via electronic communication

Dear Senator:

On behalf of the Association for Community Affiliated Plans (ACAP) and our 61 member plans in 29 states serving more than 20 million Americans receiving coverage through Medicaid, CHIP, Medicare Advantage D-SNPs, and the Health Insurance Marketplaces, I write to express our opposition to the Graham-Cassidy-Heller-Johnson amendment currently under consideration in the United States Senate.

Our plans have decades of expertise in serving low-income and vulnerable populations. ACAP has long been on record saying that current law needs to be changed to address several significant outstanding problems, and that ACAP and its member health plans stand ready to provide constructive input to explore solutions. Despite that the Senate has again put forward legislation that will do significant long-term damage to the health care system by undermining coverage for millions of Americans and destabilizing the individual insurance market.

Graham-Cassidy-Heller-Johnson does not meet ACAP’s core principles of Medicaid and Marketplace reform which we have repeatedly shared with the Senate. These principles include retaining the state option for Medicaid expansion and ensuring a stable business environment for plans serving the health insurance Marketplaces. This bill terminates the Medicaid expansion and makes massive reductions in federal Medicaid funding without protecting managed care organizations from incentives for states to undermine actuarial soundness. It also does nothing to ensure stability in the Marketplaces—it does the opposite, and could well lead to a death spiral by repealing the individual mandate penalty with no continuous coverage requirement in place.

Although Congress and the public have not yet benefitted from the opportunity to review a full Congressional Budget Office analysis of the bill’s impact on federal funding, premium levels and enrollment, this bill would result in tens of millions of Americans losing coverage. In addition, states will lose hundreds of billions of dollars in federal funds. The Congressional Budget Office has made known its inability to produce a comprehensive assessment of the bill’s impacts before the Senate intends to vote next week. As a result, ACAP, its member Safety Net Health Plans, other stakeholders, and most importantly the Senate, will not be able to evaluate what will surely be a sweeping impact on our health care system.

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