Senate health bill threatens personal care and individuals with disabilities --RSS Feed

By Julie Alexander, Lead Independent Living Services Coordinator

On Thursday, June 22, the senators who drafted the Senate version of the health care act to replace the Affordable Care Act (or Obamacare) made the bill known to others in the Senate and the public at large. This Senate bill is called the Better Care Reconciliation Act (BCRA), also known as Trumpcare, and has not yet been assigned a number. The bill will mean deep cuts in Medicaid which is a main funding source for personal care and support services for people with disabilities. The BCRA also paves the way for health care to be more expensive for these individuals and the public at large through introducing options that will mean higher deductibles and higher out-of-pocket costs will be part of insurance plans in the future.
News coverage on this issue is plentiful at this time, but it does not include a lot of details. For the bulk of this article, I have obtained information from the National Council on Independent Living, Make It Work Milwaukee, Disability Rights Education and Defense Fund (DREDF), the Survival Coalition of Wisconsin Disability Organizations and Justice in Aging, as well as reading the legislation myself.

Essential Health Benefits and Pre-Existing Conditions
The BCRA/Trumpcare can raise the cost of health care by establishing or modifying what is known as “essential health benefits.” The BCRA allows states to submit to Medicaid requests for waivers, which can change what are considered essential benefits for ALL types of health insurance plans in that state. “Essential benefits” under the ACA, including maternity care, prescription drugs, personal care and options for assistive technology to be paid for (i.e. wheelchairs, walkers, canes and adaptive equipment), may not be part of the mandatory benefits that are covered by the BCRA. If a state decides not to consider an option such as maternity care or personal care as essential, insurance providers will be able to charge higher costs for these services, put life-time caps on things not considered essential or even not offer coverage at all on benefits not considered essential.
People with pre-existing conditions could lose their ability to obtain affordable health care under the BCRA. While the BCRA requires that these individuals be given coverage and charged the same amount for insurance, since states can determine what “essential health benefits” are, individuals may not be able to receive the care they need under the insurance plans that are offered in that state. For example, if prescription drugs are not considered an “essential health benefit,” insurers could decide not to cover expensive cancer drugs in their plans. States would have the option to establish high-risk pools to cover individuals with higher health care costs. Since these high-risks pools will only have individuals with high-cost needs, there is little room for spreading the cost of health care among people with varied health care needs. There are millions of individuals who may lose access to health care because they will not be able to afford care in these high-risk pools.
Personal Care and Support Services and Medicaid
Under current rules that are part of the Affordable Care Act, for every 60 cents the federal government provides for Medicaid, the state of Wisconsin provides 40 cents. Personal care and other supports are paid for regularly because there is always federal Medicaid and state-matched Medicaid to keep services going. This will end if the BCRA becomes law. Federal Medicaid, as a funding source for any services, will be capped according to the BCRA. This means states will only get a certain amount of federal Medicaid per year and once states spend this money, there will be no federal money left for Medicaid to pay for services such as ongoing personal care, health care and other support services.
In Wisconsin, a 25% reduction in funding for health care services such as Family Care and IRIS is predicted for all Medicaid programs under this cap. The state of Wisconsin will have to raise taxes and come up with other plans if the state wants to help alleviate this reduction in some way. If this is not an option in Wisconsin it is unclear what will happen to people needing ongoing care. There are possibilities of waiting lists, more expensive institutional care (Medicaid pays higher costs for this and it may not be totally possible) or individuals may just have to rely on what happened before Medicaid was created. At that time, friends and families were charitable enough to provide care to their loved ones for free. The future is uncertain.
If these issues concern you, you can contact your federal senators to voice your opinion about the new provisions of the BCRA. Tell them about your Medicaid-covered personal care and how it keeps you independent and living in the community. Tell them about the services that support you under the Family Care program, IRIS program, PACE or Partnership because these services also are strongly based on Medicaid being a major funder. Your senators may not know what these programs are or what they mean to you.

Here are some options that you can use to contact our Wisconsin senators.
Contact Sen. Ron Johnson online or by phone at 202-224-5323 V/Relay.
Contact Sen. Tammy Baldwin online or by phone at 202-224-5653 V/Relay.
When calling you may get a person that answers the line and asks for you to provide your message or you may just get an answering machine and it will ask you to leave a message.
If you have any questions please call 414-291-7520 V/Relay.

| Tuesday, 6/27/2017 - 2:49 PM | 0 comments
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