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It would not be an exaggeration to say that advocates for preserving the Affordable Care Act are extremely concerned that a Senate bill will pass shortly before the July 4th break.  If that happens and 50 votes are rounded up, passage by the House is very likely.

The Senate language is being held very tight and it is possible a bill will be unveiled just before debate begins and that debate would likely start as close to the July 4th break as possible.  Another call-in day and day of action is likely this week and CWLA will be a part of that effort.

Publicly there were mixed messages on whether Majority Leader Senator Mitch McConnell (R-KY) target date of a vote by the July 4th break would be met but discussions continued between the 13 key Senators.  There have been comments by some Senators such as Senator Rob Portman (R-OH) and Senator Ted Cruz (R-TX) on what they are seeking hinting at compromise but there have been no public descriptions made available for the public and perhaps even some caucus members.

Senator McConnell has said he wants the issue done one way or another by summer since he has other priorities including tax cuts.  One wild card is the special election in Georgia this Tuesday.  If the Republican loses that seat that has been in Republican hands since Newt Gingrich in 1979 and most recently held by HHS Secretary Tom Price, it could create shock waves but even those waves are hard to calculate.

In the meantime, a number of new policy papers and analysis have continued to roll out.  One is a paper by the Center on Budget Policy and Priorities, House ACA Repeal Bill Puts Children with Disabilities and Special Health Care Needs at Severe Risk.

The Center paper highlights that Medicaid provides affordable and comprehensive health coverage to over 30 million children.  The paper points out that 11.2 million children representing 15 percent of all children in the United States have special health care needs, such as autism, Down Syndrome, Cerebral Palsy, depression, or anxiety.   These children often require specialized services and therapies to live a healthy life, such as nursing care to live safely at home, specialized medical equipment, or regular therapy to address physical, behavioral, or developmental illnesses and conditions, which most private insurance plans don’t cover.

The authors point out that the House-passed bill would lower Medicaid eligibility for children aged 6 to 18, and create a per capita cap or optional state block grant that would threaten the very nature of the Medicaid entitlement structure.

Mandated coverages, including youth that have left foster care and are covered by Medicaid to age 26, would fall by the wayside if states hit their annual Medicaid cap and they seek to stretch Medicaid dollars by reducing coverage.

The Center also released, People of All Ages and Incomes Would Lose Coverage Under House Bill, CBO Data Show.  The analysis took data from the CBO analysis of the American Health Care Act and took a closer examination of the projections.  What they found was that all age groups would be losing insurance by 2026.  Three million more children would be uninsured by 2026 and the uninsured rate would increase by 50 percent going from 8 percent uninsured to 12 percent.

It is thought that CBO would require up to two weeks to conduct a fresh analysis of the Senate bill but Senators may be shortening that process by regularly consulting with the Congressional Budget Office (CBO) on provisions.  After CBO issued the new assessment of the American Health Care Act that showed that the amendments made to the original bill costs $32 billion more and will reduce the number of uninsured under the original bill by only 1 million people, CWLA released a letter of opposition based on the modifications. Members are urged to use and adapt the information in that statement, which focuses heavily on how the ACA has expanded access to mental health and substance use treatment.

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