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Statement: NASW strongly opposes legislation to repeal Affordable Care Act

House Speaker Paul D. Ryan presents the first version of the American Health Care Act. Photo courtesy of Reuters.

House Speaker Paul D. Ryan presents the first version of the American Health Care Act. Photo courtesy of Reute

The National Association of Social Workers (NASW) strongly opposes legislation to repeal the Affordable Care Act because it would have a devastating impact on the health of our nation’s most vulnerable citizens and make it more difficult to provide affordable health care for poor and low-income Americans.

The House today narrowly passed a revised version of the American Health Care Act (AHCA) by a vote of 217-213. The revisions included new amendments that were fashioned to appeal to both conservative and moderate members of the Republican majority.

A change which is being referred to as the Upton Amendment – named after the Congressman who introduced the new language — adds $8 billion to cover costs for the “risk pool” of persons with pre-existing medical conditions.

While the changes were successful in garnering sufficient votes to pass AHCA they did nothing to alleviate the devastating impact of AHCA on the nation’s most vulnerable citizens.  In fact, the bill passed today will likely exacerbate the challenge of providing affordable health care for poor and low-income Americans.

The following helps to explain why:

  • The $8 billion in the Upton-Long Amendment is woefully insufficient to cover high-risk pools. According to the Center for Budget and Policy Priorities, over a 10-year period the $8 billion increase would not be enough to cover funding shortfalls for the states of Michigan, Missouri, and Colorado, let alone being able to take care of the risk pool shortfalls for the remaining 47 states.
  • In its current iteration, AHCA allows states to choose to “opt-out” of covering pre-existing conditions of enrollees. In the states that choose not to guarantee coverage for pre-existing conditions, persons with life-threatening ailments, pregnant women, and older adults would have to pay exorbitant premiums for insurance coverage or not be able to obtain coverage at all. The AHCA segregates sick people in high-risk pools with those who are even sicker. In the past, such approaches have led to coverage with very high premiums, benefit exclusions, annual and lifetime limits, and other problems.
  • The bill also decimates Medicaid allocations to states with more than $800 billion in budget cuts. This will deeply limit access to health insurance for individuals between the ages 55 and 64, younger people with disabilities, and children. We should be reminded that Medicaid subsidizes care for half of the children born in America in each year.
  • The House version of AHCA continues to be committed to discontinuing Medicaid enhancements and Medicaid expansion after 2019. This will mean that most of the 31 states (and Washington, D.C.) that have ACA’s Medicaid expansion will soon drop it. The 11 million people who were covered through Medicaid expansion will likely become uninsured.
  • In the face of the opioid overdose and suicide epidemics, it is essential there be equitable access to a full continuum of mental health and substance use disorder treatment services. Substance use disorders and mental illness should also be covered on par with other medical conditions.

The House passed their version of the AHCA without it being “scored” by the Congressional Budget Offoice (CBO). Therefore, we have no idea of the cost of this legislation.

More importantly, we do not have a CBO analysis of the human impact of the provisions in AHCA.

Without a doubt, the gutting of $800 billion from Medicaid will leave millions of single adults uninsured, as well as greatly reduced access to health care for millions of low-income children and their families.

We must now turn to the United States Senate to right the wrong caused by the House version of AHCA. NASW and other health care advocates must use their resources and energy to ensure the Senate strips out provisions in AHCA that are most devastating to vulnerable Americans.

25 comments

  1. Kathryn C Wehrmann

    Thank you for your leadership in opposing this legislation!

  2. Let’s write our congressmen & women Immediately. Social Workers Unite

  3. I agree with NASW.

  4. All Americans should have access to health care insurance including pre-existing conditions, and low income families.
    Premiums should not be raised if a person has a condition or illness.
    I agree that Obamacare has some kinks but again we are jumping the gun just to push something through the senate and house.

    • Under Obamacare my premiums were raised 500% without pre-existing conditions

      • Thank you, Rick, for your post. Increase cost is why ACA needs to be fixed not repealed and replaced by people who think nothing of cost or coverage as they receive all of their healthcare needs at the expense of taxpayers like you and me.

      • Mine also. The lowest premium is $1,018.00 per month in the state of PA. I have no pre-existing conditions.

  5. Every social worker who is represented by Republican member of Congress needs to make clear their opposition to this vote, their accountability and that all efforts will be made to ensure that they lose their seat in the next election.
    Every health care worker needs to protest and make their voice heard.
    I hope that insurance companies will make it their first act to withdraw medical insurance from members of Congress and their families who are over 50, have pre-existing conditions, are pregnant, or have a disability.
    Shame on Congress – we mustn’t let them enjoy their delusion that they have done something right.

  6. This is such a sad situation and it reveals the privilege that many of the Washington elite experience when the voices of the nation are ignored and the most vulnerable populations are harmed for the sake of lining the pockets of corporate America.
    I cannot believe that anyone would be in support of this due to it having such a significant impact throughout the country there will not be a family that is not touched by the harm this bill will accomplish

  7. Eileen Matos, LCSW

    This is all for a new President who is preening his feathers with grandiosity and no understanding of the needs of the people.. He continues to divide our country and now he is going to do it along the health care lines. His need to make changes without understanding consequences to his ACTions will drive us into a major crisis that will affect the most vulnerable of our populations .

  8. The bill does have pre-existing conditions. I disagree with the statement that the president is dividing the country, was already divided. There are SW like myself who voted for this president. Again, “this is not about parties.”The sooner we all get over that, and come together as Americans, the division will stop. Take it from am immigrant, woman and a minority, who has always voted democrat. It is insulting to Sw who actually voted for this president.

    • The bill includes pre-existing conditions until the person is unemployed for more than 2 months. This is a reality for more than 30 million people each year. What about the cuts to mental health and addiction services or the very likely end to school Medicaid reimbursement for meeting the needs of children with disabilities?

      There are so many areas that overlap the populations we serve that are harmed by the AHCA. Calling for people to “come together” does exactly NOTHING to address these issues. All it does it try to place you in some weird place of above politics or partisan thinking. It is self-serving and addresses zero needs of anyone impacted by the AHCA. You voted for the man, good for you.

    • Yes Terryann,

      Those who lead Social Workers seem to think that we must all be democrat and agree with everything democratic that gets put out there. I have now read several versions of what this bill does and does not do and have no idea which information is accurate. I don’t necessarily believe this just because it’s from my professional organization and that’s sad.

    • I am curious about why anyone who would vote for this character would be in a helping profession at all, frankly. I’m baffled.

  9. Ronald Ferraro

    The point here is that while the ACA is not perfect from my perspective, the AHCA as proposed and passed by the House is significantly worse than what existed before ACA. I believe that government has a responsibility to guarantee health care coverage, not just make it available to the better off among us.

  10. Check this out on youtube, Rand Paul explains so well…as always.
    Sen. Rand Paul on House Health Care Bill May 4th, 2017

  11. Shame on the Portion of Congress who knowingly are opting to betray the elderly and other most vulnerable Americans. If they think this is such a good coverage, I say let’s make sure this ends up being their coverage.

  12. Health Care should be a right not a privilege.

    Congress should ensure that all Americans are guaranteed to have at least the same medical coverage that they have voted for themselves.

    • Health care is already a right. Third party payor coverage is not a right, but a good to be purchased by individual choice. One size does not fit all, when it comes to any type of insurance, including health insurance. I hope the Senate version opens the market between states, includes tort reform and allows consumers to purchase the health plans that best fit their needs.

      • After twenty years of working in the medical sector – home health, inpatient and outpatient services – I can tell you that healthcare is not and has never been “a right” in the United State, though it should be. People are denied care every day- perhaps not in the emergency room, but for primary care, rehabilitation, substance abuse treatment, specialty care, dental care, reproductive care. Providers can and do say “no” to patients who don’t have the right insurance coverage (for seniors, that means Medicare plus a strong supplemental policy). Often, providers will not even consider private pay arrangements. “The market” is not going to provide for poor and low income, or middle class folks, for that matter. That is the big lie that is being spread through right wing media.

  13. We need to put a copy of the actual bill out here for people to read. I have read several versions of what people are saying the bill does and doesn’t do, and they are definitely not the same. I never know who to believe anymore and that’s sad. Are people responding to what someone says the bill does or have they actually read it?

  14. Thanks for finally talking about > Statement: NASW strongly opposes legislation to repeal Affordable Care Act | socialworkblog.org < Liked it!

  15. Laura Walter Forstat

    Please pay attention. This is harmful and shortsighted legislation that will have far reaching implications. You think you are safe? Think again.

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