Response to Graham-Cassidy, the latest Senate partisan health care repeal bill, has been swift and harsh. Physicians, patient groups, hospitals, consumer groups and senior groups have all come out against it. The American Medical Association said, “We believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care”; AARP said the bill “would result in an age tax for older Americans who would see their health care costs increase under this bill”; and the Children’s Hospital Association said, “This bill would have devastating consequences for children and families.”
Response to Graham-Cassidy, the latest Senate health care repeal bill, has been swift and harsh. Physicians, patient groups, hospitals, consumer groups and senior groups have all come out against the Senate repeal bill. The American Medical Association said “we believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care”; AARP said the “bill would result in an age tax for older Americans who would see their health care costs increase under this bill”; and the Children’s Hospital Association said “This bill would have devastating consequences for children and families.”
PHYSICIANS AND NURSES
American Medical Association: “We Believe The Graham-Cassidy Amendment Would Result In Millions Of Americans Losing Their Health Insurance Coverage, Destabilize Health Insurance Markets, And Decrease Access To Affordable Coverage And Care.” “On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing to express our opposition to the Cassidy-Graham-Heller-Johnson Amendment to H.R. 1628, the “American Health Care Act of 2017.” We also urge the Senate to reject any other legislative efforts that would jeopardize health insurance coverage for tens of millions of Americans. Instead, in the short term we urge Congress to pursue legislation that will stabilize health insurance premiums in the individual insurance market by continuing to fund cost-sharing reduction payments. Similar to proposals that were considered in the Senate in July, we believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care.” [AMA, 9/19/17]
American Medical Association: “Allowing States To Get Waivers To Vary Premiums Based On Health Status Would Allow Insurers To Charge Unaffordable Premiums Based On Those Pre-Existing Conditions.” “In addition, the amendment does not take steps toward coverage and access for all Americans, and while insurers are still required to offer coverage to patients with pre-existing conditions, allowing states to get waivers to vary premiums based on health status would allow insurers to charge unaffordable premiums based on those pre-existing conditions. Also, waivers of essential health benefits will mean patients may not have access to coverage for services pertinent to treating their conditions.” [AMA, 9/19/17]
American Medical Association: “We Also Continue To Oppose Congressionally-mandated Restrictions On Where Lower Income Women (And Men) May Receive Otherwise Covered Health Care Services.” “We also continue to oppose congressionally-mandated restrictions on where lower income women (and men) may receive otherwise covered health care services — in this case the prohibition on individuals using their Medicaid coverage at clinics operated by Planned Parenthood and other similar organizations.” [AMA, 9/19/17]
American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, American Osteopathic Association, American Psychiatric Association: “The Proposal Fails To Protect The Health Care Coverage And Consumer Protections Available Under Current Law.” “Our organizations, which represent over 560,000 physicians, oppose the new Graham-Cassidy bill and its approach to reforming our health care system. The proposal fails to protect the health care coverage and consumer protections available under current law. Additionally, it would create a health care system built on state-by-state variability that would exacerbate inequities in coverage and most likely place millions of vulnerable individuals at risk of losing their health care coverage.” [Letter, 9/13/17]
American College Of Physicians: “We Believe That The Substantial Cuts To Medicaid Authorized By This Legislation Would Cause A Significant Increase In The Number Of Uninsured Patients And That It Would Undermine Essential Benefits Provided For Patients Insured Under Current Law.” “We believe that the substantial cuts to Medicaid authorized by this legislation would cause a significant increase in the number of uninsured patients and that it would undermine essential benefits provided for patients insured under current law. We urge you to set aside this legislation and instead allow the Senate to consider any improvements to the ACA, through a more deliberative process of regular order, in which hearings are held to solicit the advice of health care experts and stakeholders, with any such improvements considered in a bipartisan manner in which both parties may offer amendments.” [ACP, 9/13/17]
American Academy Of Pediatrics: “By Turning Medicaid Into A Block Grant, Capping Its Funding And Ending Its Expansion, This Proposal Would Have Devastating Effects On The Nearly 37 Million Children Across The Country Who Rely On The Program.” “As a pediatrician, I am fearful for my patients and the uncertain future they would face under Senators Lindsey Graham (R-S.C.) and Bill Cassidy’s (R-La.) health care proposal, currently set for a vote next week in the U.S. Senate. As president of the American Academy of Pediatrics, I must speak out against this dangerous, ill-conceived policy on behalf of our 66,000 pediatrician, pediatric surgical specialist and pediatric medical subspecialist members, and stop it from advancing…By turning Medicaid into a block grant, capping its funding and ending its expansion, this proposal would have devastating effects on the nearly 37 million children across the country who rely on the program.” [AAP, 9/20/17]
American College Of Emergency Physicians: “We urge you not to bring this amendment to the Senate floor for consideration, as its passage would have devastating impacts on millions of Americans.” “We urge you not to bring this amendment to the Senate floor for consideration, as its passage would have devastating impacts on millions of Americans. ACEP cannot support any legislation that does not include emergency medical care as a covered benefit in health insurance. The Affordable Care Act included emergency services as an essential health benefit, and any replacement legislation must do the same. Yet the Cassidy-Graham-Heller-Johnson Amendment to H.R. 1628, the American Health Care Act, allows states to easily forego requiring insurers to adhere to important consumer protections, including the requirement to cover the ten essential health benefits, and protections for those with pre-existing conditions.” [ACEP, 9/19/17]
American Nurses Association: “As With All Other Repeal And Replace Proposals To Date, The Current Proposal Fulfills None ANA’s 4 Principles For Health System Transformation.” “The Graham-Cassidy bill — also supported by Sens. Dean Heller (R-NV) and Ron Johnson (R-WI) — is not substantially different from any of the other repeal and replace bills we have seen from House and Senate Republicans. It repeals Medicaid expansion in 2020; it eliminates the $1 billion Prevention and Public Health Fund; it creates high-risk pools for individuals with pre-existing conditions; it defunds Planned Parenthood for a year; it puts a per-capita cap on Medicaid funding and gives states the option to convert their Medicaid programs into block grants; and it ends premium tax credit assistance and cost-sharing subsidies and puts greater control of healthcare spending in state hands. As with all other repeal and replace proposals to date, the current proposal fulfills none ANA’s 4 principles for health system transformation.” [ANA, 9/19/17]
CONSUMER GROUPS
AARP: “The Graham/Cassidy/Heller/Johnson Bill Would Result In An Age Tax For Older Americans Who Would See Their Health Care Costs Increase Under This Bill.” “Should this bill be brought to the Senate floor for a vote, we strongly urge all Senators to vote NO. As our members expect from AARP, we will monitor each Senator’s vote should this bill come to the Senate floor and notify older Americans by reporting the vote in our publications, online, through the media, and in direct alerts to our members…The Graham/Cassidy/Heller/Johnson bill would result in an age tax for older Americans who would see their health care costs increase under this bill…We have serious concerns that Graham/Cassidy/Heller/Johnson would allow states to once again permit insurance companies to charge people with pre-existing conditions more just because they have cancer, asthma or diabetes.” [AARP, 9/19/17]
AARP: “#GrahamCassidy Would Price Gouge Older Americans With An Age Tax, Decrease Coverage, And Undermine Pre-existing Condition Protections.” “AARP stands ready to work with Congress on commonsense, bipartisan solutions to improve health care. #GrahamCassidy is not that bill. #GrahamCassidy has the same flaws as the proposals rejected by AARP, consumer groups, doctors, hospitals, & the public earlier this year. #GrahamCassidy would price gouge older Americans with an age tax, decrease coverage, and undermine pre-existing condition protections. #GrahamCassidy’s Medicaid caps would also jeopardize the ability of older Americans to stay in their own homes as they age. #GrahamCassidy is just another bad bill that would 🔺 costs & 🔻 coverage. We urge Congress to reject it & the flawed approach it represents.” [AARP Advocates, 9/15/17]
Consumers Union: “This Is Just Another Version Of The Previous Failed Proposals That Were Not Only Rejected By The Majority Of Americans, They Were Rejected By The Senate Itself.” “The Graham-Cassidy bill is the third strike in this losing game of repealing the Affordable Care Act. Just like its predecessors, this plan would leave tens of millions uninsured, threaten key consumer protections and coverage requirements, and fundamentally alter Medicaid by drastically cutting funding and shifting billions of dollars of healthcare costs onto states and consumers. This is just another version of the previous failed proposals that were not only rejected by the majority of Americans, they were rejected by the Senate itself.” [Consumers Union, 9/13/17]
National Farmers Union: “The Graham-Cassidy Bill Does Not Address The Barriers That Farmers And Ranchers Face In Accessing Health Coverage, And It Would Only Make Matters Worse.” “I write on behalf of nearly 200,000 members of National Farmers Union (NFU) who are engaged in all forms of family farming and ranching. NFU’s member-driven policy ‘affirms the right of all Americans to have access to affordable, quality health care.’ The Graham-Cassidy bill does not address the barriers that farmers and ranchers face in accessing health coverage, and it would only make matters worse. We urge you to vote no on the legislation. NFU will be monitoring each Senator’s vote and will include it in our Congressional scorecard.” [NFU, 9/21/17]
PATIENT GROUPS
ALS Association, American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association, Arthritis Foundation, Cystic Fibrosis Foundation, Family Voices, JDRF, Lutheran Services in America, March of Dimes, National Health Council, National Multiple Sclerosis Society, National Organization for Rare Diseases, Volunteers of America, WomenHeart: “This Bill Would Limit Funding For The Medicaid Program, Roll Back Important Essential Health Benefit Protections, And Potentially Open The Door To Annual And Lifetime Caps On Coverage, Endangering Access To Critical Care For Millions Of Americans.” “This bill would limit funding for the Medicaid program, roll back important essential health benefit protections, and potentially open the door to annual and lifetime caps on coverage, endangering access to critical care for millions of Americans. Our organizations urge senators to oppose this legislation…Our organizations, instead, strongly support the bipartisan hearings spearheaded by Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) in the Senate Health, Education, Labor and Pensions (HELP) Committee, and by Chairman Orrin Hatch (R-UT) and Ranking Member Ron Wyden (D-Ore.) in the Senate Finance Committee.” [Letter, 9/18/17]
American Cancer Society Cancer Action Network: “With Repeal Of The Health Care Law As Its Starting Point, The Graham-Cassidy Bill Is Distracting And, If Enacted, Would Be Disruptive To The Health Care Markets — Creating Uncertainty For Millions Of Americans.” “ACS CAN commends HELP Committee Chairman Lamar Alexander (R-Tenn.) and Senator Patty Murray (D-Wash.) for initiating this bipartisan examination of health care solutions and for restoring long-needed regular legislative order to the debate. With repeal of the health care law as its starting point, the Graham-Cassidy bill is distracting and, if enacted, would be disruptive to the health care markets — creating uncertainty for millions of Americans…On behalf of cancer patients, survivors and their families, we urge lawmakers to continue to focus on practical, bipartisan efforts to strengthen health care coverage and urge Senators Cassidy and Graham to work within, and not around, the HELP Committee process.” [ACS CAN, 9/14/17]
National Coalition For Cancer Survivorship Of More Than 35 Cancer Organizations: “35+ Cancer Orgs, Representing 16 Million #Cancer Pts & Survivors, Ask Sen To Vote No On Harmful #ACA Repeal.” “35+ cancer orgs, representing 16 MILLION #cancer pts & survivors, ask Sen to vote NO on harmful #ACA repeal.” [National Coalition for Cancer Survivorship, 9/19/17]
Coalition To Stop Opioid Overdose Of 469 Mental Health And Substance Use Disorder Groups: “We Are Very Concerned That The GCHJ’s Proposed Changes To Our Health Care System Will Result In Reductions In Health Care Coverage, Particularly For Individuals With Substance Use Disorders And Mental Illness, And We Cannot Support The Bill.” “The undersigned organizations are writing to share our serious concerns with several of the health system reforms included in the Graham-Cassidy-Heller-Johnson (GCHJ) proposal. We are very concerned that the GCHJ’s proposed changes to our health care system will result in reductions in health care coverage, particularly for individuals with substance use disorders and mental illness, and we cannot support the bill.” [Letter, 9/19/17]
DISABILITY RIGHTS
Consortium For Citizens With Disabilities: “We Cannot Overstate The Danger Facing The Millions Of Adults And Children With Disabilities If The Proposal’s Medicaid Provisions Are Adopted.” “As we have commented on multiple proposals considered by the Senate, we cannot overstate the danger facing the millions of adults and children with disabilities if the proposal’s Medicaid provisions are adopted. The proposal’s imposition of a per capita cap and the elimination of the adult Medicaid expansion would decimate a program that has provided essential healthcare and long term services and supports to millions of adults and children with disabilities for decades. We are also extremely concerned about the changes proposed to the private individual health insurance market and the tax credits that currently assist low-income individuals, including individuals with disabilities, to purchase insurance.”
The Arc: “Architects Of This Bill Are Still Ignoring The Pleas Of Their Constituents With Disabilities.” “While this piece of legislation has a new title and makes new promises, it is more of the same threats to Medicaid and those who rely on it for a life in the community. The Graham-Cassidy-Heller-Johnson proposal cuts and caps the Medicaid program. The loss of federal funding is a serious threat to people with disabilities and their families who rely on Medicaid for community based supports.” [The Arc, 9/14/17]
HOSPITALS
American Hospital Association: “This Proposal Would Erode Key Protections For Patients And Consumers And Does Nothing To Stabilize The Insurance Market Now Or In The Long Term” And “The Block Grant To Provide Support For The Expansion Population Expires In 2026, Thereby Eliminating Coverage For Millions Of Americans.” “We believe that coverage could be at risk for tens of millions of Americans under the Graham-Cassidy proposal. We continue to urge senators to work in a bipartisan manner to address the challenges facing our health care system. This proposal would erode key protections for patients and consumers and does nothing to stabilize the insurance market now or in the long term. In addition, the block grant to provide support for the expansion population expires in 2026, thereby eliminating coverage for millions of Americans. For these reasons, we oppose the Graham-Cassidy plan.” [AHA Statement, 9/19/17]
Arizona Hospital And Healthcare Association: “A Central Goal Of The Arizona Hospital And Healthcare Association Is To Ensure More Arizona Families Have Access To Quality Care They Can Afford” And “Graham-Cassidy…Falls Short On Both Counts.” “A central goal of the Arizona Hospital and Healthcare Association is to ensure more Arizona families have access to quality care they can afford. The Graham-Cassidy legislation being considered by Congress falls short on both counts. This proposal erodes critical protections for patients and consumers, and would lead to costlier premiums for many individuals — especially those with pre-existing conditions. Millions would lose coverage altogether.” [AzHHA, 9/21/17]
Kansas Hospital Association: “We Will Continue To Urge Our Senators To…Protect Health Coverage And Oppose The (Graham-Cassidy) Bill.” “‘We will continue to urge our senators to address the challenges facing our health care system, protect health coverage and oppose the (Graham-Cassidy) bill,’ said Cindy Samuelson, vice president for public relations at the Kansas Hospital Association. Her group is pushing Kansas Sen. Moran, who previously criticized his party’s efforts to roll back Medicaid, to vote against the latest bill.” [Modern Healthcare, 9/18/17]
Greater New York Hospital Association And 35 New York Provider, Labor, Consumer, And Insurers: The Bill’s “Implementation Would Catastrophically Cut Federal Funding To New York’s Health Care System And Severely Compromise Your Constituents’ Access To Health Care Coverage And Services.” “Our coalition of New York State consumers, health care and human service workers, and providers and insurers urge you to strongly oppose the new Graham-Cassidy bill to repeal the Affordable Care Act (ACA), which could be voted on in the Senate in the coming days. If the bill clears the Seante, it would be sent to the House for your consideration. Your opposition to the bill is critical, as its implementation would catastrophically cut Federal funding to New York’s health care system and severely compromise your constituents’ access to health care coverage and services.” [GNYHA, 9/19/17]
Federation Of American Hospitals: “The Graham-Cassidy Proposal Could Disrupt Access To Health Care For Millions Of The More Than 70 Million Americans Who Depend On Medicaid And The Marketplaces For Their Health Coverage.” “The Graham-Cassidy proposal could disrupt access to health care for millions of the more than 70 million Americans who depend on Medicaid and the marketplaces for their health coverage. It is time to move on to secure the health coverage for those who have it, and find solutions for those who don’t. We urge the Senate to reject legislation that fails to move us forward in assuring Americans access to affordable health care and coverage.” [FAH, 9/20/17]
Children’s Hospital Association: “This Bill Would Have Devastating Consequences For Children And Families.” “The nation’s children’s hospitals stand in strong opposition to the most recent legislative proposal introduced by Sens. Lindsay Graham, R-S.C., Bill Cassidy, R-La., Dean Heller, R-Nev., and Ron Johnson, R-Wis. Their legislation would slash funding for Medicaid, the nation’s largest health care program for children, by one-third, reducing access and coverage for more than 30 million children in the program. Furthermore, the legislation weakens important consumer safeguards, and as a result, millions of children in working families would no longer be assured that their private insurance covers the most basic of services without annual and lifetime limits and regardless of any underlying medical condition. This bill would have devastating consequences for children and families.” [CHA, 9/18/17]
America’s Essential Hospitals: “It Appears To Significantly Restrict Federal Health Care Funding Through Per-Capita Caps And Block Grants, Which Would Shift Costs To States, Patients, Providers, And Taxpayers.” “It appears to significantly restrict federal health care funding through per-capita caps and block grants, which would shift costs to states, patients, providers, and taxpayers. Further, by taking an approach so close to that of the earlier House and Senate plans, it’s reasonable to conclude it would have a similar result: millions of Americans losing coverage…Further, it would impose strict new limits on how states raise support for the safety net. Rather than providing flexibility, this would limit states’ coverage and financing choices. Rather than consider a proposal with no CBO score or committee review, the Senate should stay focused on bipartisan efforts to shore up the insurance market, extend Children’s Health Insurance Program funding, and delay Medicaid DSH cuts.” [AEH, 9/15/17]
Catholic Health Association: “I Strongly Urge You To Reject The Graham-Cassidy-Heller-Johnson Legislation And Instead Support Bipartisan Efforts To Improve Our Health Care System Focusing On Insurance Market Stabilization, Affordability, And Coverage Access And Expansion.” “On behalf of the Catholic Health Association of the United States (CHA), the national leadership organization of more than 2,000 Catholic health care systems, hospitals, long-term care facilities, sponsors, and related organizations, I strongly urge you to reject the Graham-Cassidy-HellerJohnson legislation and instead support bipartisan efforts to improve our health care system focusing on insurance market stabilization, affordability, and coverage access and expansion.” [CHA, 9/19/17]
MEDICAID PROGRAMS
National Association Of Medicaid Directors: “We Are Concerned That This Legislation Would…Fail To Deliver On Our Collective Goal Of An Improved Health Care System.” “The Board of Directors of the National Association of Medicaid Directors (NAMD) urges Congress to carefully consider the significant challenges posed by the Graham-Cassidy legislation. State Medicaid Directors are strong proponents of state innovation in the drive towards health care system transformation. Our members are committed to ensuring that the programs we operate improve health outcomes while also being fiscally responsible to state and federal taxpayers. In order to succeed, however, these efforts must be undertaken in a thoughtful, deliberative, and responsible way. We are concerned that this legislation would undermine these efforts in many states and fail to deliver on our collective goal of an improved health care system.” [NAMD, 9/21/17]
SCHOOLS
The School Superintendents Association And The Save Medicaid In Schools Coalition: “Graham-Cassidy Reneges On Medicaid’s 50+ Year Commitment To Provide America’s Children With Access To Vital Healthcare Services That Ensure They Have Adequate Educational Opportunities And Can Contribute To Society.” “The 70 undersigned organizations of the Save Medicaid in the Schools Coalition are concerned that the Graham-Cassidy bill jeopardizes healthcare for the nation’s most vulnerable children: students with disabilities and students in poverty. Specifically, Graham-Cassidy reneges on Medicaid’s 50+ year commitment to provide America’s children with access to vital healthcare services that ensure they have adequate educational opportunities and can contribute to society by imposing a per-capita cap and shifting current and future costs to taxpayers in every state and Congressional district. While children currently comprise almost half of all Medicaid beneficiaries, less than one in five dollars is spent by Medicaid on children. Accordingly, a per-capita cap, even one that is based on different groups of beneficiaries, will disproportionately harm children’s access to care, including services received at school. Considering these unintended consequences, we urge a ‘no” vote on Graham-Cassidy.” [Letter, 9/19/17]
INSURERS
America’s Health Insurance Plans: “The Graham-Cassidy-Heller-Johnson Proposal Fails To Meet [Our] Guiding Principles, And Would Have Real Consequences On Consumers And Patients.” “The Graham-Cassidy-Heller-Johnson proposal fails to meet these guiding principles, and would have real consequences on consumers and patients by further destabilizing the individual market; cutting Medicaid; pulling back on protections for pre-existing conditions; not ending taxes on health insurance premiums and benefits; and potentially allowing government-controlled, single payer health care to grow.” [AHIP, 9/20/17]
Blue Cross Blue Shield Association: “We Share The Significant Concerns Of Many Health Care Organizations About The Proposed Graham-Cassidy Bill.” “Although we support providing states with greater flexibility in shaping health care options for their residents, we share the significant concerns of many health care organizations about the proposed Graham-Cassidy bill. The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions. The legislation reduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans. Legislation must also ensure adequate funding for Medicaid to protect the most vulnerable.” [BCBSA, 9/20/17]
Blue Shield Of California: “We Believe This Proposal Will Cause Millions Of Californians To Lose Their Health Insurance Coverage While Requiring Major State Tax Increases Over The Long-Term To Fund Basic Levels Of Access.” “We are therefore writing to express our strong opposition to the Cassidy-Graham proposal that the Senate may soon consider. We believe this proposal will cause millions of Californians to lose their health insurance coverage while requiring major state tax increases over the long-term to fund basic levels of access. This would undo much of the substantial progress California has made expanding coverage in recent years.” [Blue Shield of California, 9/21/17]
Association Of Community Affiliated Plans: “We Are Disappointed To See That The Senate Is Repeating — And In Some Ways, Doubling Down On — Many Of The Same Mistakes As It Made With The Better Care Reconciliation Act.” “We are disappointed to see that the Senate is repeating — and in some ways, doubling down on — many of the same mistakes as it made with the Better Care Reconciliation Act. As with previous efforts to overhaul the health care system, ACAP has compared the language of the Cassidy-Graham proposal against a set of stated principles surrounding health reform, which we have shared with Congress before…We’ve seen what’s possible with health reform; there have been promising talks in the Senate HELP Committee around stabilizing Marketplaces and bipartisan progress around the must-pass funding extension for the Children’s Health Insurance Program (CHIP), for which no new allotments exist after the end of the month. We urge the Senate in the strongest possible terms to turn away from partisan politics and instead build on the promising work around CHIP and the HELP committee.” [ACAP, 9/18/17]
