The Health Cost of Fighting For Healthcare

August 10, 2017 | Emily Kovalesky, 2017 AAPD Summer Intern

In July, there was a vote to repeal the Affordable Care Act. As an AAPD Intern placed in the United States Senate I could not have been more in the thick of things when the vote took place. Because of the possible repeal and replace, repeal only, and skinny bill many people faced losing insurance coverage, increased costs, and loss of Medicaid. The energy that week was intense. I was surrounded by protesters, friends, colleagues, and more. I was going in to work early and leaving late. I brought pizzas to ADAPTers camping out. I attended the NCIL rally on the Capitol lawn. I attended the ADA Anniversary press conference that 4 senators spoke at. I watched debates in the senate gallery until 11pm and then stayed up until 2am the night of the actual vote. I did everything I could to try to make a difference in the fight for healthcare. I still am because I know the fight is not over, just on temporary slowdown. Because of this, my body is in a highly sensitive state.

What people don’t tell you is how tiring it is from a disability standpoint. The people fighting for their lives are the people who do not necessarily have the energy to be doing so. For some people in the office it was just another day of chaos, maybe a little more emotional than usual. For the other interns in my senate office it was just an exciting week to be working. For me…it was draining, exhausting, mostly depressing, but mandatory. I could not sit back and take in the moments as an important political debate. I had to be as involved as possible because, not only my care but, many of my closest friends and allies’ care was on the line. Being involved and fighting for what I need meant using up energy that my body didn’t necessarily have. As someone with chronic health conditions, including genetic and autoimmune disorders, my body does not necessarily take well to being pushed. But, when you are fighting for your rights, you have to push. Everyone that week was pushing. People I know who were in the same health state as me, pushed to their limit. This included both physical and mental health limits. Despite limits being crossed, people had no choice but to keep fighting and face the consequences from their body later on. It is quite ironic that some faced requiring more medical care because of the fear of losing their medical care. Rights should not come at the cost of health. Healthcare rights should definitely not come at the cost of health.

 

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Emily Kovalesky is a 2017 AAPD Summer Intern placed with Senator Bob Casey (D-PA).

We Did It! Harmful Healthcare Repeal Efforts Fail

July 28, 2017

Late last night the latest Senate healthcare repeal effort – known as the “Skinny Repeal” – failed to pass, bringing an end (for now) to these harmful healthcare repeal efforts. After Senator McCain cast the final deciding vote, Majority Leader McConnell announced that the Senate would be moving on to the National Defense Authorization Act and other legislative efforts.

This victory was the result of tireless advocacy efforts and protests from the disability community and our allies. Our community made a difference by rallying together. You made a difference.

Thank You!

We know these past few months have been a whirlwind of various repeal bills and we greatly appreciate your continued advocacy to save Medicaid and other essential health services by keeping the Affordable Care Act in place.

Please also take a moment to thank all of the Senators who voted no, especially Senators Collins, McCain, and Murkowski for protecting our care.

It would be naive to think this fight is over for good, but take some time to rest and celebrate this victory. You can count on AAPD and our allies to closely monitor and fight against any activities on Capitol Hill that threaten the lives and liberty of people with disabilities.

 

Action Alert! We’re not out of the woods yet on Healthcare

Please continue visiting, calling, tweeting, and emailing your Senators!

July 20, 2017

Thank you so much for all of your advocacy over the past few weeks to protest the American Health Care Act and Better Care Reconciliation Act – together we sent the message loud and clear that we will not sit idly by as our healthcare and services are stripped away. Your advocacy made a difference!

Unfortunately, the Senate is still not listening. The effort to repeal the Affordable Care Act (ACA) and harm Medicaid is back again with two new versions.

The Senate’s “Better Care Reconciliation Act” (BCRA) and a new bill, the “Obamacare Repeal Reconciliation Act” (ORRA), are being readied for a vote next week. It is unclear which bill the Senate will move on at this point, but we expect a “motion to proceed” sometime next week — likely Tuesday or Wednesday. These bills are harmful to people with disabilities for many reasons.

  • The ORRA cuts taxes on the rich by removing health care from the poor and middle class
  • The ORRA would eliminate health care coverage for 32 million people by 2026; 17 million by next year (Congressional Budget Office)
  • The ORRA would increase health care plan premiums by at least 100%
  • The ORRA stops all Medicaid expansion at the end of 2019 (Center on Budget and Policy Priorities)
  • The BCRA guts Medicaid by cutting over $700 billion
  • Both bills make it harder to provide home and community based services by eliminating the Community First Choice option for Medicaid
  • Both bills eliminate the protections against discrimination for pre-existing conditions
  • Both bills eliminate the requirement for essential health benefits (which include prescription drugs, mental health services, rehabilitative and habilitative services, and devices, and more)
Bar graph developed by the Center on Budget and Policy Priorities to highlight how ACA Repeal-Without-Replace Would Lead to 32 Million Losing Coverage and Individual Market Collapse. The increase in uninsured would be 17 million the first year after the bill is enacted, 27 million after three years, and 32 million by 2026. Premiums would increase by 25% the first year after the bill is enacted, by 50% after three years, and by 100% by 2026. The share of people living in areas with no individual market insurers would be 10% the first year after the bill is enacted, 50% after three years, and 75% by 2026.

ACA Repeal-Without-Replace Would Lead to 32 Million Losing Coverage and Individual Market Collapse (Center on Budget and Policy Priorities)

 

Vertical bar graph produced by the Congressional Buget Office to show the Net Effects of the Obamacare Repeal Reconciliation Act of 2017 on the Budget Deficit. The repeal of Medicaid expansion woudl cut Medicaid funding by $842 billion. Termination of subsidies for nongroup health insurance would decrease the budget deficit by $454 billion due to cutting tax credits and selected coverage provisions. Reduced collections of penalty payments from employers and uninsured peopel would add $210 billion to the budget deficit. Repeal of taxes on high-income people, the annual fee imposed on health insurers, and excise taxes enacted under the ACA would increase the budget deficit by $613 billion. Overall the ORRA would reduce the budget deficit by $473 billion.

Net Effects of the Obamacare Repeal Reconciliation Act of 2017 on the Budget Deficit (Congressional Budget Office)

 

 

Take Action!

Everyone needs to continue visiting, calling, tweeting, and emailing their Senators to tell them to vote no on the motion to proceed to consider these bills. All Senators must understand the damage this bill will do to the lives and liberty of people with disabilities and their families. We are grateful for all the advocacy you have already done – it has been effective. Please, keep it up!

 

Contact your Senators

The message is clear:

“Senator _____ must reject any bill that causes large coverage losses, ends the Medicaid expansion, caps and cuts the Medicaid program, or guts critical protections for people with health conditions.”

Toolkit to ADAPTandRESIST to SaveMedicaid – ADAPT

Focus on telling stories when you meet with, call, or contact your Senators. Write stories or record brief 60-90 second videos about you, your child, your parent, your relatives, or your friends who have a disability and need the support of Medicaid and health care. Include pictures. Share these stories on Facebook and Twitter and ask your friends and family to do the same. Our Senators need to see the human face of Medicaid.

The most effective outreach is to meet with your Senator (or their staff) in-person. When you do so, share your story of how access to health care and home and community-based services are important to you or your loved ones with disabilities. Those stories will particularly be impactful.

Contacting Congress allows you to easily search for your Senators and access information on their D.C. offices.

 

Engage your Senators through Social Media

Tweet your Senators and use the hashtags #SaveMedicaid, #NoCutsNoCaps, #ProtectOurCare, #ADAPTandRESIST, #KeepAmericaCovered, and/or #CoverageMatters

Sample Tweets:

[insert your Senator’s Twitter handle] Over 10 million people with disabilities rely on #Medicaid for healthcare coverage. Please – #ProtectOurCare & #SaveMedicaid.

[insert your Senator’s Twitter handle] Don’t allow insurers to discriminate against people w/ disabilities because of pre-existing conditions. #ProtectOurCare

[insert your Senator’s Twitter handle] The #BCRA is a threat the life, liberty, and independence of people with disabilities. #ProtectOurCare #SaveMedicaid

[insert your Senator’s Twitter handle] Medicaid provides essential services to millions of people with disabilities. #SaveMedicaid #NoCutsNoCaps

[insert your Senator’s Twitter handle] Repeal without a replacement is not an option! #SaveMedicaid #NoCutsNoCaps #ProtectOurCare

 

States to Target:
  • Arizona
  • Alaska
  • Colorado
  • Indiana
  • Maine
  • Nevada
  • North Dakota
  • Ohio
  • Pennsylvania
  • West Virginia

Please be sure to thank Senators Capito (R-WV), Collins (R-ME), and Murkowski (R-AK) for their commitment to not vote for a repeal bill without a replacement.

 

Contact your Governors

While Senators have the most direct influence on the legislative future of the BCRA and ORRA, contacting Governors is another great way to put additional pressure on Senators. You can find contact information for governors here.

 

Social Media Graphics:

You are welcome to use any of the graphics below as part of your social media outreach. Thank you to SuMo Design Workshop for pulling these together!

 

Additional Resources and Analyses

 

Previous AAPD Healthcare Action Alerts

 

Action Alert! Senate Delays Healthcare Vote – Keep Up the Pressure!

June 30, 2017

After days of fierce advocacy by the disability community and our allies – a special shout-out to ADAPT activists in DC and around the country – Senate Majority Leader Mitch McConnell (R-KY) delayed the vote on the Better Care Reconciliation Act (BCRA) until after the July 4th recess.

The BCRA would repeal the Affordable Care Act (ACA) and threaten the lives and independence of people with disabilities. The Congressional Budget Office (CBO) estimates that the BCRA would cut Medicaid by $772 billion and that 15 million people will lose Medicaid coverage over the next 10 years.

The bill would change the Medicaid system to a per capita cap, which would limit the amount of funding states receive each year, leaving individual states to decide if they limit the amount of services they provide, limit the number of people they cover, or some combination of both. Either way, millions of people with disabilities would lose the services that allow us to go to school, work, and live in our communities.

The Senate vote on this bill was delayed, but the fight is not over yet! We saw this scenario play out with the House bill in May – after the initial bill did not have enough support to pass, the bill was tweaked to appease certain Members and it passed. We can’t let that happen with the Senate bill. NO tweaks can fix this bill!

We can’t get complacent! Call, visit, tweet, and email your Senators to tell them to VOTE NO on the BCRA! If your Senator has stated they won’t support the bill, thank them and ask them to hold firm on their stance. If you have already contacted your Senators reach out again! Every Senator needs to hear from the disability community that this bill is a threat to our life, liberty, and independence.

 

TAKE ACTION

Engage your Senators In-Person

The Senate is on recess beginning today (6/30) through Sunday (7/9). Take advantage of this time to engage your Senators during town halls, July 4th parades, barbeques, office visits, etc. You can find public events for Members of Congress all across the country thanks to the Town Hall Project.

The message is clear: “Senator _____ must reject any bill that causes large coverage losses, ends the Medicaid expansion, caps and cuts the Medicaid program, or guts critical protections for people with health conditions.”

When you meet your Senators in-person, share your story of how access to health care and home and community-based services are important to you or your loved ones with disabilities. Those stories will particularly be impactful.

 

Call, Tweet, and Email your Senators

Contacting Congress allows you to easily search for your Senators and access multiple methods to contact them (phone, email, Facebook, Twitter, etc.) and addresses of their home state offices.

 

Senators to Target

It is important to contact the Senators in your state. In addition to that, we are also focusing on these Senators, which we believe are critical to stopping this bill:

Primary:
  • Portman (OH)
  • Capito (WV)
  • Moran (KS)
  • Paul (KY)
  • Murkowski (AK)
  • Collins (ME)
  • Heller (NV)
  • Johnson (WI)
  • Lee (UT)
Secondary:
  • Flake (AZ)
  • McCain (AZ)
  • ·Cassidy (LA)
  • Cruz (TX)
  • Gardner (CO)
  • Daines (MT)

 

Engage Your Senators on Twitter

Tweet your Senators and use the hashtags #ProtectOurCare, #SaveMedicaid, #ADAPTandRESIST, #NoCutsNoCaps, #KeepAmericaCovered, and/or #CoverageMatters

Sample Tweets:

[insert your Senator’s Twitter handle] Over 10 million people with disabilities rely on #Medicaid for healthcare coverage. Please – #ProtectOurCare & #SaveMedicaid.

[insert your Senator’s Twitter handle] Don’t allow insurers to discriminate against people w/ disabilities because of pre-existing conditions. #ProtectOurCare

[insert your Senator’s Twitter handle] The #BCRA is a threat the life, liberty, and independence of people with disabilities. #ProtectOurCare #SaveMedicaid

[insert your Senator’s Twitter handle] Medicaid provides essential services to millions of people with disabilities. #SaveMedicaid #NoCutsNoCaps

 

Social Media Graphics:

You are welcome to use any of the graphics below as part of your social media outreach. Thank you to SuMo Design Workshop for pulling these together!

 

Record Short Videos on the Impact of the ACA and Medicaid

Please share short videos about the impacts of the ACA and Medicaid and consequences of the BCRA. Short 1-2 minute videos from your phone are great. You can do it at home, in the office, while at lunch, etc. You can post to twitter and/or Facebook and tag Senator Bob Casey (D-PA) at @SenBobCasey and #USSpeaksOut. You should also tag your own Senators. Here are the points you can address in your video:

  • Say who you are
  • Where you are from
  • Why saving Medicaid is important/what it does for you or why you oppose the current Senate bill
  • Oppose the current Senate bill
  • Call for Senators to work on a bi-partisan solution to health care

 

Additional Resources and Analyses

 

Action Alert! Last Chance to Tell Your Senators to Save Healthcare

The Better Care Reconciliation Act, the US Senate’s version of the American Health Care Act, is Expected to Come to a Vote This Week

June 27, 2017

Update (6/27/2017, 2:35pm ET): The Senate has delayed their vote on the Better Care Reconciliation Act until after the July 4th recess. We must keep up the pressure! After the House of Representatives delayed their first vote they reorganized and were able to pass their bill. The same thing could happen in the Senate. Please keep calling, visiting, emailing, and tweeting your Senators to tell them not to support this bill!

The Senate’s version of the American Health Care Act (AHCA), the Better Care Reconciliation Act of 2017 (BCRA), was released to the public last Thursday and analyses of the bill are now available. As expected, the Senate’s bill proposes drastic cuts to Medicaid and services that people with disabilities rely on to live. The bill would force more people with disabilities into nursing homes and would increase the chances of people dying due to lack of care. The Senate is expected to vote on this legislation before the 4th of July recess, likely this Thursday (6/29).

Now is the time to contact your Senators to oppose this legislation! These next couple days are our last chance to convince the Senate that this bill is a bad deal for people with disabilities and for all Americans. The Congressional Budget Office (CBO) recently released their nonpartisan analysis of the bill, which estimates a $772 billion dollar cut to Medicaid over the next 10 years. The CBO also estimates that an additional 22 million more people will be uninsured by 2026, which includes 15 million people who currently receive coverage through Medicaid.

Next steps for the BCRA: voted on by the Senate and then sent to the House of Representatives where it will either have to go through the reconciliation process or be accepted by the House as is.  At the end of this process, the resulting bill will be on President Trump’s desk where it will be signed into law. NOW is the time to make sure your Senators understand the life-saving coverage that people with disabilities receive thanks to Affordable Care Act (ACA) as well as the services and supports provided by Medicaid that enables people with disabilities to go to school, work, and live in their communities.

The BCRA is similar to the House of Representatives’ bill, as shown in the Center on Budget and Policy Priorities’ (CBPP) comparative graphic below:

[Image Description: Graphic with dark blue background. The title says REPUBLICAN HEALTH BILLS: SENATE BILL HAS SAME HARMFUL IMPACTS AS HOUSE. The font for REPUBLICAN HEALTH BILLS: is dark yellow and the font for SENATE BILL HAS SAME HARMFUL IMPACTS AS HOUSE is white. Under the title on the left side of the graphic is a list of impacts and the font is in white. The impacts are: Causes millions of people to lose health coverage; Ends Medicaid expansion coverage for millions of low-income adults; Caps and cuts Medicaid for seniors, people with disabilities, and children; Cuts tax credits and raises premiums by thousands of dollars for many older people; Raises individual market premiums by 20% for 2018; Lets insurers drop coverage for maternity care, mental health, and substance abuse treatment; Cuts health benefits for people with opioid addiction by billions of dollars; Endangers rural hospitals dependent on Medicaid funding; Cuts taxes by more than $50,000 per year for millionaires; Cuts taxes by over $100 billion for drug companies and insurers. Under the title on the right side of the graphic are the words from left to right, House and Senate. The font is in dark yellow. Under each of those is a list of 10 yellow check marks in a white-outlined circle with dark blue background. Each pair of check marks are on the same level as its corresponding impact to the left which was previously described. Each level is separated by a faint, thin white line. On the bottom right corner of the graphic is the source in small, faint light-blue font: Center on Budget and Policy Priorities I CBPP.org]

[Image Description: Graphic with dark blue background. The title says REPUBLICAN HEALTH BILLS: SENATE BILL HAS SAME HARMFUL IMPACTS AS HOUSE. The font for REPUBLICAN HEALTH BILLS: is dark yellow and the font for SENATE BILL HAS SAME HARMFUL IMPACTS AS HOUSE is white. Under the title on the left side of the graphic is a list of impacts and the font is in white. The impacts are: Causes millions of people to lose health coverage; Ends Medicaid expansion coverage for millions of low-income adults; Caps and cuts Medicaid for seniors, people with disabilities, and children; Cuts tax credits and raises premiums by thousands of dollars for many older people; Raises individual market premiums by 20% for 2018; Lets insurers drop coverage for maternity care, mental health, and substance abuse treatment; Cuts health benefits for people with opioid addiction by billions of dollars; Endangers rural hospitals dependent on Medicaid funding; Cuts taxes by more than $50,000 per year for millionaires; Cuts taxes by over $100 billion for drug companies and insurers. Under the title on the right side of the graphic are the words from left to right, House and Senate. The font is in dark yellow. Under each of those is a list of 10 yellow check marks in a white-outlined circle with dark blue background. Each pair of check marks are on the same level as its corresponding impact to the left which was previously described. Each level is separated by a faint, thin white line. On the bottom right corner of the graphic is the source in small, faint light-blue font: Center on Budget and Policy Priorities I CBPP.org]

 

A Glimpse on the CBO’s Analysis of the BCRA

  • Millions more people will lose health insurance over the years under the BCRA:
    • 2018: 15 million
    • 2020: 19 million
    • 2026: 22 million
  • For people under 65, total number of uninsured by 2026 under BCRA: estimated 49 million (in contrast to 28 million under current law)
  • Medicaid Enrollment by 2026 for people under 65: About 16% lower
  • Increases in premiums under the BCRA vs current law: 20% in 2018 and 10% in 2019
  • Average premiums under the BCRA will be 30% lower in 2020, but deductibles will be higher.

 

Take Action

Since the Senate bill could be voted on by Thursday, June 29, you must connect with your Senators NOW. You can:

Call, Visit, and Email your Senators

Contacting Congress allows you to easily search for your Senators and access information on their offices.

 

The key states and target Senators we are focusing on are:

  • Maine:  Collins
  • Alaska:  Murkowski and Sullivan
  • Nevada:  Heller
  • West Virginia:  Capito
  • Colorado:  Gardner
  • Louisiana:  Cassidy
  • Arizona:  Flake
  • Ohio:  Portman
  • Pennsylvania:  Toomey
  • Montana:  Daines
  • Nebraska:  Fischer and Sasse
  • Missouri: Blunt
  • Wisconsin:  Johnson
  • Indiana:  Young
  • Georgia:  Isakson
  • Alabama:  Shelby
  • South Carolina: Graham
  • Florida:  Rubio

Continue to share your stories with Member offices as well as through op-eds, newsletters, and letters-to-the-editor. Everyone needs to hear a story of how Medicaid cuts will harm children, families, adults with disabilities, service providers, schools, communities, state budgets, and workplaces. Without Medicaid, all of our institutions and every family in America will suffer.

 

ADAPT Actions and Resources:

 

Engage Your Senators on Twitter

Tweet your Senators and use the hashtags, #ProtectOurCare, #SaveMedicaid, #NoCutsNoCaps, #ADAPTandRESIST, #KeepAmericaCovered, and/or #CoverageMatters

Sample Tweets:

[insert your Senator’s Twitter handle] Over 10 million people with disabilities rely on #Medicaid for healthcare coverage. Please – #ProtectOurCare & #SaveMedicaid.

[insert your Senator’s Twitter handle] Don’t allow insurers to discriminate against people w/ disabilities because of pre-existing conditions. #ProtectOurCare

[insert your Senator’s Twitter handle] The #AHCA would leave people w/ disabilities & millions of others without healthcare. #ProtectOurCare & #KeepAmericaCovered

 

Social Media Graphics:

You are welcome to use any of the graphics below as part of your social media outreach. Thank you to SuMo Design Workshop for pulling these together!

Don’t Take Our Healthcare Graphics – MoveOn.org

Preexisting Condition Graphics

 

Additional Resources

  • Congressional Budget Office’s Analysis Report on the Better Care Reconciliation Act of 2017
    The Congressional Budget Office released their analysis report on Monday, June 26, 2017, to provide an explanation on the effects that the BCRA will have on the economy and the people’s access to health care. This webpage contains the overview of the report and the report document itself.
  • A Self-Advocate’s Guide to Medicaid
    The Autistic Self Advocacy Network (ASAN) recently released their third plain language advocacy resource: A Self-Advocate’s Guide to Medicaid. This guide has six parts: Medicaid introduction and background, Who Can Get Medicaid?, What Does Medicaid Pay For?, Medicaid funding, What Could Happen to Medicaid?, and a summary and glossary explaining the terms used in the toolkit.
  • Join the Fight to Protect Medicaid
    The Center for Public Representation developed this website to help people with disabilities, their families, and advocates/allies understand the impact of AHCA and give them the tools to advocate.
  • Protect Our Care Initiative
    Families USA hosts and action center on their website that provides updates on the status of the American Health Care Act as well as an Action Kit to help advocates contact their Members of Congress.

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