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

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

The Honorable Mike Enzi
Chairman
Committee on Budget
United States Senate
Washington, DC 20510

The Honorable Tom Price
Chairman
Committee on Budget
United States House of Representative

The Honorable Orrin Hatch
Chairman
Committee on Finance
United States Senate
Washington, DC 20510

The Honorable Fred Upton
Chairman
Committee on Energy & Commerce
United States House of Representatives
Washington, DC 20515

December 15, 2016

Dear Senator McConnell, Speaker Ryan, Chairmen Enzi, Hatch, Price and Upton:

On behalf of the Partnership for Medicaid – a nonpartisan, nationwide coalition of health care providers, safety net health plans, counties, and labor – the undersigned organizations write to provide input on ongoing conversations on Capitol Hill regarding the future of the Affordable Care Act (ACA).

We understand that among the options being considered by congressional leaders at this time is a repeal of the ACA in early 2017 — including a full rollback of Medicaid expansion — with a commitment to passing a replacement of the law at a later date. We believe a decision to repeal the ACA before enactment of a permanent replacement could lead to significant disruption for the American people and for the health care industry.

As you know, the Medicaid program has served as the vehicle for coverage for the majority of those covered under the ACA. As the foundation of the health care safety net, Medicaid covers more than 70 million people in the country, is a leading economic force in state and local economies, and vital to the financial stability of safety net providers. Today, more than 90 percent of people in the United States have health care coverage – the highest level in history. We urge you to ensure that all of these people retain access to affordable coverage and health care services in the future. We are concerned that a decision to repeal the ACA before replacing it with a permanent plan will lead to uncertainty in future coverage sources for affected patients, providers, health plans, and employers.

Health insurers have indicated that under a scenario where the law is repealed without a replacement plan in place, they may not be able to continue to provide coverage options in 2018 or even sooner. Health care providers would be unable to adequately plan for the future. States and local governments, already constrained by tight budgets, could be left with no choice but to cut health care spending without proper time to plan for sustainable alternative solutions.

Most importantly, more than 20 million patients, including more than 10 million people who gained coverage through recent Medicaid expansions, would remain in limbo regarding the future of their health coverage.

We urge congressional leaders to take the time needed to develop and enact effective policies to ensure coverage and access to affordable care for Americans under Medicaid and other programs. Before enacting any major policy changes, we urge Congress to consult with all key stakeholders, including states, counties, providers, health plans, and patients, to ensure Congress has the information it needs to make well-informed decisions. The Partnership looks forward to continuing to work with Congress to find innovative ways to improve health care delivery.

Sincerely,

AFL-CIO
America’s Essential Hospitals
American Academy of Pediatrics
American Congress of Obstetricians and Gynecologists
American Dental Association
American Health Care Association
Association for Community Affiliated Plans
Association of Clinicians for the Underserved
Catholic Health Association of the United States
Children’s Hospital Association
The Jewish Federations of North America
National Association of Community Health Centers
National Association of Counties
National Association of Pediatric Nurse Practitioners
National Association of Rural Health Clinics
The National Council for Behavioral Health
National Health Care for the Homeless Council
National Hispanic Medical Association

CC:

The Honorable Harry Reid, Minority Leader, United States Senate
The Honorable Nancy Pelosi, Minority Leader, United States House of Representatives
The Honorable Bernie Sanders, Ranking Member, Senate Committee on Budget
The Honorable Chris Van Hollen, Ranking Member, House Committee on Budget
The Honorable Ron Wyden, Ranking Member, Senate Committee on Finance
The Honorable Frank Pallone, Ranking Member, House Committee on Energy and Commerce
The Honorable Charles Schumer, Minority Leader-Elect, United States Senate
The Honorable Greg Walden, Incoming Chair, House Committee on Energy and Commerce
The Honorable John Yarmuth, Incoming Ranking Member, House Committee on Budget
Andrew Bremberg, Transition Team, President-Elect Donald Trump

 

Partnership for Medicaid Letter on ACA Repeal