The American Health Care Act (AHCA), now called the Better Care Reconciliation Act of 2017 (BCRA), is well on its way to replacing the current law of the land, The Affordable Care Act (ACA). The change of name happened as the bill bounced around the Senate and a new version was published for consideration last week. Even with the changes, for many health care service providers, the passing of this bill means cuts to funding from long-standing programs such as Medicaid.
An initiative of the Trump administration, this proposal would considerably restructure the way states currently receive funding from the Federal government for health care related services. Ultimately, the new structure would cap the amount of federal funding states receive per each person enrolled in Medicaid. This means a significant decrease in federal funding when compared to the current entitlement-style program that takes place under the ACA.
To get an idea of how much of Medicaid is made up by the federal government, in 2015, it made up 63 percent of total Medicaid spending according to a 2016 report by the Office of the Actuary.
For many people with disabilities, their family members and providers, this comes at a bad time. The initiative to provide the option for people to receive essential services in home or community based settings, as opposed to in an institution, has greatly expanded in recent times. In the past 10 years, the number of people on the Home and Community Based Services (HCBS) waiting list has more than doubled.
As of now, more than half of all Medicaid spending for long-term care is now for services provided in the home or in a community based living situation.
As each state works to refine its individual system of support for the massive transition from institution to home and community based support settings, the proposed bill threatens to impede all progress from the top-down.
For now, the Better Care Reconciliation Act of 2017 has yet to gain quite enough support in the Senate – but it’s getting close. A vote is expected to occur shortly after the July 4th holiday.
Many provider organizations are already taking action and you can too. If you or people you know may be affected by this bill, it is possible to voice your concern in this process. Here are some ways to consider:
- The service provider Mosaic has created The Mosaic Allied Voices Action Center, an online tool that makes it easy to contact your state elected official with a statement, which can be found here.
- You can also join the American Network of Community Options and Resources (ANCOR) along with its partners in its “Save Our Services” campaign by checking out their list of materials for taking action, which include instructions for scheduling In-District meetings, attending town halls and inviting members of congress to visit your agency.
- Watch and share the stories behind five people who deeply rely on Medicaid and/or the Affordable Care Act for their daily needs and well-being, as posted by the Arc of the United States, an organization for people with disabilities: Javi, Alice, Bryan, Thelma and Calvin (video).
There is an achievable goal in sight. You, along with others, can influence the Senate to either stop the bill or make the necessary changes that would allow Medicaid to continue funding those who rely on the services it provides.
To see what qualifies as Home and Community Based Settings for long term care, click here.