Still Lurking: Federal Threats to Health Care

Just over a year ago, congressional Republican leadership began its all-out campaign on affordable and comprehensive health care—an effort that morphed and intensified through all of 2017. The unprecedented resistance and organizing against the harmful (and wildly unpopular) efforts stopped the majority of these destructive proposals to repeal the Affordable Care Act and make drastic cuts to the Medicaid program.

This year, Congress did not start its legislative session with major “repeal and replace” efforts on health care. In fact, opportunities to take health care away from millions of people by only a simple majority in Congress (using “budget reconciliation” process), whether under the guise of “entitlement reform” (changes to Medicaid, Medicare, and Social Security) or another major health law repeal effort seem less and less likely for 2018.

This is good news. But it should not instill a false sense of complacency among those who care about protecting high-quality, affordable health coverage and care.

President Trump and members of Congress remain interested in reversing the care and coverage gains under the Affordable Care Act and Medicaid

Unfortunately, there are many indications that rolling back health coverage and consumer protections remains a top priority for the president and congressional Republicans.

President Trump included a strong push for legislation in his proposed FY19 budget that repeals the Affordable Care Act and guts Medicaid. While the Trump budget appears to be dead on arrival on Capitol Hill, it would not be surprising to see narrow versions of some of the president’s proposals make their way into hearings and legislation, especially on the House side this year. It is unlikely that bad Medicaid or ACA proposals would be able to garner the 60 votes needed to pass the Senate. However, we remain concerned that these attacks will continue to surface on the congressional agenda throughout the year.

Here are some of the threats we’re tracking

Repeal and replace bills: Some in Congress are still pushing for repeal of key parts of the Affordable Care Act through versions of the Graham-Cassidy proposal and other efforts, despite the fact that these proposals were firmly rejected by the American people last year

Shrinking Medicaid and Medicare: Speaker Paul Ryan is still talking a lot about legislative efforts to ‘reform’ Medicaid, Medicare, and safety net programs, cutting the services that support low-income Americans:

• These “incremental reforms” could include smaller standalone proposals that start in the House, including work requirements for Medicaid, nutrition programs, and housing assistance

Creating strict requirements, making it harder for people to get health care through Medicaid:

• The president’s budget also outlines a vision for massive changes to Medicaid through the approval of waivers that include work requirements, time limits, and eligibility changes
• “Workforce development” and “community engagement” are buzz words to watch in conservatives’ health-related proposals that signal more barriers to care

Remind your members of Congress that you oppose these policies

These are real legislative threats that we could see this year. We stand with all of our partners ready to organize and fight any attempt to undermine health coverage and care.  Today and every day it remains important to deliver the message to Congress on a regular basis that we oppose changes to Medicaid or other key programs that would take coverage away, remove key protections, or make coverage more unaffordable. The continued drumbeat makes a real difference in staving off harmful changes to programs people rely on for life-saving health care.