Today (December 8) marks exactly one month since the national elections, and as a nation we are living through a period of great uncertainty. As President-elect Trump pulls together his selections for the members of the Cabinet in advance of his inauguration on January 20, Congress is moving NOW to attempt to address structural change in health care. This effort is of grave concern to people with disabilities across our country.
The first component of concern is that Republican Congressional leadership will act to pass a repeal of at least major portions of the Affordable Care Act (ACA), also known as Obamacare. For Illinois, this puts 1.2 million people at risk of losing their health care coverage, either because they became covered through Medicaid expansion or through the state insurance marketplace. It also puts Illinois at risk of losing $49.9 billion in federal funds ( see this link from the Urban Institute). Interestingly, there appears to be bipartisan support for keeping the ban on insurance discrimination on the basis of pre-existing conditions, but it's hard to know what exactly will happen. ACA repeal would also eliminate the Community First Choice Option waiver.
The second area of concern is that there appears to be no solid plan for a replacement for the ACA. This could mean that those who lose coverage under appeal will not have access to health care. Plus, it will blow a giant hole in the ability of hospitals to provide services. It would take many months to devise a workable replacement with input from stakeholders, so the idea of structural change without a replacement is very scary.
Third, particularly in the U.S. House, Speaker Paul Ryan is seeking to supplement ACA repeal with a major change to the way Medicaid is funded by the federal government, called "block grants" or "opportunity grants." The National Council on Disability issued a report on 2013 on block grants. Instead of providing federal funds in a structured way to various individual Medicaid programs, Speaker Ryan wants to take back ALL federal Medicaid funding, cut it down, and redistribute what is left in a single grant to each state, to distribute as that state sees fit. Illinois, as an example, operates nine home and community based services Medicaid waiver programs . There is no possible way that the State of Illinois can make up for the loss of federal funds to those programs, should a block grant occur. In fact, no state has the funds to make up for massive cuts in federal Medicaid funds. People with disabilities WILL be at risk of losing Medicaid services if block grants go through.
Fourth, there is also an alternative proposal called "per capita caps." You can learn more about per capita caps at this link . If Congress decided to use per capita caps, there would be a limit set on how much the federal government will contribute per enrollee. While the amounts are supposed to increase with inflation, there is no way these set amounts can compensate for the flexibility in spending required by many people with disabilities or seniors. This is also a dangerous proposal.
We need to move quickly. Action on all of the above is occurring right now, and our members of Congress, plus our Governor, need to hear from YOU that:
• It is unrealistic to repeal the ACA without a working replacement
• Block grants mean elimination of services for thousands of people with disabilities and seniors
• The per capita cap is not flexible enough for the individualized needs of people with disabilities and seniors
You can take quick action at this link . Please share with your family members and friends. This is urgent and important for the health and safety of millions across this country.