The following is extensive and was compiled by Allan I.Bergman, CEO, HIGH IMPACT. There are seven documents attached here as well. Please take the time to review, send letters, make calls and advocate strongly to defeat the GRAHAM-CASSIDY-JOHNSON-HELLER BILL and save Medicaid. ~Michael Steinbruck
The attachments are: Talking Points from Families USA, September 15, 2017; Community Catalyst analysis, September 2017; NHELP in-depth points on Medicaid cuts, September 14, 2017; ANCOR Talking Points, September 18, 2017; Letter to Congress from 10 Governors; Statement from Governor Sununu; and, statement from Governor Holt.
I also have carefully drafted the following template for an Action Alert for you and your colleagues to use to motivate the grass roots. I used parts of a new alert from Beth Swedeen from the Wisconsin Boar for People with Developmental Disabilities. Please note that she has done what I think is essential to get the “grass roots” to be scared and angry is to use the terms that people know for Medicaid in Wisconsin. Every state has its own jargon and we must use it for people to understand that this is about them!!!
You also will need to put in the names and telephone numbers of your two U.S. Senators. Obviously, you may choose to make other edits to meet your audience needs and that is fine.
Please work with your organization, its board of directors, families and colleagues as well as all of your partners or coalitions with other regional or statewide disability and aging organizations to get this widely disseminated on Wednesday and Thursday.
The last point below is very important. We must help inform and motivate our family, friends and colleagues in Alaska, Maine, West Virginia, Ohio, Kansas and Tennessee to act on this alert.
I trust that the template will make it much easier for you to “customize” and then disseminate with as few or as many of the attachments as you desire.
URGENT AND TIME LIMITED ACTION ALERT TO PRESERVE MEDICAID HOME AND COMMUNITY-BASED SERVICES & SUPPORTS: DEFEAT THE GRAHAM-CASSIDY-HELLER-JOHNSON BILL.
CONTEXT FOR THIS ALERT: PARTISAN POLITICS ON CAPITOL HILL
Determined to meet their campaign promises to “Repeal and Replace Obamacare”, the Republicans in Congress and President Trump are making a last-ditch effort to meet this promise with another variation on the theme of the bills they could not pass in June and July of this year. They hope to pass a bill before Saturday, September 30th, when authorization to pass the bill with only 51 votes rather than the usual 60 votes, runs out. In an attempt to make it look like “regular order” of business, the Senate Finance Committee, chaired by Senator Orin Hatch (UT) and Ranking Member Ron Wyden (OR), is holding a hearing on the bill on Monday morning, September 25th at 10:00 am. No witnesses have yet been announced. It is possible that Senate Majority Leader McConnell could call a floor vote on the bill in the U.S. Senate as early as Tuesday, September 26th, without any official financial calculations from the Congressional Budget Office.
Regardless of “spin”, this bill boils down to one item for the Republican Leadership and President Trump: “This is our last shot!”
Our goal is to make sure that their “last shot” does not hit the target!
MAJOR NATIONAL ORGANIZATIONS AND 12 GOVERNORS (BIPARTISAN) OPPOSED TO THIS BILL:
As of today, almost every national health care organization including the American Medical Association and almost every national disability and chronic disease/health care organization and AARP have declared formal opposition to the bill as have 12 bipartisan state Governors: Alaska, Walker; Colorado, Hickenlooper; Louisiana, Edwards; Maryland, Holt; Massachusetts, Baker; Montana, Bullock; Nevada, Sandoval; New Hampshire, Sununu; Ohio, Kasich; Pennsylvania, Wolf; Vermont, Scott; and, Virginia, McAuliff.
We need to do an all-out assault on this bill to protect Medicaid and protect the supports and services that make it possible for individuals who are aging, people with the full range of disabilities and children with disabilities and complex medical needs to live at home with their families or in the community with a meaningful, valued life. We must defeat this bill and cannot cease until midnight on September 30th, although we expect Congress to go on scheduled recess on the 29th and 30th.
INFORMATION ON CURRENT MEDICAID BENEFICIARIES AND COSTS AND PROJECTIONS ON AGING:
According to a January 2017 report from the Congressional Budget Office, we know the following about Medicaid numbers: There were 76 Million individual Medicaid beneficiaries at a total cost of $331 Billion.
Children make up 45% of the beneficiaries and 19% of the cost;
Adults make up 36% of the beneficiaries and 34% of the cost;
Children and Adults with disabilities make up 12% of the beneficiaries and 33% of the cost; and,
Senior Citizens (65 and older) make up 8% of the beneficiaries and 14% of the cost.
Conclusion: Because of higher health care needs and the provision of long term services and supports (LTSS), children and adults with disabilities and senior citizens account for 47% of the expenses and only 20% of the beneficiaries. In the case of hundreds of millions to billions of dollars in cuts in each of the states, these two populations will be devastated since most of the children and adults without disabilities are not expensive and the vast majority are enrolled in managed care plans.
In addition, a recent U.S. Department of Health & Human Services Research Brief stated that, of persons turning 65 years of age today (which is 10,000 per day for the Baby Boomers), 52 percent of them will need some form of LTSS in the future, and that many of them will be funded by Medicaid because of their poverty or low income status. We also know that people with disabilities are increasingly living longer lives and approaching that of their birth group, further impacting on the Medicaid budget.
THE GRAHAM-CASSIDY-JOHNSON-HELLER BILL:
The Graham-Cassidy-Johnson-Heller bill to repeal the Affordable Care Act (ACA or ObamaCare) introduced last week contains the same ideas that were in the Senate and House ACA repeal bills—including cuts and per capita caps to Medicaid and weakening of consumer protections—and would have the same negative effects on people with disabilities and their families, but even worse.
Like earlier health care repeal bills, the Graham-Cassidy proposal would:
- make major cuts to Medicaid and impose a Medicaid per capita cap in each state for 4 groups – children, single adults, children and adults with any disability and senior citizens ;
- give states the ability to let insurers exclude essential health care services (like mental health care, rehabilitation, prescription medications) that are currently required of all plans;
- impose annual and lifetime limits as we had prior to ACA, which will lead to an increase in family bankruptcies;
- impose significant and potentially unaffordable premiums for individuals with preexisting conditions;
- raise deductibles and out-of-pocket costs, and
- replace the current ACA Medicaid expansion funds and subsidies with a block grant to states with considerably less funding and a greater reduction to states with a larger share of federal Medicaid funding in their current base.
Under the Graham-Cassidy bill, the Medicaid per-capita cap starts in 2020 and every state’s Medicaid funding would be reduced rapidly over time. These large and growing cuts from the per-capita cap are the primary reason the Congressional Budget Office expects the Cassidy-Graham bill’s total Medicaid cuts to rise from a 26 percent cut to total federal Medicaid spending in 2026 to a 35 percent cut by 2036, compared with current Medicaid law.
Medicaid pays for the Forward HealthCard and almost 20 Wisconsin programs—including Family Care, IRIS, Children’s Long Term Support, BadgerCare, intensive autism services, etc.—that help older adults, people with disabilities, families with children, and low income working adults.
The DPCC has estimated that between 2020 and 2026, states will lose a total of $800 Billion in federal funding to Medicaid and for the subsidies and other payments for the individual insurance market exchanges, which also impact the lives of individuals with disabilities. The range of estimated loss is a low of $203 Million in Nebraska to a high of $27.8 Billion in California!!! The four Senate sponsors lose big dollars as well: Graham (S.C.), $804 Million; Cassidy (LA.), $3.22 Billion; Heller (NV.), $639 Million; and, Johnson (WI), $252 Million.
ACTION STEPS NEEDED TO BE TAKEN BY EVERYONE BEGINNING TODAY: WE NEED AT LEAST THREE REPUBLICAN SENATORS TO VOTE NO ON THIS LEGISLATION:
- Call Senator ………………(202) ………………… and Senator…………. (202) ………….to tell them that you oppose the Graham-Cassidy-Johnson-Heller bill and how its changes to Medicaid would affect you and your family. Also contact them by email and on their Facebook pages
- Starting Wednesday morning, September 20th, through Sunday, September 24th, our Senators will be at home. If they have public events, join them and let them know you opposed the bill and why.
- Visit your Senator’s district offices and bring along a family member and a friend or two. If you have a friend or colleague in the media, bring them along as well to cover the real facts and stories.
- Call Governor…(insert Governor’s name and phone number and email………………….).and tell him/her to issue a statement or letter about their opposition to the Graham-Cassidy-Johnson-Heller bill and how it will impact our state and how cuts in Medicaid will impact you and your family. Tell him/her about their 12 colleagues who are opposing the bill. If our Governor is one of the 12, please be sure to thank them for taking a stand for their citizens.
- Write stories about what will happen if Medicaid is cut. Tell your stories – in 3 minutes or less, if possible – videotape them and share them on Facebook and Twitter.
- Send this email to family, friends, colleagues in the following states where key Republican Senators can be convinced to continue to say “NO” to this bill (Collins, Miurkowski and McCain) or be persuaded to take a “NO” vote next week.
Maine: Collins: (202) 224-2523
Alaska: Murkowski: (202) 224-6665
West Virginia: Capito (202) 224-6472
Arizona: Flake (202) 224-4521
Arizona: McCain (202) 224-2235
Ohio: Portman (202) 224-3353
Kansas: Moran (202) 224-6521
Tennessee: Alexander (202) 224-4944
Tennessee: Corker (202) 224-3344
Thank you for your advocacy and perseverance on this urgent fight.