Take Action to Defend Health Care for the Most Vulnerable

The House has introduced the Affordable Care Act (ACA) "repeal and replace" legislation, called the American Health Care Act. The legislation proposes not only to make major changes to the insurance coverage provisions of the ACA — eliminating the individual and employer mandate, premium tax credits, and cost-sharing subsidies — but also to fundamentally restructure the Medicaid program. The legislation has now been approved by the House Energy & Commerce and Ways & Means Committees and is expected to be taken up in the House and Senate in the coming weeks.

CHA (Catholic Health Association) strongly opposes the American Health Care Act, which asks the low-income and most vulnerable in our country to bear the brunt of the cuts to our health care system.

Specifically, we oppose the proposal to cap federal Medicaid financing beginning in FY 2019, thereby eliminating the federal-state shared financing partnership for the Medicaid program. Medicaid is already a lean program, with spending per beneficiary considerably lower than private insurance and growth in spending per beneficiary slower than private insurance. 

Capping the federal financing for the Medicaid program, whether through per capita caps or block grants, fundamentally undermines the health care safety net and will lead to major reductions in benefits and coverage for vulnerable individuals and families.

We urge you to contact your Representatives and Senators and urge them to oppose this legislation as currently drafted. Specifically, urge them to:

1. Reject the proposal to cap federal Medicaid financing with a "per capita cap."
   • Capping Federal Medicaid dollars will:
     • Cause major reductions in benefits and coverage for vulnerable individuals and families.
     • Sharply reduce federal payments and shift costs onto states, health providers and beneficiaries
     • Shift the risk of all costs above the cap to the states, including:
       • public health crisis like the opioid epidemic;
       • increased mental and behavioral health services;
       • new drugs or medical advances; and
       • natural or man-made disasters such as hurricanes, tornadoes or lead poisoning
     • Lock in federal funding levels based on earlier state benefit choices, constraining new investments
   • For those in Medicaid expansion states, capping Federal funds will:
     • End the state's enhanced Federal matching rate for new enrollees as of Jan. 1, 2020
2. Ensure health care coverage is available and affordable for all
   • Adjust the proposed tax credits to ensure affordability, especially for low-income individuals and families, by basing them on income in addition to age
   • Eliminate the 30% increase in monthly premiums for those who are unable to maintain "continuous" health insurance coverage, including individuals with pre-existing conditions

For more information about the legislation, see the House Ways & Means Committee notice and Energy & Commerce Committee notice.

You can reach congressional offices through the Capitol switchboard at (202) 224-3121.

In addition, a sample letter is available on e-Advocacy.

Thank you for your attention to this urgent matter, and for all that you do to support Catholic health care.