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PA Providers to Senators Toomey and Casey: Reject the BCRA

June 28, 2017

Newest joint letter reinforces major concerns with Senate health care legislation

Although U.S. Senate leaders have postponed a vote on the Better Care Reconciliation Act (BCRA) until after the July 4 recess, Pennsylvania’s health care provider community continues its push to protect access to affordable, reliable health care coverage.   

Twenty-eight provider groups and organizations today sent a joint letter to Senator Pat Toomey (R-Pa.) and Senator Bob Casey (D-Pa.), urging them to reject the BCRA. 

In a previous letter, the group cautioned that the American Health Care Act (AHCA) threatened coverage, weakened Medicaid, and undermined consumer protections. The BCRA, the group wrote today, “would trigger, over time, even deeper cuts to the Medicaid program that covers children and adults with chronic conditions, along with the elderly and individuals with disabilities who need long-term services and support.”

The group outlined their concerns with the BCRA, which include:

  • Medicaid Expansion:  Phasing out the enhanced federal match for Medicaid would be a “crippling blow” for Pennsylvania, as it faces a $2.5–$3 billion funding gap.
  • Medicaid Per Capita Financing:  The proposed formula used for the per capita cap would tie funding to general inflation (CPI-U) beginning in 2025, compared to the AHCA’s plan to tie the cap to the higher medical inflation index (CPI-M).
  • Insurance Subsidies:  The BCRA would lower the subsidy threshold “for people who can receive financial assistance from 400 percent to 350 percent of the federal poverty level.” Additionally, subsidies would be tied to a skimpier benchmark plan, making the benefits less generous. These changes “would land hardest on older, lower-income citizens, who could see their contribution toward their premiums nearly double and their other out-of-pocket costs increase substantially.” 
  • Consumer Protections:  The BCRA allows states to apply for waivers for coverage of essential health benefits. Under this plan, “some types of care, such as maternity benefits, prescription drugs, or opioid addiction treatment might not be included in standard insurance coverage in states that waive the rule.”

“The Senate’s delay of the vote is just that:  a delay,” said Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP). “The BCRA could cause more than 400,000 Pennsylvanians to lose coverage in 2018. The 28 provider groups agree that this is unacceptable and we will not stay quiet on this issue.”

HAP worked in collaboration with provider groups to draft the letter. HAP has collaborated with provider groups and hospitals on joint letters sent May 2, June 7, and June 21.

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