In yet another interesting turn of events this week, Senate Majority Leader Mitch McConnell decided not to move forward with a vote on H.R. 1628, the Better Care Reconciliation Act of 2017, ahead of the July 4 congressional recess. Over the past week, activity on the health policy front has been dizzying. Upon release of the bills, hundreds of health and human service organizations, including the Alliance for Strong Families and Communities, issued statements opposing the bill. The Alliance issued its statement opposing the bill. Republican senators and governors also voiced their concerns. Conservatives were disappointed that the Senate bill did not go far enough to repeal current law and Moderates expressed their concerns over the changes being made to the Medicaid program—both the fiscal impact and rollback of the Medicaid expansion.

Where are we today? McConnell is trying to win over support given that nine Republican senators have publicly come out indicating that they cannot support the bill in its current form. He can only afford to lose two Republican votes in order pass this bill with a simple majority vote under reconciliation rules.

What is currently in play? Adding more money to fight the opioid epidemic to a fund that is being created under the Senate bill, setting up health savings accounts to pay for more premiums, and keeping the tax on high-income earners to continue to provide federal subsidies to help offset the cost of insurance.

What is still on the table? Changing how the federal government finances the Medicaid program, which will have a significant impact on the health and human services sector. Yesterday, the Congressional Budget Office released a longer-term analysis of the Senate measure, at the request of Democrats, that showed that the bill would cut the Medicaid program by 26 percent in 10 years and 35 percent in 20 years. Governors are also starting to release reports that offer their impact analysis. Arizona's Medicaid program released its assessment, resulting in potential state impact of $7.1 billion. In Oregon, state taxpayers could face a potential cost shift of $6.2 billion and loss of coverage for 440,000 within four years.

What can you do? Members of Congress will be in your state next week for the July 4 recess. Next week will be critical for this current health reform debate. They need to hear from you:

  • Use your personal Facebook page or your organization's Facebook page to help educate your friends and followers about what is at stake in this current health reform debate. You can share the Alliance’s recent Facebook post.
  • Search online to see if your elected officials will be hosting a town hall near you. If you are able to attend, ask them how they will make sure that the proposed cuts to Medicaid will not hurt people.
  • Call on your governor to elevate the impact of the Senate health care bill on your state while your senators are back home. 

Additional Resources

  • Urbans Institute’s Health Policy Center published a new state-level analysis of the Senate’s bill. The findings show that the legislation’s impact would vary considerably by state, both in terms of the share of the population losing coverage and the impact on state’s coffers. State-by-state estimates of the impact of the Senate bill on health care coverage and costs by 2022 are available online—amounting to over 24 million nationwide. In addition to the analysis, the below map provides an illustration of change in coverage under the Senate bill across the states.
  • Kaiser Family Foundation released a side-by-side comparison of current law, the House-passed American Health Care Act and the proposed Senate Better Care Reconciliation Act of 2017.

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