The House passed its bill, the American Health Care Act (AHCA), in May. Last week, the Senate unveiled its ACA repeal bill, called the Better Care Reconciliation Act of 2017 (BCRA). The Senate plans to vote on the bill this week. Although there are some minor differences between AHCA and BCRA, as noted by the Center on Budget and Policy Priorities, both bills would “do much the same damage to health care coverage, affordability and quality.” Reports today of an analysis of the Senate bill by the Congressional Budget Office (CBO) have confirmed this – by 2026, the number of uninsured will increase by an estimated 22 million people, with 15 million more uninsured by next year.
Since threats to the Affordable Care Act (ACA), Medicaid and Medicare became more apparent following the 2016 election, the Center for Medicare Advocacy has seen a significant increase in stories from individuals who rely on these programs and would be harmed if they are changed as planned. Here are some of their stories.
Medicaid Cuts
Eligibility for Medicaid was expanded by the Affordable Care Act and would effectively end if either of these bills becomes law. “Per capita caps” would replace the current Medicaid funding system. This would cut and cap Medicaid more deeply over time, making it harder for states to finance it, leading to reduced services for older adults, people with disabilities and families with children.
Real Harm
- My son was saved by expanded Medicaid when he developed a fast moving infection, flesh eating disease and quickly received medical help because he finally had insurance. He did not hesitate to go to the ER which I believe saved his life. – B.D.
- My name is E.V. and I am living ONLY because of Medicaid. I was a top 10% tax-bracket earner along with my wife. In 2005 I was diagnosed with Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease). There is no risk-factor in this disease except age and military service. We both ate very healthy diets and were world class water athletes. Since 2005, I persevered for two years in my career before finally becoming quadriplegic and dependent on mechanical ventilation for breath.
Between 2008-2010 we consumed our life savings and all the equity in our former house paying for caregivers to monitor me 24/7/365. This is necessary for anyone on mechanical ventilation because any cessation in the flow of air literally means death within 5 minutes. At that point we were destitute and had consumed an additional $150,000 of funds from my family. Since 2011 I have been kept alive via Medicaid paying for my caregivers. Without Medicaid I would have died in late 2010 because I had no funds with which to pay for caregivers and my family are unable to provide the 24/7/365 vigil (that is universal for all in my situation).
In my time since 2008 I have become a respected patient advocate in the global ALS community, have become a resource of knowledge and experience for fellow patients, and have created my own research organization which is helping advance medical knowledge about ALS. Calling me a "taker" is insulting and factually false. I earned my benefits and continue to do so for myself and all other ALS patients. If Medicaid spending is reduced, I die, and all the valuable resources which I provide go with me.
It's that simple. Cut Medicaid and people die. – E.V., Age 49
ACA Repeal
People with pre-existing conditions would be at risk under either the House or Senate bill. The House bill would let states waive ACA standards for what health care plans must cover, as well as lift the prohibition on charging people with pre-existing conditions higher premiums. The Senate bill would allow states to waive benefit standards, leading to people with pre-existing conditions losing access to services they need. Further, plans would be allowed to lift limits on individuals’ total out-of-pocket expenses.
Real Harm
- I have been an RN for 35 years and NEVER thought I would ever be in the position of needing Medicaid! The first time I had cancer I was able to work through chemo and treatment with insurance. However, it recurred and I was in the position of having to quit working during this go around. Since I had had cancer, high blood pressure and asthma I couldn't even get a quote for an individual policy. My only choice was to ask my manager to fire me so I could [go on] COBRA the health insurance. THAT is a decision no one in this great country should ever have to make. With the ACA I had coverage when I needed a pacemaker and a cardiac ablation – both saved my life. – J.H.
Medicare Weakened
At first glance, Medicare is not a target of current health reform efforts, but make no mistake – Medicare would be harmed by both the House and Senate bills. In addition to accelerating the insolvency of the Part A Trust Fund, and increased Part B premiums due to a repeal of a tax on prescription drugs, 1 in 5 Medicare beneficiaries also have Medicaid (individuals known as “dual eligibles”). Cuts to Medicaid are cuts to 11 million dual eligibles.
Real Harm
- Medicare along with Medicaid … have been my only source of survival after I retired with [health] problems [and allowed me] to have [a] meal a day. My husband had serious health problems and we needed Healthcare very much. We … have been helped with payment of Part B of Medicare, help with getting medicines and all doctors’ fees were taken care of. … I am eternally thankful to … Medicare, Medicaid …. Please do not take away any of them, because I just cannot be alive without them. I lost my husband last year and I will be in streets if any changes [are] made. – S. M., Age 68
- Our life would change dramatically without the help we’re getting and barely making it from medications to health care supplies for my son who has been a paraplegic with diabetes and a heart condition for almost 20 years. Without this help WE WILL LOSE OUR HOME AND BE HOMELESS as he lives with us his senior parents and help him as much as we can now we are barely making it with the help of collecting recyclables for extra money. Please don't take away from our son's Medicare and Medicaid because his medical supplies are very very expensive we could not afford it if that was taken away. – D.G., Age 63
Real people will be really harmed if the Senate bill passes. We urge Senators to consider the consequences of BCRA and vote as if lives depended on it. Because they do.