Thank you for contacting me about the American Health Care Act. I appreciate you taking the time to write and share your thoughts with me.
Too often, the discussions regarding the healthcare are portrayed as distant policy conversations in Washington, D.C. The reality, however, is that these issues have real consequences for folks in our neck of the woods. This is about people.
This is about the mom I met in Tacoma whose 24-year-old daughter has bipolar disorder. Her daughter is now able to have insurance because the ACA enables her to stay on her parents’ insurance until her 26th birthday. And that insurance policy now treats mental illnesses the same as physical ailments because the law now establishes mental health parity.
This is about the cancer survivor I met who said she never thought she would be able to have health insurance because of her pre-existing conditions. She told me that she now has insurance as part of the Medicaid expansion and is getting the treatments that she needs. She said, “This is about life or death for me.”
This is about every woman I represent who no longer has to pay more for insurance simply because she is a woman. And it’s about every person whose life may be saved because they now have access to free preventive services like annual check-ups, mammograms, and cancer screenings.
This is about every staff member at Franciscan, Multicare, Olympic Medical Center, Mason General, Summit Pacific, Grays Harbor Hospital, Harrison Hospital, Jefferson Healthcare, and every other health provider in our region. These health care providers have saved millions of dollars – and are able to continue to be significant employers in our region – because they are now more financially viable because they have seen a dramatic reduction in the number of uninsured patients walking through their doors.
And it’s about the more than 20 million people who now have insurance coverage – including roughly half a million Washingtonians who did not before – because of this law.
I wasn’t in Congress when the Affordable Care Act was passed. There are parts of the law that undeniably represent real progress for the folks I represent. That said, there are also improvements that I believe ought to be made. In fact, I’ve sponsored several bills to try to reduce health care costs for small businesses, improve access to primary care, and strengthen care in rural areas. I’ve said that if there are reasonable proposals to improve the law, I’d be open to supporting such improvements.
Unfortunately, what we’re seeing in Congress is heading in the wrong direction. The proposal by Republicans in Congress would effectively dismantle some of the progress made under the Affordable Care Act. This new plan, known as the American Health Care Act (or the AHCA for short) doesn’t pass the test of improving the system. As written, it is expected to cover fewer people and cost those purchasing insurance more. I am deeply concerned about the impacts this bill could have.
First, the Republican plan would leave millions of Americans without healthcare coverage. The non-partisan Congressional Budget Office estimates that 14 million fewer people will be covered under the AHCA during the first year alone. This number jumps to 24 million in ten years. This will not only hurt the folks who lose coverage. It will hurt local healthcare providers who will see a spike in uncompensated care. That’s why the American Hospital Association and the American Medical Association have come out in opposition to this bill.
Second, the Republican plan does real damage to the Medicaid system. Medicaid provides healthcare to lower-income Americans and their families, people with disabilities, nursing home residents, children, and others. In our state, two-thirds of Medicaid recipients are seniors and people with disabilities. It’s a difference-maker. In Washington state alone 20,000 people got cancer treatment because of the healthcare they received through the Medicaid expansion. Unfortunately, the AHCA proposal would cut off funds for states to add new enrollees, reduce the amount of Medicaid dollars states receive for current enrollees, and would lock out those who have a gap in coverage.
Third, the AHCA negatively impacts women’s health services. Millions of women rely on Planned Parenthood for primary care visits, cancer screenings and other health services. Despite the fact that federal law currently prohibits tax dollars being used to fund abortions, the Republican proposal includes a provision prohibiting Planned Parenthood from receiving Medicaid reimbursements for any of the care it provides – including mammograms, cervical cancer screenings, family planning assistance, and other care. This impacts a lot of people, especially lower-income women. One in five women in our country have visited Planned Parenthood, with over three-fourths having incomes of 150 percent or less of the federal poverty level.
Fourth, this bill eliminates the Affordable Care Act’s Prevention and Public Health Fund. This important fund supports approximately 12 percent of the CDC’s entire budget and helps ensure that Americans are protected from communicable diseases such as Ebola, Zika, measles, and mumps. We all know the CDC is at the frontlines of stopping epidemics before they spread. What’s more, our state gets $14 million from this fund, with those dollars covering roughly 50 percent of our state’s immunization program. The Republican plan would zero this prevention fund out entirely.
Fifth, this bill would impede the progress we’ve been making in the fight against the opioid epidemic and mental health challenges. Currently, as a result of the Medicaid expansion, nearly 1.3 million people receive treatment for mental-health and substance abuse disorders, including 30,000 people in Washington state who got treatment for substance abuse disorders through the Medicaid expansion. Unfortunately, as mentioned, the bill pulls the plug on the Medicaid expansion. Beyond that, though, the bill proposes eliminating the requirement that Medicaid cover basic mental health and addiction services. That’s why the American Psychiatric Association and mental health advocates have raised concerns about the bill.
Sixth, the bill cuts health care for working people and those living paycheck to paycheck in order to give nearly $600 billion in tax breaks to special interests and the super-wealthy. The AHCA proposes two tax cuts specifically for the wealthiest Americans. These proposed changes would not save $1 – not $1 – for folks earning less than $200,000 per year. In contrast, if you’re a millionaire, you’ll get – on average – a $50,000 tax cut. In fact, according to the Center for Budget and Policy Priorities, our nation’s 400 highest income taxpayers (who earn, on average, over $300 million/year) would see an annual tax cut of roughly $7 million. If that wasn’t enough, the Republican plan would allow insurance companies to get a tax deduction for pay and bonuses they provide to their executives over $500,000. For the life of me, I can’t figure out the problem that provision is trying to solve.
And finally, this bill would hurt seniors. Changes in the bill would shorten the solvency of the Medicare program, hastening the exhaustion of the Medicare trust fund by four years. In addition, the Republican proposal changes the law to allow insurance companies to charge seniors five times more than young people for healthcare coverage. That’s why groups like the AARP have come out against it.
Sadly, this proposal was voted out of two Congressional committees in the dark of night. In neither Committee did the bill even get a hearing.
As I’ve mentioned, we’ve heard from the American Hospital Association, the American Medical Association, and others involved in healthcare that this bill goes in the wrong direction. We’ve also heard from many of you. Thank you for adding your voice.
I believe Democrats and Republicans should be working together to fix problems with the law and to promote accessible and affordable health insurance that works for every family and employer. What’s more, the effort to strengthen our health care system goes beyond the Affordable Care Act. Our nation still spends too much money paying for unnecessary procedures. We need to focus on rewarding value and wellness over volume – not just paying providers for how much care they provide, but for actually helping to improve the patients’ health.
Congress has real work to do to improve our health care system for doctors, hospitals, rural providers, and patients. Rather than playing politics, that should be the focus. Please know that, as your representative, I’ll keep at it!
I will be sure to keep your thoughts in mind as Congress debates this issue in the future. I encourage you to continue to share your views with me on this topic or any other issue. Thank you for reaching out. It is an honor to serve as your representative.
Member of Congress