Are McSally's improvements on the American Healthcare Act enough?

I appreciate McSally's efforts, but they are really just band-aids that don’t help much. The Medicaid “delay” just puts the most pain after the next Presidential election, CPI-MED+1 just increases the state block grants by 1%, and how much healthcare can a person in the age range where they are most likely to need health insurance buy with $4000 in tax credits? Money they don’t get back until the middle of the following year. It’s all lipstick on a pig. What do you think?


REP. MCSALLY FIGHTS FOR CRUCIAL IMPROVEMENTS DURING AHCA NEGOTIATIONS

March 20, 2017 Press Release

WASHINGTON, D.C. – U.S. Representative Martha McSally today declared her support for an amended version of the American Health Care Act of 2017 (AHCA). After weeks of advocating for specific changes to the legislation on behalf of her constituents, Rep. McSally successfully negotiated for revisions to the legislation that are victories for Southern Arizona—including billions in increased resources for states to provide robust coverage for the most vulnerable.

“The Affordable Care Act (ACA) has been an unmitigated disaster in Arizona—leaving us without real choices statewide. The exchanges for 14 of the state’s 15 counties are devoid of competition because they are left with only a single insurer selling coverage. However, the transition to a new system will take time and those on Medicaid and ACA exchanges deserve continuity and stability during the transition,” stated Representative McSally. “Over the past weeks, I have proposed detailed, specific changes to the AHCA that would provide better coverage and a stable transition for seniors, the disabled, children, and middle class families. Through lengthy negotiations with House leadership and the executive branch, I am pleased to have played a role in moving this bill in the right direction. I’m thankful leadership heard my concerns and worked with me to adopt these recommendations to ease the transition to a system that increases choice and access while bringing down health care costs. AHCA is not perfect and I still have concerns, but I will continue to work closely with Senators McCain and Flake, Governor Ducey, local stakeholders, and constituents to strengthen the AHCA while supporting other thoughtful bills throughout the legislative process.”

Speaker Ryan said, “I appreciate Rep. McSally’s support on the AHCA. Her unwavering commitment to her constituents and her tenacity throughout the negotiating process has led to positive changes and I believe this is a better bill as a result of her involvement.”

Rep. McSally and Rep. MacArthur sent a letter today to leadership requesting that three crucial provisions be included in the AHCA which would directly benefit her constituents in Southern Arizona. This culminates weeks of discussions with House leadership, Health and Human Services Secretary Tom Price, Vice President Pence, and others. As a direct result of her advocacy, a revised version of the bill was filed tonight which included all three provisions.

The text of the letter can be found below:

The Honorable Paul D. Ryan
Speaker of the House
H-232, United States Capitol
Washington, DC 20515

Dear Mr. Speaker,

As we work to finalize the House version of the bill that will be the first step in replacing the Affordable Care Act (ACA) with a better system that increases choice and access while bringing down the cost of health care, we have some concerns with the American Health Care Act (AHCA) in its current form.

As you are aware, the ACA has had an especially harmful impact on our states and has nearly destroyed the market for individual health insurance plans. Neither Arizona nor New Jersey residents have real choices and their insurance premiums have increased to an unacceptable degree - Arizona being the highest in the nation over the past year. It is clear that our healthcare system must be repaired.

We write to bring to your attention a few issues in the AHCA that are of great concern to us and our constituents.  The transition from the ACA Medicaid expansion to the Medicaid system with more state control and flexibility, as well as the individual market stabilization measures in the AHCA, will already be complex and take time. In order to prevent unnecessary hardship to low- and middle-income people, and to states, the Medicaid expansion not be moved up—as some have suggested—and remain at December 31, 2019, and that individual enrollment in expansion not states be frozen between now and December 31, 2019.

Making the transition before 2020 will make it more difficult for states and beneficiaries to adapt and potentially leave some people on the edge of poverty and at risk of falling through the cracks.
To ensure that the most vulnerable in our communities continue to have access to the health care they need, we request that states be given additional resources to provide robust traditional Medicaid coverage. The AHCA’s per-capita caps are supposed to increase by the consumer price index for medical care (CPI-MED), but we believe this is inadequate—especially for elderly and disabled Medicaid enrollees.

The per-capita allotments to states for elderly and disabled Medicaid enrollees should be increased by CPI-MED +1%. This will give additional resources to states and provide added flexibility to adjust to the new per-capita cap system and continue to provide high-quality care through their Medicaid programs.  The new tax credits created by the AHCA are simply too small for older Americans ages 50-64. These individuals, many living on fixed lower incomes, cannot afford to pay additional amounts to purchase quality health insurance.

We understand that other initiatives in the AHCA and administrative actions by the Department of Health and Human Services (HHS) are intended to bring down the cost of plans, but this gap between the ACA subsidies and the AHCA tax credits is too large for ages 50-64. As is, we are concerned that many in this age bracket could lose coverage and access to health care, likely increasing their vulnerability and decreasing their health.

As such, the tax credits provided for ages 50-64 must be increased, ideally by at least $2000 per year, which will cost around $85 billion over ten years. We must find a way to accomplish this.

Thank you for your work on the AHCA. Please carefully consider the impact of this legislation, and work to address the concerns we have communicated in our many meetings and in this letter. We sincerely hope that you will continue improving this legislation so that it can truly offer Arizonans, New Jerseyans, and all Americans additional choices, lower costs, and increased access to high quality, affordable health care.