Legislative Update June 22, 2017

n4a legislative update

Senate Unveils Health Care Reform Bill
Cuts to Medicaid Deeper than House Bill  
June 22, 2017

After weeks of crafting legislation behind closed doors, Senate Republican leaders today unveiled legislative text that lays out their proposal to repeal and replace the Affordable Care Act and significantly reform the federal-state Medicaid program. Known as the Better Care Reconciliation Act of 2017, the Senate proposal reflects many of the same policies that garnered narrow House approval last month, but makes significantly deeper cuts to the federal Medicaid program.  

Lawmakers, advocates and other health care stakeholders will now have only one week to analyze and consider the proposal before it comes to the chamber floor for an anticipated vote next week. The non-partisan Congressional Budget Office (CBO) is expected to release its analysis of the measure very soon, and because the policy process used to move this health care reform proposal through Congress requires only a simple majority for passage, Senators will only need to secure 50 Republican votes to approve the bill (with Vice President Mike Pence as the tie-breaking vote).  

If the Senate’s proposal passes the Senate, it will need to go back to the House for consideration before being signed into law. While we have heard some preliminary concern from some Republicans in the House, as of right now, we expect that the House would ultimately approve the measure.  

The time to act is now, and advocacy on this important issue cannot wait. Earlier this week, n4a released our #SaveMedicaid campaign with tools and resources that Aging Network leaders and stakeholders can use to support your state advocacy efforts. Advocacy is particularly important if you live in the key states of ME, OH, WV, CO, AK and AZ.  

First Glance at the Senate Health Care Reform Bill  

While n4a and other health care and aging advocates will need time to comb through the proposal, overall, the Senate bill largely tracks the House approach to health care reform. Some key differences—especially as they relate to restructuring Medicaid, could have significant implications for older adults. Until we are able to evaluate the bill more comprehensively, here are a few initial details we can share about the Senate’s approach to ACA repeal and replace and Medicaid reform.  

The Senate plan to repeal and replace the ACA would:

  • Roll back the ACA’s individual mandate for insurance coverage.
  • Follow the House plan to change the age-rating for premiums, which means that states could allow insurance companies to charge older consumers up to five times more for insurance coverage.
  • Maintain the ACA’s approach to provide income-based subsidies to buy individual insurance on the marketplace, but rolls back those subsidies and eliminates them for people making over 350 percent of the federal poverty line (FPL). Under ACA, subsidies are available for people making up to 400 percent of FPL.
  • Maintain the House approach to repealing the ACA’s taxes on higher-income earners and insurance companies—revenues which currently pay for Medicaid expansion and extending the solvency of Medicare.
  • Phase out Medicaid expansion more gradually than the House bill, but include deeper cuts to Medicaid in the long-run.
  • Eliminate the Prevention and Public Health Fund.
  • Maintain some protections for patients with pre-existing conditions by not allowing states to roll back the requirement that insurance plans cover Essential Health Benefits. However, the bill would give states the option to apply for a waiver to determine what is considered an Essential Health Benefit, and therefore could still jeopardize coverage for people with pre-existing conditions.
  • Provides initial funding certainty, through 2019, that the federal government will pay cost-sharing payments to insurance companies that limit out-of-pocket costs for low-income consumers. Uncertainty about whether the Trump Administration would continue to pay these subsidies to insurance companies has caused significant turmoil in the insurance market.

The Senate’s plan to reform the federal Medicaid program would:

  • Allow states to choose between a per-capita cap or block grant structure to receive federal Medicaid funding.
  • Cut Medicaid more deeply than the House-passed bill. Because the Senate bill would index the federally guaranteed rate of growth for Medicaid funding to a more constrained measure than the House bill, federal funding to states would grow even more slowly over time. This would ultimately shift more costs to states than the House bill, which could jeopardize critical long-term care services for older adults.

Next Steps for Health Care Reform

The CBO will have to weigh in about cost and coverage implications for the Senate Better Care Reconciliation Act. An estimate could take a day or two, but ultimately, it will be difficult for advocates to evaluate exactly what this proposal will mean for older adults on the Marketplace and Medicaid. Last month, the CBO estimated that the House bill would cause 23 million people, including 14 million (17 percent of) Medicaid beneficiaries, to lose health insurance coverage over the next 10 years and significantly increase costs and reduce coverage options for poorer, sicker and older Americans.

While the CBO estimated that the current version of AHCA would cut $834 billion—or nearly 25 percent—from Medicaid over ten years, we anticipate that the Senate plan may mean even deeper cuts to Medicaid.

n4a remains opposed to the approaches taken by both the Senate and the House to repeal and replace the ACA and restructure Medicaid, which is a critical health and long-term care safety net for low-income older adults and caregivers. We continue to encourage Congress to take the time to address the key issues raised in our January 2017 Policy Brief.

See our new grassroots advocacy tools to help #SaveMedicaid!

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This Legislative Update is an n4a membership benefit. For more information about these and other federal aging policy issues, please contact n4a’s policy team: Amy Gotwals (This email address is being protected from spambots. You need JavaScript enabled to view it.) and Autumn Campbell (This email address is being protected from spambots. You need JavaScript enabled to view it.), 202.872.0888.

NCOA Advocacy Alert

 

What you need to know about the nation's only jobs program for seniors

At 58, Patti Miller found herself with no home, just $10 in her pocket, and desperate for work. She had lost her husband to cancer, and her job and savings to the 2008 financial crash. 

What saved her was the Senior Community Service Employment Program (SCSEP), the nation's only job training and placement program for low-income seniors. SCSEP gave her skills, confidence, dignity—and a paid position at a local Head Start.

SCSEP has been helping seniors like Patti since 1965. But under the Administration's FY18 budget, it is slated for elimination. Read why it's worth saving >>

Howard Bedlin

Vice President, Public Policy & Advocacy

n4a Legislative Update June 14, 2017

Legistlative Update

Senate Moving on Health Care Reform Details are Scarce, but Advocacy Necessary   June 14, 2017

For several weeks, a group of 13 Republican Senators have met regularly to hash out the Senate’s proposal to repeal and replace the Affordable Care Act (ACA) following narrow House passage last month of the American Health Care Act (AHCA). Unfortunately, because negotiations are happening behind closed doors, other lawmakers and stakeholders have not seen details of the Senate’s proposal.  

We understand that members of this health care task force are sending their proposal to the non-partisan Congressional Budget Office (CBO) piece-by-piece without disclosing those legislative components publicly. Because the CBO is required to weigh in on legislation before it comes to the full chamber for a vote, it is conceivable that leadership may bring a health care reform bill to the floor that their Senate colleagues and health care stakeholders haven’t seen.  

While the specifics and timing of a potential vote on this bill are still unknown, what is clear is that the Senate is likely to follow the House in proposing an ACA repeal and replace package that has significant implications for older adults and also drastically restructures and cuts the federal Medicaid program. We also know that once a bill is brought to the floor, it will likely move very quickly to approval, and there will be very little opportunity to make changes and improvements to the proposal. Should an ACA repeal and Medicaid reform bill pass the Senate, we fully expect that it would quickly pass the House and be signed into law.  

The time to act is now, and advocacy on this important issue cannot wait until details of the Senate bill are disclosed! Area Agencies on Aging and other aging advocates must continue to reach out to lawmakers about the importance of protecting Medicaid, especially for older adults. To assist local advocacy efforts, n4a will be releasing updated tools and resources next week that AAAs and other aging advocates can use to engage their lawmakers.  

We also encourage AAAs—and your organization/advisory board leadership—to join us for a conference call on Tuesday, June 20 at 11:30 a.m. ET to discuss our advocacy strategy in the Senate. Register for the call now! The call-in number is: 1-877-309-2074 and the access code is: 749-628-482.  

Recap on ACA Repeal & Replace Proposals  

As n4a’s May 25th Legislative Update detailed, the CBO estimated that the American Health Care Act (AHCA), which passed the House in early May, would cause 23 million people, including 14 million (17 percent) Medicaid beneficiaries, to lose health insurance coverage over the next 10 years. According to the CBO score, the bill would also significantly increase costs and reduce coverage options for poorer, sicker and older Americans.  

Furthermore, CBO estimated that the current version of AHCA would cut $834 billion—or nearly 25 percent—from Medicaid over ten years. Because AHCA restructures Medicaid from the current federal-state partnership, wherein the federal government guarantees to match state spending on the program regardless of cost or enrollment, to a per-capita cap or block grant structure that limits federal contributions, reduced federal outlays would shift significant costs and risks to states.  

n4a remains opposed to the American Health Care Act, as it does not adequately address the ACA issues we raised in our January ACA Policy Brief and goes beyond ACA-related provisions to fundamentally undermine federal support for Medicaid, weakening this key health and long-term care safety net for older adults.

There is still much legislative work to be done before any health care reforms are finalized. Stay tuned for more information and resources from n4a and join us for a conference call on Tuesday, June 20 at 11:30 a.m. ET to explore these important issues and necessary advocacy!

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This Legislative Update is an n4a membership benefit. For more information about these and other federal aging policy issues, please contact n4a’s policy team: Amy Gotwals (This email address is being protected from spambots. You need JavaScript enabled to view it.) and Autumn Campbell (This email address is being protected from spambots. You need JavaScript enabled to view it.), 202.872.0888.

 

I4A Network Alert

I4A Alert

Illinois Aging Network Alert

A periodic report of the impact of the state budget crisis on Illinois Seniors and Community Programs on Aging, from

I4A - Illinois Association of Area Agencies on Aging

Contact:  Joy Paeth 618-222-2561 or Jon Lavin 708-383-0258

Aging Network Continues to Lose Ground

Number of the Day – 12

According the Department on Aging, twelve different organizations have dropped Community Care Program Contracts since July 1, 2016.  Not all have completely left the program - some sold components of their business with the purchaser becoming the new contractor, some closed sections of their programs while keeping others, but most have laid off staff and stopped serving Illinois seniors because payment for half their clientele was not and is not forthcoming.  The costs of staff and the costs of doing business in Illinois must still be paid even though there is no State Budget resulting in payments are almost twelve months in arrear. 

Right now there are nineteen current Community Care Program Providers that are reporting severe financial distress, some delaying their payrolls.   This affects home care and adult day services staff who are already paid minimally. They are waiting for a paycheck, hoping their landlords will understand the delay in their rent, and dealing with reduced food and transportation budgets.

Here, in the last days of the 2017 General Assembly scheduled session, there seems to be some profiles in courage as bills have passed one or the other chamber to realistically and fairly deal with the Budget, but there also seems to be a willingness to permit the impasse to continue and to convince voters that someone else is to blame for the state situation, or even worse to say that Illinois can get out of this mess with smoke and mirrors. 

I4A asks that the General Assembly and Governor care enough about older persons to put aside the posturing and solve the budget mess.  We will have your backs if you step up and do what is right for Illinois – pass a budget, identify revenues to solve the current and long term challenges, and stop the politicking that tells the public “integrity and action” are mistakes.  Doing what is right is right – the current situation is wrong!

Distributed for I4A by:

Jonathan Lavin

Chief Executive Officer

AgeOptions

1048 Lake Street

Oak Park, Illinois 60301

708-383-0258

708-524-0870 fax

708-309-1361 cell

Medicaid Managed Care Transformation

Date:  Ap

Date: April 7, 2017

To: All Medical Assistance Providers

Re: Medicaid Managed Care Transformation

Date:  Dat
The Illinois Department of Healthcare and Family Services (HFS) is transforming its current managed care program. HFS intends to extend its Medicaid managed care program into every county in Illinois beginning on January 1, 2018.
HFS has recently issued a Request for Proposal (RFP) with the intent to award contracts to no fewer than four (4) and no more than (7) qualified, experienced, and financially sound Managed Care Organizations (MCOs) to enter into risk-based contracts for the Medicaid managed care program.  
The program will expand managed care coverage to additional populations including special needs children and children under the care of the Department of Children and Family Services (DCFS). Through this transformation, more than 80 percent of Medicaid beneficiaries will transition into a managed care health plan, an increase from the 65 percent who are currently enrolled in a managed care health plan.
HFS recognizes that providers are an important part of the overall transformation process. HFS encourages providers to begin contract discussions when MCOs are reaching out to establish networks. Providers who have contracted with MCOs that are awarded a contract will be able to seamlessly serve Medicaid participants during this period of transformation. In addition, the only way for providers to ensure payment for services rendered to clients enrolled with MCOs under the transformed Medicaid Managed Care Program is to contract with the MCOs.
The RFP webpage can be accessed for additional information including the draft model contract and also includes Frequently Asked Questions. Continue to visit the Medicaid Managed Care Program RFP webpage for updates, including contract award notices and transformation timelines.
 
Thank you for your continued support of the Illinois Medicaid Managed Care Program.  
Felicia F. Norwood
Director

Get in touch

Location

ECIAAA
1003 Maple Hill Road
Bloomington, IL 61705-9327

Contact

Email: aginginfo@eciaaa.org
Phone: 309-829-2065
Fax: 309-829-6021

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Seniors

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Phone: 1-800-888-4456