policy

January 6, 2017

The Honorable Mitch McConnell
Majority Leader
United States Senate
Washington, DC 20510

The Honorable Paul Ryan Majority Leader
Speaker
United States House of Representatives
Washington, DC 20515

Dear Leader McConnell and Speaker Ryan:

We, the undersigned organizations, would like to provide our view on the importance of the Medicaid program for vulnerable populations as Congress considers potential changes to the Affordable Care Act this month.

Our organizations work to improve the health of underserved communities and to develop and support those clinicians who serve them. We represent clinicians, patients, staff, and administrators, as well as clinics, health departments, hospitals, and national, regional, and state primary care organizations, and professional societies. Together, we work on the front line in delivering healthcare to America’s underserved and vulnerable communities; communities where individuals typically have little or no other access to healthcare services. These individuals, millions of whom are insured through the Medicaid program today, often lack access to pharmaceuticals, behavioral health, oral health care, and other necessary health services.

We are very concerned that among the options being considered by congressional leaders is a repeal of the Medicaid expansion included in the Affordable Care Act — with a commitment to passing a replacement of the law at a later date. We believe a decision to repeal the Medicaid expansion before the enactment of a thoughtful, viable, and permanent replacement would lead to a significant disruption for many Americans, safety net providers and other stakeholders within the health system.

As the foundation of the healthcare safety net, Medicaid currently covers more than 70 million people in the United States. Including Medicaid covered individuals, approximately 90% of all people in the United States have healthcare coverage today – the highest level in history. We urge you to ensure that any change in current law enables this level of coverage to continue, or better yet, to rise in the future. Study after study has concluded that insurance status matters when it comes to access to care, and we see that in practice every day. But we need that commitment before repealing a significant part of a program that is working for millions today. Individuals enrolled in Medicaid are some of our most vulnerable individuals and families, and without a replacement plan will most likely lose insurance altogether.

We have heard loud and clear your commitment to repeal the ACA, but please remember that it has been the law of the land for almost seven years. As a result, any legislative and administrative change made will be difficult to implement quickly at the state and local level without major disruptions to the healthcare delivery system. States already constrained by tight budgets could be left with no choice but to eliminate Medicaid coverage for thousands of people without the proper time to plan for sustainable alternative solutions.

We look forward to continuing to work with you to find innovative ways to improve the quality, financing, and delivery of care in our country. However, we would ask that Congress consult with all key stakeholders, including patients, families, states, counties, providers, and health plans throughout the process in order to take the time needed to develop and enact realistic and effective policies to ensure continuous coverage and access to affordable care. Those insured through the Medicaid program are our neighbors, families and friends, and it is too important to do otherwise.

Thank you for your consideration of this request, and we look forward to working with you in the 115th Congress.

Sincerely,

Association of Clinicians for the Underserved
Action Wellness ADAP Advocacy Association
AIDS Action Baltimore
Alamosa County Public Health Department
American Association of Colleges of Pharmacy
American Muslim Health Professionals
American School Health Association APLA Health
Arizona State Association of Physician Assistants
Association for Community Affiliated Plans
Association of Asian Pacific Community Health Organizations
Association of Assistive Technology Act Programs
Asthma and Allergy Foundation of America
Briar Cliff University
California Consortium of Addiction Programs & Professionals
California Primary Care Association
CaliforniaHealth+ Advocates
Center for New Beginnings
Cincinnati Health Network
Clay County Medical Center
Coles County Health Department
Community Access National Network
Community Health Centers of Burlington
Community Healthcare Center
CommunityHealth
Council for Exceptional Children‐Division for Research
Crescent Community Health Center
Crook County Health Department
Cuyahoga County Board of Health
Denise Olin, Inc. Psy.D.
Disability Law Center of Alaska
Disability Law Colorado
Disability Rights California
Disability Rights Maryland
Disability Rights New Jersey
Disability Rights North Carolina
Disability Rights Oregon
Disability Rights Tennessee
Disability Rights Vermont
East Texas Community Health Services, Inc.
Eating Disorders Coalition
Episcopal Diocese of Atlanta
Esperanza Health Center
Family Health Centers, Inc. of Louisville
Family Practice & Counseling Network
Family Voices Indiana
Family Voices NJ
Family Voices of North Dakota
Family Voices of Tennessee
Frontier Health
GLMA: Health Professionals Advancing LGBT Equality
Good Samaritan Health & Wellness Center
Great Salt Plains Health Center, Inc.
Guided Pathways Support for Youth & Families
HealthNet (OH)
HIV Medicine Association
Holland Free Health Clinic
Idaho Parents Unlimited
Illinois Association for Behavioral Health
Illinois Primary Health Care Association
Immigrant Service Providers Group/Health
Indiana Primary Health Care Association
Iowa Primary Care Association, Inc.
J. Addoh Underserved, LLC
Jamaica Family Practice and Osteopathic Medicine
Jefferson County Public Health
JL Family Services
KYANNA Black Nurses Association of Louisville, KY
League of United Latin American Citizens
Logan County Health District
M&M Behavioral Health Consultants
Maryland United for Peace and Justice
Meridian Psychological LLC
Metro Community Provider Network
Michigan Family Voices
Montana Public Health Association
Mountain Family Health Centers
National Association of Community Health Centers (NACHC)
National Association of County and City Health Officials
National Disability Rights Network
National Physicians Alliance
New Jersey Association of Mental Health and Addiction Agencies, Inc.
New York State Association of County Health Officials
NH Family Voices
North Side Christian Health Center
Northwest Human Services
Ohio Public Health Association
PAVE
Positive Women’s Network, Michigan Regional Chapter
Presidio County Health Services
Project Inform
Reproductive Health Access Project
Rhode Island Parent Information Network
RiverStone Health
Roaring Fork Schools
Rural Health IT Corporation
Salud Family Health Centers
School‐Based Health Alliance
Shasta Community Health Center
Siouxland Community Health Center
SouthEast Lancaster Health Services
Statewide Parent Advocacy Network of New Jersey
SynerGenius Telepresence
Tennessee Disability Coalition
The AIDS Institute
The Holland Free Health Clinic
The Institute for Family Health
The Michael J. Fox Foundation
The National Council for Behavioral Health
Unity Health Care, Inc.
Venice Family Clinic
Vermont Coalition for Disability Rights
Vermont Family Network
Virginia Community Healthcare Association
Westside Family Healthcare
Youngstown City Health District

cc:

The Honorable Charles Schumer
Minority Leader
United States Senate
Washington, DC 20510

The Honorable Nancy Pelosi
Minority Leader
United States House of Representatives
Washington, DC 20515

Coalition Letter to Congress against ACA Medicaid Expansion Repeal