The Senate appears to be moving toward a potential vote next week on new legislation recently introduced by Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI) that would repeal and replace parts of the Affordable Care Act (ACA).

The sponsors are attempting to garner the needed 51 votes for passage before reconciliation instructions expire on September 30, after which time the bill would require 60 votes for passage under regular Senate rules.

A summary of the proposed legislation includes:

  • Creates Block Grants for Medicaid
  • Repeals the ACA individual and employer mandates
  • Maintains most of ACA taxes, repeals device tax
  • Eliminates subsidies
  • Ends Medicaid expansion
  • Weakens ACA protections on pre-existing conditions

While the bill has not yet been scored by the Congressional Budget Office (CBO), it is believed that it could put coverage at risk for millions of Americans resulting as much as 14 million fewer insured individuals after one year.

In addition, the bill would reduce the amount of funding for traditional Medicaid by transitioning financing for the program to a per capita cap model with trend factors that are generally below historic spending growth, potentially jeopardizing coverage and services for our most vulnerable.

In addition, the bill would erode key protections for patients and consumers through repealing the ACA’s Medicaid expansion, Basic Health Program and Health Insurance Marketplace subsidies effective January 1, 2020 and establish a block grant program for states to create their own health care programs from 2020 to 2026.

States could use the funds to help individuals enroll in coverage, but they also could use the funds for other health-related purposes. This change would allow states to waive many insurance rules for coverage provided through the block grant program. States could eliminate some or all of the essential health benefits and allow insurers to charge individuals with pre-existing conditions any amount in premiums, effectively pricing many individuals out of coverage.

Given these concerns, SDAHO is urging Senator Thune and Rounds to oppose the proposed legislation and work in a bipartisan manner to address the challenges facing our health care system. Please access our Legislative Action Center to participate in this legislative advocacy effort.

For additional information, please see the Legislative Advisory prepared by the American Hospital Association (AHA).