Healthcare Havoc: Senate Showdown Kills Obamacare Replacement

Submitted by Conner Sheets, Intern, Government Affairs (GAO)

If you’ve been following the news lately then you know that the efforts of Senate Republicans to repeal and replace Obamacare have been shut down; what you may not know is how we got to this point.

The recent argument in the Senate over healthcare began with the drafting of the Better Care Reconciliation Act (“BCRA”). The bill attracted controversy over the mystery of its creation and the large number of Americans that would go without care if the bill were to become law. When we heard that Senate Majority leader Mitch McConnell planned to bring the BCRA to a Senate vote, BAYADA Home Healthcare mobilized. Employees, clients, and families sent over 125,000 emails and placed over 600 phone calls to key Senators. In the end, McConnell decided he didn’t have the needed votes and we took a collective deep breath.

Unfortunately, the peace did not last long. The Senate voted to bring three pieces of legislation to the debate floor: an edited BCRA, a “repeal now, replace later” bill, and a “skinny repeal” that got rid of some parts of Obamacare without removing the legislation completely. Millions of clients currently receiving services under Medicaid would be harmed by any of these bills, so BAYADA wasted no time in mobilizing once again. Over the course of two-and-a-half days, BAYADA employees, clients, and supporters sent an astonishing 69,000 emails to key Senators! One by one, the three bills failed in the Senate.

There is no doubt that the incredible movement of BAYADA and our friends played a role in protecting Medicaid during this debacle. Whether you are a Democrat, a Republican or an Independent, the issue was simple – save the Medicaid program and the services that we know are crucial to the health and well-being of so many of our clients and caregivers. We’d like to thank each of every one of those who took action and helped protect the lives of Medicaid clients everywhere. Your efforts are making sure the government stays a government “by the people, for the people”.

NJ HCA Advocacy Day in Trenton – May 25

Submitted by Louise Lindenmeier, Director, NJ Government Affairs (GAO)

BAYADA participated with the NJ Home Care Association in Trenton for a Home Care Advocacy Day. Over 30 BAYADA employees joined other providers for an informative morning of speakers including regulators, lobbyists, and legislators. After lunch, there was an opportunity to attend a health committee hearing, where legislators heard bills pertaining to health issues and then voted on moving the legislation forward. The day was successful and very informative.

NJ Personal Care Assistant Legislation A320/S1018 Awaits Governor’s Signature

Submitted by Louise Lindenmeier, Director, Government Affairs (GAO)

As we continue on our PCA journey for increased reimbursement rates, the next effort to increase the PCA reimbursement rate now sits on the governor’s desk. A320/S1018 would require the minimum reimbursement rate for PCA in managed Medicaid to be no lower than the state’s fee-for-service rate. Currently, we are asking all the PCA aides and clients to sign and send letters to the governor’s office, urging him to sign the legislation into law.

NC Long Legislative Session Gaveled Out

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

Last week Speaker Tim Moore and President Pro Tempore Phil Berger ended the long legislative session after passing, along party lines, North Carolina’s 23 billion dollar budget. The budget contained a few provisions we asked for, but not everything. The budget was sent to Governor Roy Cooper for signature. As expected, the budget was vetoed and must be sent back to the General Assembly. Lawmakers plan to return in August where the Republican-majority has sufficient votes to override the veto. It is reported the General Assembly will reconvene for as many as three Special Sessions this year – on August 3rd to address any bills vetoed by Governor Cooper, and on September 6th and November 15th to address redistricting, as the US Supreme Court ruled that our current NC House and Senate maps unconstitutionally disenfranchised African American voters.

While members are back in their districts our Hearts for Home Care Ambassadors will be reaching out to schedule home visits and hosts legislative round table with their offices.   Watch for ways to get involved.

BAYADA to US Senate: No hearing. No vote.

Submitted by Dave Totaro, Chief Government Affairs Officer (GAO)

 

This is the most important “Call to Action” in BAYADA’s history. The US Senate in Washington is pushing through a bill that would drastically cut services and access to care by trying to vote on a bill without any hearings or any debate.

As Hearts for Home Care, you will undoubtedly be a driving force to preventing this potentially damaging action. In fact, more than 2,400 of our champions have already sent more than 120,000 letters to senators and our #NoHearingNoVote hashtag has been posted more than 700 times with a reach of 2 MILLION users on Twitter! Continue to have conversations with your colleagues and encourage advocacy. We have complete and total confidence that your efforts will be paramount to our success!

Take action three different ways!

 

  1. Email US Senators: If you haven’t already, please visit www.bayada.com/actnow to take action now. Note: You will be asked to enter your work e-mail and home zip code to take action.After you take action, forward the link to three friends and share it on your social media pages!
  2. Facebook profile frame: Use these instructions to add a #NoHearingNoVote frame to your profile picture.
  3. #NoHearingNoVote social media post: Post a photo of yourself, your fellow Hearts for Home Care, or your loved ones holding up a sign showing that we’re standing up for our clients and caregivers. When you share, be sure to include the hashtag #nohearingnovote in the caption.

Where are we now?

On Thursday, June 22, the Senate released the Better Care Reconciliation Act, a “discussion draft” of its version of the American Health Care Act. Four Republican senators have stated publicly they do not support the bill in its current form, meaning it cannot pass the Senate without changes being made to it. The Congressional Budget Office (CBO) is not expected to release a cost estimate of the legislation until early next week. A vote in the Senate could occur prior to the July 4 recess.

This version of the legislation would make broad changes to federal spending in these five areas:

  1.    Medicaid: Reduces federal matching rate for adults covered by the Medicaid expansion; caps the growth in per-enrollee payments for most Medicaid beneficiaries
  2.    Tax credits and related coverage provisions: Eliminates subsidies to purchase plans from the individual market in 2020; revises ACA tax credits
  3.    Patient and state stability fund grants: Provides $112 billion to states and insurers to reduce premiums for insurance purchased in the individual market
  4.    Penalty payments: Eliminates the employer mandate and individual mandate penalties
  5.    Noncoverage provisions: Repeals multiple taxes not relating to coverage, including the tax on high-income people and the medical device tax

Advocacy to Equalize Access Continues in Pennsylvania

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

Last week, the Pennsylvania Homecare Association (PHA) and I met with House Public Health Chairman Matt Baker to discuss the best path forward regarding our legislation, which begins to equalize access to presumptive eligibility. During the discussion, we considered potential bill sponsors, a potential legislative hearing, and potential today blocks. The bill language will now go to the Legislative Reference Bureau for approval and formatting. This is the final step before a co-sponsor memo is released and we can activate our advocates and ask for legislative sponsors. More updates coming soon.

Government Affairs Office Continues Advocacy Efforts in Massachusetts

Submitted by Laura Ness, Director, Government Affairs (GAO)

This week, the Government Affairs Office (GAO) traveled to Massachusetts to advocate for amendment 513. The amendment requires the state to collect and make publicly available data on the hospitalization costs of the continuous skilled nursing population. This was accepted in the Senate budget and now needs to be approved by the conference committee. Our request is that the legislature approves the amendment but requires the data to be available by December 31.

PA House and Senate Pass Pension Reform

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

After years of debates and proposals, the House and Senate have put a state employee pension reform package on the governor’s desk. The legislation will not alleviate the budget deficit this year, but it will help the state in future budgets. This legislation was described as relieving a pressure valve for legislators. With this monumental task behind them, legislators are looking forward to moving on to additional issues. This is good for home health care because legislators have more of an appetite to listen to requests for additional funding now that the looming pension crisis is behind them.

BAYADA to US Senate: No hearing. No vote.

Submitted by Dave Totaro, Chief Government Affairs Officer (GAO)

This is the most important “Call to Action” in BAYADA’s history. The US Senate in Washington is pushing through a bill that would drastically cut services and access to care by trying to vote on a bill without any hearings or any debate.

As Hearts for Home Care, you will undoubtedly be a driving force to preventing this potentially damaging action. In fact, more than 2,400 of our champions have already sent more than 120,000 letters to senators and our #NoHearingNoVote hashtag has been posted more than 700 times with a reach of 2 MILLION users on Twitter! Continue to have conversations with your colleagues and encourage advocacy. We have complete and total confidence that your efforts will be paramount to our success!

Take action three different ways!

  1. Email US Senators: If you haven’t already, please visit www.bayada.com/actnow to take action now. Note: You will be asked to enter your work e-mail and home zip code to take action.After you take action, forward the link to three friends and share it on your social media pages!
  2. Facebook profile frame: Use these instructions to add a #NoHearingNoVote frame to your profile picture.
  3. #NoHearingNoVote social media post: Post a photo of yourself, your fellow Hearts for Home Care, or your loved ones holding up a sign showing that we’re standing up for our clients and caregivers. When you share, be sure to include the hashtag #nohearingnovote in the caption.

Where are we now?

On Thursday, June 22, the Senate released the Better Care Reconciliation Act, a “discussion draft” of its version of the American Health Care Act. Four Republican senators have stated publicly they do not support the bill in its current form, meaning it cannot pass the Senate without changes being made to it. The Congressional Budget Office (CBO) is not expected to release a cost estimate of the legislation until early next week. A vote in the Senate could occur prior to the July 4 recess.

This version of the legislation would make broad changes to federal spending in these five areas:

  1. Medicaid: Reduces federal matching rate for adults covered by the Medicaid expansion; caps the growth in per-enrollee payments for most Medicaid beneficiaries
  2. Tax credits and related coverage provisions: Eliminates subsidies to purchase plans from the individual market in 2020; revises ACA tax credits
  3.  Patient and state stability fund grants: Provides $112 billion to states and insurers to reduce premiums for insurance purchased in the individual market
  4.  Penalty payments: Eliminates the employer mandate and individual mandate penalties
  5.  Noncoverage provisions: Repeals multiple taxes not relating to coverage, including the tax on high-income people and the medical device tax

Delaware Rate Floor Bill Passes House Committee

Submitted by Shannon Gahs, Associate Director, DE Government Affairs (GAO)

Following compelling testimony by clients Nancy and Christopher Lemus, Delaware Association for Home and Community-based Care (DAHCC) President Bob Bird, Delaware Pediatrics (DP) Associate Director Mandy Brady, and myself, the House Health & Human Development Committee passed a bill that would set a minimum reimbursement rate paid by Medicaid managed care organizations (MCOs) to home health care providers for skilled nursing services.
Representatives asked probing questions, sparking true debate over the measure. The vote was 10-0 with 4 additional members absent. The bill must still pass the full House, the Senate Health, Children & Social Services Committee, and the full Senate. The legislature closes on June 30. If this bill passes, MCOs would not be able to pay any less than the Department of Health and Social Services (DHSS) pays for the same care, giving DHSS the ability to ensure access to needed services.

Nancy Lemus giving testimony at the hearing