Yesterday, Senate Republican leaders released the draft text of the Better Care Reconciliation Act, their legislation to repeal and replace the Affordable Care Act (ACA).  The Senate has been working to draft the bill for several weeks since the House passed its ACA bill, called the American Health Care Act (AHCA), in early May.  While the Senate bill makes some improvements to the House bill – it would not allow plans charge premiums based on health status, for example – it includes several provisions that would harm the bleeding disorders community.  In general, the bill will increase premium and out-of-pocket costs to individuals, while providing them with plans that cover less of the services they need.  In particular, the bill will:

  • Allow states to define the essential health benefits (EHBs).  EHBs ensure access to broad coverage and important patient protections only apply to services defined as EHBs, including the elimination of lifetime limits. Changes to EHBs would seriously undermine the ban on lifetime and annual caps and the annual maximum for out-of-pocket expenses.
  • Repeal the Medicaid expansion and making significant cuts to Medicaid financing that could cause many individuals in our community to lose coverage as states limit benefits or reduce eligibility in response to budget cuts.
  • Change tax credits so they are tied to less generous coverage, and letting states change rules for the medical loss ratio (the proportion of premiums that have to be used on health care services) will lead to costs increasing for people who actually use healthcare coverage. It will cost more to buy a plan that covers less.   

For these reasons, NHF opposes the legislation.  Since it could go to a vote as early as next week, NOW is the time to call your Senators to tell them to vote NO on BCRA! Given the partisan split in the Senate (52 Republicans to 48 Democrats), if more than 2 Republican Senators vote no on the bill, it will fail. Your calls could not be more important!

Here is what to do:

Enter your address here and you will be able to see contact information for your Members of Congress.  Call your two Senators and once you reach a staff person or voicemail system, use the following talking points to tell your story:

  1. As a member of the bleeding disorders community, you are calling to discuss the Senate’s health reform bill, BCRA. 
  2. I oppose the bill because it allows states to define the essential health benefits (EHBs). EHBs ensure access to broad coverage and several patient protections only apply to services defined as EHBs, including the elimination of lifetime limits. Changes to EHBs will allow lifetime and annual caps to return. 
  3. I also oppose the bill’s Medicaid policies. Changes to the Medicaid expansion and Medicaid financing could cause many individuals in our community to lose coverage as states limit benefits or reduce eligibility in response to budget cuts. Approximately one third of our community is insured by Medicaid.
  4. In addition, many of the changes in this bill, including those to the tax credits and medical loss ratio determination, have the potential to increase premium and out-of-pocket costs to individuals while providing them with plans that cover less of the services they need.
  5. Please vote NO on the BCRA!

You can also send an email to your Senators’ offices using the contact forms on their websites.  If you have participated in NHF’s Washington Days and have the contact information for the staffers with whom you have met, please contact them directly.

If you have any questions about NHF’s policy efforts, please email us at: advocate@hemophilia.org.