Are You a Part of the Movement to Protect Medicaid? The grassroots momentum calling to save the Affordable Care Act (and truly improve upon it) is growing, as are groups calling to protect a broad range of human and civil rights. Constituents are emailing, flooding call lines, and attending town hall meetings in record numbers. As you receive this Mobilizer, Congressional members are home on break--NOW is the time to catch them in person and tell them what Medicaid means/would mean for your health center and for people experiencing homelessness. They start back in D.C. on Monday. Learn what you can do under Take Action. Let’s be an active part of the awakening happening across the country! Not on our mailing list?
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Status of Cabinet Appointments- Tom Price was confirmed as Secretary of HHS on February 10 despite concerns about his financial trading, his opposition to the Affordable Care Act, and his desire to defund Planned Parenthood. Learn five quick ways that he can make significant changes at HHS without Congressional action.
- Ben Carson was nominated to be HUD Secretary and had a confirmation hearing on January 12, but has not yet been confirmed. It is unknown when the Senate will have its full vote on Carson.
- Seema Verma has been nominated to lead the Centers for Medicare and Medicaid Services (CMS). Read about Verma's Medicaid work in Indiana, Kentucky, and other states to introduce work requirements, lock-out periods, and out-of-pocket payments at all income levels. Verma breezed through her first Senate hearing, which you can watch online. A final vote on her appointment is not yet scheduled.
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Trump Administration Executive Orders
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ACA Changes - On February 16, Republican leadership released the “Obamacare Repeal and Replace Policy Brief and Resources” guide, which provides more detail about the changes they plan to introduce in legislation soon. While offering few specifics, the guide stipulates repealing the Medicaid expansion and offering states that expanded a payment rate for “a limited period of time” before lowering reimbursements to the state’s current Medicaid reimbursement level for other populations. This would mean a significant reduction in federal funding. The guide indicates that states would have a choice between per capita payment or a block grant “beginning at a year in the future.” More details to come.
- Paul Ryan, Speaker of the House, and Kevin Brady, House Ways and Means Committee Chairman, said they will put out repeal legislation by the end of March. The House Energy and Commerce Committee has tentatively scheduled a hearing on February 28th. The House plan is rumored to include a major overhaul to Medicaid.
- Meanwhile, President Trump cautiously said repeal/replace may not be done until next year, and Senator Lamar Alexander, Chair of the Senate Committee overseeing Health issues, said he wants a replacement voted on before summertime.
- CMS has begun issuing administrative changes to the ACA. On February 15, a proposed rule was issued on changes to the private plans offered in marketplaces. The rule tightens special enrollment requirements, shortens open enrollment at the end of 2017, removes federal oversight of state network adequacy requirements, and allows lower premium plans (but likely higher deductibles). This rule illustrates the type of changes possible without needing Congressional action. We anticipate more of these types of administrative changes as the new HHS leadership settles in.
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On the Single-Payer Front
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"Repeel?" John Cole. The Scranton Times-Tribune, January 31, 2017.
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Medicaid Stories of the Month “My patient, James, is a 57-year-old who lives with Type I Diabetes, hypertension, neuropathy, and bipolar disorder with schizoaffective features. Though he often secures jobs working in the kitchens of local restaurants, his poor health conditions have just as often conspired to prevent him from maintaining steady employment, and thus from maintaining stable housing arrangements. Over the years James’s diabetes had become increasingly difficult to control, leading to the amputation of the big toe on his right foot. Further amputations seemed likely without consultation and care from a specialist, something that was beyond James’s grasp as an uninsured Tennessean. Fortunately, he recently qualified for Social Security Disability income and, with it, Medicaid through the state’s TennCare program. With health insurance to help pay for care from a podiatrist and other specialists the condition of James’s lower extremities has improved. It has also enabled James to secure a provider to manage his complex mental health instead of having to go from one mental health safety net provider to another. This has afforded him an appreciably better quality of life, including steady involvement at a local church. I only wish he was able to enroll in Medicaid before he was on disability so we could have seen these changes sooner." – Medical Provider
Tennessee (non-expansion state)
“Lisa, 23, used drugs such as heroin and methamphetamine for five years. She also struggled with bipolar disorder, which further complicated her ability to stop using drugs. She tried quitting with no luck, until eight months ago when she accessed recovery support services through Central City Concern (CCC). In Lisa’s case, medication-assisted treatment helped her tackle her opioid addiction, so she could then focus on her severe bipolar disorder and other medical issues. Lisa now lives in supportive alcohol and drug-free recovery housing and works in CCC’s Community Volunteer Corps. She hopes one day to become a peer mentor and help others to overcome their opioid addiction. Without Medicaid expansion, Lisa wouldn’t have had access to critical recovery services that led to integrated health care, housing and employment services. Lisa says: 'It’s something I think about all the time. Without the Oregon Health Plan, I just don’t know where I’d be.'" – Provided by Central City Concern
Oregon (expansion state)
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Print and share our one-pager for clients, which might help respond to concerns about what will happen to our patients’ health care. It also includes tips encouraging clients (and anyone!) to call their Senators about protecting Medicaid. This is a Word document—please tailor any of this information to your local health center as appropriate!
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Join Save my Care to get district specific call-in information.
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Plan to attend the March for Science on Saturday, April 22, in Washington, D.C.—with satellite marches scheduled in many other cities and towns. Sign up for more information at the site and organize your own group! As health care providers and advocates, let’s promote evidence-based practices, data-driven health care solutions, and promote local research showing that Housing is Health Care & Medicaid saves lives!
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This publication and all HCH advocacy are funded by dues from Organizational Members of the Council. Consider joining the Council to support this work.
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