New Repeal and Replacement Proposal Would End Coverage for Pre-existing Conditions and Essential Health Benefits

UrgentLate last month, the American Health Care Act (AHCA), which would have devastated the Medicaid program and left millions uninsured, was pulled from the House floor. According to an article in today’s New York Times, the majorities in Congress are discussing a proposal to move forward with the bill.

In addition to all of the harmful provisions in the original AHCA, the new proposal would eliminate community rating, which requires insurers to charge the same price regardless of health status, and the requirement that insurers cover a standard minimum benefits package, known as the Essential Health Benefits. These two changes would effectively get rid of the protections for people with pre-existing conditions and allow insurers to put annual and lifetime caps on payment for covered benefits.

There could be a vote to pass a new bill with these amendments as early as this Friday. Please call your Members of Congress at 844.898.1199 and tell them “Don’t take away our health care.”

RulesLast week, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for 2018. According to the press release, the proposed rule includes “reforms that are critical to stabilizing the individual and small group health insurance markets to help protect patients.”

However, many of the policy changes in the proposed rule would harm consumers. For example, a recent analysis from the non-partisan Center on Budget and Policy Priorities explains that the proposed rule would reduce the advanced premium tax credits that help make plans purchased through the Marketplace more affordable for moderate-income individuals in families.

According to the analysis, the proposed rule would result in lower tax credits because it lowers the actuarial value standards for “silver” level plans. This means that premiums and the percentage of costs covered by the insurer would decrease, but deductibles and copayments for consumers would increase. Under the Affordable Care Act, tax credits for consumers purchasing coverage through the Marketplace are calculated based on the second lowest cost silver plan. By allowing for lower value silver plans, the new rule would force consumers to pay more out of pocket to maintain their current level of coverage.

Furthermore, the CMS proposed rule also includes provisions to require consumers to provide supporting documentation for special enrollment periods before they can enroll in coverage. The proposed rule would also permit insurance companies to collect any missed premium payments before allowing consumers to re-enroll. Both of these changes could lead to gaps in coverage for consumers or deter enrollment.

Finally, the proposed rule would reduce the open enrollment period for individual and small group health insurance plans from 13 weeks to 6 weeks, which would give consumer significantly less time shop around for and enroll in the best plan for them.

ProtestJoin members of New York City’s Congressional delegation, City officials, New York health care providers, advocacy groups and patients this Saturday morning at 11:00 AM at Gouverneur Health Auditorium, 227 Madison Street, on the Lower East Side of Manhattan to oppose efforts to dismantle the Affordable Care Act (ACA).

This rally comes on the same day that members of the House across the country are calling for a “National Day of Action” to oppose efforts to “Make America Sick Again.”

We hope to see you there!

HeartsMembers of Congress are debating a repeal of the Affordable Care Act (ACA) and major cuts to Medicaid, Medicare, and other health coverage programs. We know consumers are looking for ways to get involved in the fight for health care.

This Valentine’s Day, HCFANY and partners are launching a Valentine’s Day campaign. Here are the different ways you can participate:

  • Use one of the sample Valentines or make your own and mail them to the district offices of your representative in Congress
  • Use one of the sample Twitter “tiles” and tweet a message to your elected officials on Valentine’s Day asking them to have a heart and save our health care. A list of Twitter handles for New York members of Congress can be found here.
  • If your representative in Congress is already supportive of the ACA, this is a great opportunity to say thank you!

Sample messages and hash tags:

  • This Valentine’s Day, have a heart. Save our health care.
  • Thank you for showing the ACA some love. Happy Valentine’s Day.
  • #SaveOurHealthCare
  • #ProtectOurCare
  • #IfILoseCoverage