Advocacy Works. Let's Keep It Going.

March ended up being a roller coaster of activity because of the American Health Care Act. Thanks to an intense advocacy campaign from countless people and organizations, the law that would have caused 24 million people to lose health insurance did not come to pass. “We’re going to be living with Obamacare for the foreseeable future” said House Speaker Ryan to reporters shortly after his Obamacare repeal bill collapsed. However, there’s still a need to reform the health care system, and there are still plenty of challenges to ensuring health and housing for everyone. There’s more information below, but see our updated Frequently Asked Questions and the Council’s statement on health reform. 

March Roundup

• March was consumed by controversy over the failed American Health Care Act, which would have ended the Medicaid expansion and imposed limited per capita caps or block grants to states as a financing substitute for the whole program (along with many other harmful provisions). Congress eventually pulled the bill after it became clear they could not get enough votes to pass it. Whether Congress takes new steps to repeal/replace the ACA is unclear. 
• Seema Verma was confirmed as Administrator of the Centers for Medicare and Medicaid Services (CMS). Learn 10 Things you Didn’t Know about Seema Verma.
• HHS Secretary Tom Price and Verma sent a letter to Governors on Medicaid, encouraging states to charge premiums and copays, and implement work requirements at all income levels. Learn more about work requirements. 

• President Trump released his Year 2018 budget recommendations on discretionary funding. View a breakdown. Remember, Trump’s budget is only a recommendation—Congress will determine what the budget really looks like. Read how Trump Budget Will Increase Homelessness and watch How Advocates Can Stop Trump’s Cut to HUD in its Tracks. Items of particular concern in Trump’s budget include:
  • Cuts the already struggling HUD budget by $6.2 Billion, 13% less than current levels. Eliminates HOME, Community Development Block Grant, and the Choice Neighborhood programs that provide state grants for affordable housing and other development. It also would cut Housing Choice vouchers, public housing, and other housing programs.
  • Cuts Health and Human Services budget by $15 Billion, 18% less than current levels, with reductions to the Low Income Home and Energy Assistance Program (LIHEAP), the mental health block grant, the community services block grant, HIV funding programs, and public health programs. 
  • Eliminates the U.S. Interagency Council on Homelessness.
• Ben Carson was confirmed as Secretary of Housing and Urban Development (HUD). Read about Carson’s Controversial First Public Remarks as HUD Secretary.
  

Council Policy Events and Publications

• New Issue Brief: Insurance Coverage at HCH Projects, 2013-2015. Patients at HCH projects were five times more likely to gain insurance coverage if they lived in Medicaid expansion states. Find out how your state has changed insurance coverage for HCH patients, and why Medicaid is vital for people who are homeless.
• Health Reform Webinar: Thursday, April 20, 1-2 ET: The National HCH Council will host a health reform webinar that describes the current state of affairs and what you can do to help push for needed change. Register here.
• Health Reform Pre-conference Institute: On Wednesday, June 21, 2017, the Council’s annual conference will include a PCI dedicated to health reform and the HCH community. This event is designed to provide the latest information on what’s happening and how we can best move forward to provide high-quality care during a tumultuous time.

On the Horizon in D.C.

• ACA Repeal and Replace: With the defeat of the American Health Care Act, it is unclear what next steps—if any—will be taken to repeal, replace, and/or change the Affordable Care Act, which remains in effect. (We’ll cover more in our upcoming webinar!)
• 2017 Budget: On April 28 a government-wide temporary funding bill for Year 2017 expires. Congress must pass another spending bill or extension for the remainder of the year, or the government will shut down.
• 2018 Budget: The new 2018 budget year begins October 2017. An initial budget from the Trump Administration cuts block grant programs and makes cuts to numerous HUD programs, which could increase homelessness. Around May we expect Trump to release the remainder of his budget recommendations (on mandatory spending, taxes, etc.) and Congress to work on their annual budget resolution (a precursor for passing the final budget). Priority items include funding for health centers and other HRSA funding, housing vouchers and other HUD funding, and funding for opioid disorders and other SAMHSA funding. We’ll also be on the look-out for changes to SNAP (food stamps) and Medicaid.

Want to know whether your advocacy works? Congressional offices were overwhelmed by calls, emails, tweets, and other contacts over the American Health Care Act. One Hill staffer wrote that his office usually gets 120-200 calls a week, but those numbers have doubled this year. We asked Hill staff how the HCH Community can best be heard, and this is what we got: "One of the best ways to influence a Member of Congress is to hear from people on the ground in their state or district, especially health providers and people who count on health care that’s at risk." They emphasized that even small things, like making a phone call, gets the attention of their boss, especially when call lines are busy. When a multitude of calls comes in from people worried about the latest health care bill, “everyone in the office knows about it.”

On the Single-Payer Front

• The Fake Freedom of American Health Care (NY Times, March 18, 2017)
• Why Cystic Fibrosis Patients in Canada Outlive Those in the U.S. (NY Times, March 20, 2017)
• What Comes Next for Obamacare? The Case for Medicare for All (NY Times, March 24, 2017)
• Urban Institute report: The Sanders Single Payer Health Care Plan: The Effect on National Health Expenditures and Federal and Private Spending (May 2016)
• HR 676: Is your Congress member one of the 72 members who have co-sponsored HR 676, the single payer legislation? If not, ask them to! (Note, this is 13 more co-sponsors than last month.)
• Senator Bernie Sanders may introduce a single-payer bill in the U.S. Senate after recess. Look for more information in the April Mobilizer.

What We're Reading

• Center on Budget and Policy Priorities: House Proposed Fix Prioritizes Tax Cuts for the Richest and 24 Million People Would Lose Coverage
• The Commonwealth Fund:  ACA Repeal/Replace Legislation and the Future of Medicaid
• Webinars: What State Advocates Can Do to Help Save Federal Health and Safety Net Programs  (enter your registration info in order to view), Protect Medicaid Services, and Per Capita Caps and Block Grants
• Book Club: If you haven’t yet read Matthew Desmond’s Evicted, check it out. This book is up-front and personal and illustrates the intersection of poverty, poor health, and tenuous housing. 

Medicaid Stories of the Month

"Medicaid has helped me in so many ways. I get all my medical needs met. I go to the dentist every six months for a teeth cleaning. All my meds are delivered to my house, which I'm thankful for because I do not have a car. I also have therapy and counseling. When I go to the emergency room my bills are covered. Without Medicaid I could not afford those bills if I had to!"

"There are so many people who fight poverty—they have nowhere to stay and they have little food. They are often in survival mode for years. By the time I see them in a medical clinic setting, it’s the first time they think about their cholesterol or their blood pressure and get into a space where they can grasp that. Most patients I have met would give anything to be able to work and earn every bit they can. Most people want to work and they’ll do anything, but there are physical and mental inabilities sometimes. I’m seeing patients who would have sought treatment three years earlier at a less advanced stage of disease and would not have been so sick, and would have a higher survival rate and better quality of life. Many would have returned to work if it was caught earlier. By having a Medicaid benefit, they are able to stay healthier and in the workforce for much longer."

– Cecile Martin, FNP
   St. Joseph’s Mercy Care, Atlanta, Georgia

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