September 22, 2017

The U.S. Senate is expected to make one last attempt next week to pass legislation to repeal and replace much of the Affordable Care Act (ACA).  The new proposal, which will come in the form of an amendment to the House-passed bill (H.R. 1628) by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA), includes a provision to converting traditional Medicaid financing to a federal per enrollee cap.
If enacted, this provision will lead to potentially significant cuts in cost-effective health insurance and supportive services for people with disabilities as states will face even larger funding deficits in their Medicaid programs.


Please contact your Senators and urge them to oppose the Graham-Cassidy amendment to H.R. 1628.  If you live in Kansas, Ohio or Alaska, your calls to Senators Jerry Moran, Rob Portman, and Lisa Murkowski are particularly critical as they are considered undecided at this time.  Let them know that their commitment to protecting the most vulnerable in our society (i.e., the disabled) will not be met if the Medicaid reimbursement caps are enacted.

In early May, the House of Representatives narrowly approved H.R. 1628, the American Health Care Act, which would repeal and begin replacing significant parts of the Affordable Care Act (ACA).  Several attempts by the Senate to pass an alternative version of H.R. 1628 failed in July.  On September 30, a budget procedure prohibiting a filibuster on the legislation will expire, giving the Senate just one week to attempt to pass a version of H.R. 1628 – in the form of the Graham-Cassidy amendment – with a simple majority vote.

Like previous measures considered, but rejected, by the Senate, the Graham-Cassidy amendment would establish Medicaid per capita spending caps, which would drastically reduce the Federal government’s contribution to state Medicaid programs.  This will lead to steep cuts in programs critically important to people with Down syndrome, such as employment supports through Long-Term Services and Supports (LTSS), and Section 1915(c) Home and Community-Based Services (HCBS). These are optional services that states are not mandated to provide, and would likely be the first services to be cut by reimbursement caps.