The U.S. Senate returned from recess to tackle the issue of passing the American Health Care Act (AHCA).  It now appears that majority leader Mitch McConnell, R-Ky., intends to complete work and have the Senate vote on the bill by the end of June to avoid weighing down the rest of Republicans’ agenda. He is leading a 13-member working group that is getting close to a framework considering provisions that would reduce premiums and provide more generous tax subsidies than those in the House version. The Senate is expected to have a draft of the bill this week.

With this in mind, the time is now for a “call to action” to share our concerns related to key provisions in the House bill. The American Hospital Association (AHA) sent an Action Alert yesterday, and SDAHO will be activating the “Voter Voice” system requesting health care leaders to send Sen. John Thune and Sen. Mike Rounds a personal message. Watch for additional email messages that will be sent later this week.

McConnell is likely to push for some “modest” changes to the House bill that would involve maintaining the required $133 billion in savings and $666 billion in tax cuts. These cuts would have a larger negative impact on non-expansion states, including South Dakota. There is wrangling over which inflationary index would be utilized, along with discussions on a new cap for Medicaid payments. Conservatives prefer the urban consumer price index that would reduce Medicaid spending even further. While moderates would like to see an inflationary index more closely tied to the rate of medical inflation.

The Senate parliamentarian will be releasing a ruling soon as to if the proposed changes adhere to the Byrd rule of reconciliation. Also, an updated Congressional Budget Office (CBO) scoring will be required. The most recent CBO score estimated that the bill would yield $133 billion in savings by the next decade and 24 million people would lose coverage by 2026.