The latest effort to repeal the Affordable Care Act would tear a colossal hole in the safety net for the poorest Americans, preventing many people from accessing the comprehensive care they need to thrive – or sometimes simply survive. The repeal would be devastating for homeless New Yorkers.
Among other reforms, the Graham-Cassidy bill would repeal the Medicaid expansion that enabled many low-income people to obtain health insurance and would transition Federal health care funds into a capped allotment that would be distributed to states in the form of a block grant. The proposal to alter the distribution of Federal funds among states would be disproportionately damaging to New York: Estimates vary, but New York State is expected to face a reduction in funds of more than 25 percent relative to current law over the 2020 to 2026 period. Overall, this bill would jeopardize health care coverage for 2.7 million New Yorkers – with the hardest hits felt by poor New Yorkers, children, seniors, and people with disabilities.
Senators are expected to vote on the bill – and decide the fates of millions of Americans – before September 30th. Call your Senators today at (202) 224-3121 and urge them to reject the Graham-Cassidy bill.
By enabling states to waive protections for people with pre-existing conditions and coverage for mental health and addiction services, the bill would be catastrophic for the most vulnerable Americans. The draconian cuts to Medicaid alone would be devastating to the millions of people who rely on this program for health care. The New York Times’ Kate Zernike, Reed Abelson, and Abby Goodnough summarized how the Graham-Cassidy bill aims to remake Medicaid:
The bill would make the most sweeping changes to Medicaid since the program’s inception in 1965. It goes farther than previous Senate proposals, and a bill passed by the House in May, by eliminating the expansion of Medicaid set up by the Affordable Care Act, which has extended the program’s coverage to 11 million more lower-income people, and putting the money into block grants starting in 2020.
The states could use that money for a variety of health care expenses, including creating high-risk pools to cover particularly expensive patients, to create a health care exchange run by the state, or to subsidize the cost of premiums or out of pocket costs for people with private insurance.
In all, Medicaid now covers 74 million Americans, most of them poor but also middle class people with disabilities and in nursing homes. The federal government shares the cost of Medicaid with states, and has traditionally paid between 50 and 75 percent of the costs, with poor states receiving more money. The commitment was open-ended; the government covered its share no matter the cost, or how many people enrolled. The federal government picked up the entire cost of the Medicaid expansion at first, with that share ultimately tapering to 90 percent.
Like previous Republican proposals, Graham-Cassidy would cap traditional Medicaid spending on a per-person basis, based on a complex formula.
It’s hard to overstate the potential effects. Medicaid now provides medical care to four out of 10 American children, and covers the costs of nearly half of all births in the United States, as well as care for two-thirds of people in nursing homes and also for 10 million children and adults with physical or mental disabilities.