legislation that has been negotiated among select Republican senators behind closed doors.

The repeal bill is being considered under special expedited procedures that apply to certain budget-related legislation. These rules limit debate, prevent a filibuster and permit passage with a simple majority vote. There are very specific rules for this type of procedure; the Senate parliamentarian has already made a preliminary finding that some of the bill provisions appear to violate the rules for this type of expedited vote.

Regardless, NOW is the time to let the Senate know what’s important to you! Every senator has at least one staff member dedicated to health care. Call 844-257-6227 to be connected directly to your Senators' offices. Or, click on the Advanced Reading tab (above) for your Senators' contact info. Make your voice heard!

FORCE continues to advocate that the U.S. health care system must:

  • prohibit discrimination (including higher rates) based on preexisting conditions
  • limit out-of-pocket costs for patients
  • restrict lifetime and annual caps on benefits
  • allow young adults to remain on family coverage until age 26
  • maintain coverage of essential health benefits and preventive care
  • sustain funding for cancer research, CDC and PCORI programs
  • provide Medicaid to those who need it

We want to ensure that health care reform preserves or improves access to care for every American. FORCE does not view this as a partisan issue, but an issue of ensuring that all members of the hereditary cancer community can obtain the services and protections they deserve. See our Advocacy Alert for information about what you can do and a letter template (downloads as Word file) you can use as a framework for contacting your elected officials.

Advanced Reading

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  • Sen. James Risch (R)
    Alex Curd, Assistant to the Chief of Staff/Legislative Assistant
    alex_curd@risch.senate.gov 
    202-224-2752

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