Trump Administration plans to ‘repeal and replace’ Affordable Care Act raises concern in Alabama

By: Mynecia Steele, Special to the Democrat

After two unsuccessful tries, the Trump Administration was able last week to convince the U. S. House of Representatives to narrowly pass, by a 217 to 213 vote, a measure to ‘repeal and replace’ the Affordable Care Act, sometimes called Obamacare.
Trump and members of the House Republican leadership celebrated victory last week in the White House Rose Garden. Trump called the legislation “a great healthcare plan that will give all Americans access to health care at lower premiums and better care.” But many questions and concerns remain before this legislation passes the U. S. Senate and reaches the President’s desk for final signature.
“The Trump administration may make changes in the ACA, but will not totally repeal it while President Trump is in office,” said Elmore Patterson, CEO of the Greene County Health System, which operates the hospital, nursing home and a physician’s clinic in Greene County.
“Eliminating the Affordable Care Act will leave even more Americans without healthcare,” said Patterson. He sees the attempts to repeal the ACA as a “waste of time.” There does not seem to be a thought-out replacement for the ACA. The repeal will only increase the number of uninsured citizens, and that is not what the country needs,” said Patterson. A study by the non-partisan Congressional Budget Office said as many as 24 million people will loose health care under the Trump proposal.
“The thing is, they would have to find a way to keep the good things about the Affordable Care Act, and get rid of the bad,” said Patterson.
Former Governor Robert Bentley never allowed the expansion of Medicaid in Alabama. So, Alabamians never reaped the full benefits of the Affordable Care Act, said Patterson. Many low income working people, who made more than the base minimum of around $5,000 annually to qualify for Medicaid and less than the $15,000 annually to qualify for subsidies on the ACA state exchange, were left out of care. The Supreme Court gave states the discretionary power to expand or not expand Medicaid for people up to 138% of the state poverty level ($11,000 for an individual in Alabama). Alabama did not expand Medicaid and over 300,000 people, some of the poorest and the sickest in the state, were left without insurance coverage.

Alabama healthcare will be further limited with President Trump’s plan, said Dr. Dedra Reed of the Franklin Primary Health Center, in Mobile, Alabama. “I don’t think Trump should repeal Obamacare, because millions of people would lose coverage. Medicaid won’t be expanded, and many rural hospitals will be forced close down because they will not have people who can pay for needed healthcare.”
In 2015, AP reported that eight rural Alabama hospitals were closed within the last 15 years. Many others are staying open with subsidies and support from sales taxes and other local non-healthcare generated support.
When former President Obama’s administration originally proposed the Affordable Care Act, and even after it was approved the public reacted in both negative and positive ways.
“Current health care with Obamacare has given many people healthcare coverage without being penalized for preexisting conditions,” said Dr. Dedra Reed of the Franklin Primary Health Center, in Mobile, Alabama. “I think it can be improved by lowering premiums and making it more affordable for everyone.”
Proposals for a new health plan have received similar reactions.  “I make so little money, I can’t qualify for subsidies in health care plans–at least as far as I’m currently aware,” said Lyra Galle, a senior Professional and Public Writing, and English major at Troy University. “The health care plan my mom has through work doesn’t allow family members on the plan, so that puts me in a sticky situation.” Obamacare does allow insurance companies to cover students and young adults, up to age 26, to be covered on their parent’s health care plans.
“Ultimately, before Obamacare, with Obamacare, or the Republican health care plan that recently passed wouldn’t have benefited me. I think it’s a bad idea to repeal Obamacare, and I think it’s a move purely to spite Democrats.” People are uncertain that President Trump will successfully pass a new healthcare plan while in office. And, some don’t want him to. Galle is one of those uncertain people. “I didn’t think Trump would win the election, but he did. At this point, I don’t know what to expect,” Galle said.

Rep. Sewell Statement on CBO Analysis of GOP Repeal Bill

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Washington, D.C. – Today, the nonpartisan Congressional Budget Office (CBO) released projections of how many Americans would gain or lose insurance under the Republican proposal to repeal the Affordable Care Act as well as cost projections for the proposed bill. The CBO analysis comes nearly a week after the Ways & Means Committee considered and voted to advance the Republican repeal bill. Congresswoman Terri A. Sewell voted against the repeal bill in committee.
“The CBO report released today makes one thing clear: the Republican repeal bill will cost American lives and leave millions uninsured,” said Rep. Terri Sewell. “Under this bill, 14 million Americans would lose their insurance within the next year. Over the next decade, that number would rise to an unsustainable 24 million uninsured Americans. Our healthcare infrastructure, from our rural hospitals to our network of family physicians, cannot withstand that kind of blow to health coverage. I believe that all Americans have a right to affordable healthcare, but this legislation turns healthcare into a privilege. For families in my district, the Republican repeal bill means more expensive coverage with fewer protections. We cannot ask working Americans to go broke, bankrupt, or do without healthcare.”
Today’s report from the CBO and Joint Committee on Taxation shows that by 2018, five million fewer people would be covered under Medicaid, six million fewer Americans would be covered in the individual market, and a total of 14 million more Americans would be without insurance. The CBO report estimates that in 2018 and 2019, average premiums for single policyholders in the non-group market would rise 15 to 20 percent under the GOP repeal bill.
In addition, the report shows that low-income seniors will see premium increases of $12,900, while the average 40 year old will see an average premium increase of $700. CBO projects that the actuarial value of all plans will decrease under the AHCA.

Rep. Sewell Statement on GOP Health Bill

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Washington, D.C. – On Monday, Republicans in Congress released legislation to replace the Affordable Care Act. The GOP health bill would make large cuts to Medicaid, destabilize Medicare by reducing funding for the Medicare Trust Fund, and increase health costs for working and low-income families. Estimates suggest that 357,000 Alabamians are at risk of losing their coverage if the Affordable Care Act (ACA) is repealed.
“For my constituents, access to affordable healthcare is a life or death issue,” said Rep. Terri Sewell (D-AL). “After seven years of calling for the Affordable Care Act’s repeal, it is unconscionable that the best Republican leadership has to offer is a plan that cuts Medicaid, destabilizes Medicare, and takes insurance away from millions of hardworking Americans. In fact, estimates suggest that 357,000 Alabamians are at risk of losing their coverage if we repeal the ACA. Our access to care is a fundamental right, not a privilege. Protecting care for seniors, disabled Americans, and working and low-income families goes to the heart of who we are as a country. We cannot settle for a health plan that leaves millions of Americans without the coverage they need.”
Studies show that the GOP health plan would increase costs for the average enrollee by $1,542 if the bill were in effect today. At the same time, the proposed bill eliminates requirements for insurance companies to cover preventative care, and makes it possible for insurers to discriminate against seniors. By cutting Medicaid and reducing health assistance to low-income families, the health bill would reduce revenue for rural hospitals nationwide, 700 of which have been labeled as financially at risk.
Patients across Alabama’s 7th District would lose assistance under the GOP health plan. In Jefferson County, residents’ health coverage tax credits will be 33% lower than they were under the ACA.
Despite concerns raised by both Republicans and Democrats, House Republicans plan to move forward with consideration of the health bill in the Ways and Means Committee and Energy and Commerce Committee on Wednesday, March 8. Rep. Sewell is a member of the Ways and Means Committee and will participate in tomorrow’s markup of the GOP health bill.

10 million may lose health insurance coverage under GOP’s Obamacare replacement plan, S&P says

By: Dan Mangan | CNB

Between 6 million and 10 million people would lose health insurance coverage if a Republican proposal to replace the Affordable Care Act becomes law, a new report estimates.
The top end of those losses, or 10 million people, is equal to half of the 20 million or so people who have gained coverage in the past seven years under Obamacare.
The sobering estimate came from S&P Global Ratings on Tuesday, less than a full day after House GOP leaders released their plan for gutting key elements of the ACA, and replacing it with new rules.
S&P Global Ratings said it expected that if the plan were approved, there would be a decline in enrollment in the individual health insurance plan market of between 2 million and 4 million people.
There also would be a decline of between 4 million and 6 million people in the nation’s Medicaid system after 2020 to 2024, according to the report.
But profitability among U.S. insurers “will likely improve,” the company said, pointing to the fact that the replacement plan “can result in an improved risk pool in the individual market.”
The report said that the replacement plan would likely increase the affordability of individual insurance plans for younger adults, and reduce the affordability of those plans “for the older population.”
S&P Global Ratings also said it expected there would be a “large difference between states both in terms of insured rates,” that is the percentage of people with health coverage, “and benefits covered by insurance plans.”

The report is certain to be used by supporters of Obamacare in their efforts to defeat the Republican plan and keep most, if not all, of the ACA intact as the law of the land.
The nonpartisan Congressional Budget Office has yet to “score” the plan, which would analyze both the proposal’s costs to the federal government, and its effect on the number of people insured in the United States.
The ACA has been credited with driving down the nation’s uninsured rate to record low levels through the creation of government-run marketplaces for individual insurance plans, and by expanding Medicaid eligibility standards to more poor adults than previously were covered.
The GOP proposal calls for ending the ACA rule requiring most Americans to have some form of health coverage or pay a fine. It also calls for replacing Obamacare’s system of subsidies for premiums for plans purchased on government-run marketplaces with refundable tax credits that can be used to buy coverage both on and off those marketplaces.
And the proposal would freeze the ACA’s expansion of Medicaid benefits to nearly all poor adults in 31 states by 2020, and switch the way the federal government funds the Medicaid programs of states to a block grant system.

Congresswoman Terri Sewell appointed to serve on House Ways and Means Committee

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Washington, D.C. – On January 11, 2017, Congresswoman Terri A. Sewell (AL-7) was appointed to serve on the House Ways and Means Committee by the House Democratic Steering and Policy Committee and approved by the full Democratic Caucus.

“I am honored to sit on the prestigious House Committee on Ways and Means. Since my election to Congress in 2010, I have maintained a strong interest in serving on this coveted committee because of its profound impact on the health and welfare of my Alabama constituents.  From healthcare and Medicare to Social Security and tax reform, the issues before the Ways and Means Committee directly affect the everyday lives of the people I represent and the concerns I have fought so passionately to defend.

“As the second African American woman ever to serve on the House Ways and Means Committee, I hope to bring a unique voice to the Committee that is further enhanced by the perspective of representing underserved communities in the industrial and rural South.  Given the Republican agenda in the 115th Congress to repeal the Affordable Care Act, to privatize Medicare and to undermine Social Security, it will be imperative to have strong advocates who will fiercely protect the social safety net that provides a lifeline for so many Americans.

“ If Democrats are to win back the South, we have to understand the plight of the unemployed white coal miner, the disaffected single mother and the struggles of everyday Americans to earn a decent wage, educate their children and dare to live the American dream.  It is this missing perspective that I will represent at the policy table by my appointment to the House Committee on Ways and Means.”

The Committee on Ways and Means is the oldest and most powerful committee of the United States Congress, and is the chief tax-writing committee in the House of Representatives. The Committee derives a large share of its jurisdiction from Article I, Section VII of the U.S. Constitution, which declares, “All Bills for raising Revenue shall originate in the House of Representatives.”

Since 1865, the Ways and Means Committee has continued to exercise jurisdiction over revenue and related issues such as tariffs, reciprocal trade agreements, and the bonded debt of the United States. Revenue-related aspects of the Social Security system, Medicare, and social services programs have come within Ways and Means’ jurisdiction in the 20th century.

The roster of Ways and Means Committee members who have gone on to serve in higher office is impressive. Eight Presidents and eight Vice Presidents have served on Ways and Means, as have 21 Speakers of the House of Representatives, and four Justices of the Supreme Court.

New report shows Medicaid expansion in Alabama can improve behavioral health care access

In Alabama 85,000 uninsured people with a mental illness or substance use disorder had incomes that could qualify them for expanded Medicaid under the Affordable Care Act in 2014.
Today, the U.S. Department of Health and Human Services released a report showing that Alabama can greatly improve access to behavioral health services for its residents by expanding Medicaid under the Affordable Care Act. Substance use disorders and mental illness are prevalent and serious public health problems in American communities.
In Alabama, 85,000 uninsured people with a mental illness or substance use disorder had incomes that could qualify them for expanded Medicaid under the Affordable Care Act in 2014, the most recent year for which data is available.  The report also finds that people with behavioral health needs made up a substantial share of all low-income uninsured individuals: in Alabama, about 30.3 percent. While some of these individuals had access to some source of health insurance in 2014, many will only gain access to coverage if Alabama expands Medicaid, and others would gain access to more affordable coverage.
“Today’s report shows that Medicaid expansion is an important step Alabama can take to address behavioral health needs, including serious mental illness and opioid and other substance use disorders,” said Secretary Sylvia M. Burwell.
Today’s report highlights that, along with its other benefits, Medicaid expansion would dramatically improve access to treatment for people with mental and substance use disorders, thereby improving health outcomes. Research shows that low-income adults with serious mental illness are significantly more likely to receive treatment if they have access to Medicaid coverage, with benefits for their health. The report estimates that if Alabama expanded Medicaid, 16,000 fewer individuals would experience symptoms of depression and 24,000 additional individuals would report being in good or excellent health.
To date, 30 states plus DC have expanded Medicaid under the Affordable Care Act. However, 20 states—including many of the states that would benefit most—have not yet seized this opportunity. Previous studies have found that if these states do not change course, over 4 million of their citizens will be deprived of health insurance coverage in 2016.
States that choose to expand Medicaid may achieve significant improvement in their behavioral health programs without incurring new costs. State funds that currently directly support behavioral health care treatment for people who are uninsured but would gain coverage under expansion may become available for other behavioral health investments.  For example, several states that expanded Medicaid reported that they expected reductions in general funds needing to be allocated to the uninsured for treatment ranging from $7 million to $190 million in 2015. This creates opportunities to meet other pressing health, mental health and substance use disorder needs. States can also expect to have a more productive workforce, because expanding treatment will permit a reduction in adverse workforce outcomes stemming from mental and substance use disorders. Research shows that depressed employees incur significantly more disability days than do otherwise similar employees, and substance use disorder treatment was associated with $5,366 annually in employer savings from reduced absenteeism alone.
Thanks to the Affordable Care Act, states have the opportunity to expand Medicaid coverage to individuals with family incomes at or below 138 percent of the federal poverty level. Health care costs for people made newly eligible through the Medicaid expansion are paid for with 100 percent federal funds in 2016, and 95 percent in 2017, scaling down to 90 percent in calendar years 2020 and beyond. President Obama recently proposed an extra incentive for states that have not yet expanded their Medicaid programs, which would provide any state that takes up Medicaid expansion the same three years of full Federal support and gradual phase down that those states that expanded in 2014 received.