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Independent Living News & Policy from the National Council on Independent Living

The Senate Proposed Health Care Bill: CBO Score Released: A Breakdown of Potential Destruction

By Matthew Schwartz, NCIL Summer Policy Intern

On Monday, the Congressional Budget Office (CBO) released their report on the Better Care Reconciliation Act of 2017 (BCRA), the Senate’s version of the healthcare bill. The CBO report shared what would happen if the new healthcare bill was implemented. Unsurprisingly, the estimation is as destructive as previously predicted.

The BCRA would cause an estimated 22 million more Americans to be uninsured by 2026 – a total of roughly 50 million uninsured citizens – doubling the current amount of people uninsured under the Affordable Care Act (ACA). The Senate’s version would also reduce the federal deficit by $326 billion by the year 2026. Some will claim that this reduction is beneficial; however, the deficit reduction is achieved through cuts that threaten the lives of Americans with disabilities. 

These “reductions” come from cuts in outlays for Medicaid, with spending on the program declining sharply by 26 percent in 2026. This is dangerous for people with disabilities who rely on Medicaid to receive necessary assistance. The BCRA would additionally repeal the penalties on employers who do not offer insurance, further increasing the amount of people without health insurance. Money is saved at the cost of adequate human living, especially hurting those with disabilities.

The Senate is hiding the worst of their budget cuts for the future. The bill would, for instance, leave in place the Affordable Care Act (ACA) expansion of Medicaid through 2020. Then, Medicaid will be cut and per capita caps will be imposed. Per capita caps cannot happen. Read more about the horrendous effects of caps on people with disabilities.

The BCRA would additionally terminate federal matching for states that elect the Community First Choice Option, the service that provides home and community-based attendants to certain Medicaid recipients. This change would decrease direct spending by about $19 billion over the next 10 years. People with disabilities will be forced into nursing homes and other institutions. This is not an option.

Many will claim that the CBO is unclear and unsure with their report. That is a false narrative. Page 10 of the report says: “The direction of certain effects of this legislation is clear. For example, the amount of federal revenues collected and the amount of spending on Medicaid would almost surely both be lower than under current law. And the number of uninsured people under this legislation would almost surely be greater than under current law.” The Senate’s proposed healthcare bill will cut Medicaid and double the number of citizens uninsured in this country.

This means more people with disabilities not receiving adequate assistance, more people with disabilities being ostracized and sent to nursing homes or institutions, and more people with disabilities further being pushed aside and marginalized in society.

Take Action!

We need people around the country to build on last week’s momentum and take action! We have included a list of priority Senators below, but this is important for everyone! Here are several ways you can take action:

  1. Follow ADAPT’s lead and hold a protest at your Senator’s office! CILs around the country have been organizing protests and similar die-ins in their states. Now that the bill has been introduced, it’s time to redouble those efforts.
  2. Call your Senator TODAY and demand they vote no on this terrible bill! You can reach your Senators by calling the Capitol Switchboard at (202) 224-3121 and asking the operator to connect you or by using this directory. You can find a sample script in our recent alert, but the main points you want to get across are that this bill will be harmful to their disabled constituents and they should vote NO on the Better Care Reconciliation Act. Call often, because they need to hear from us regularly!
  3. Contact your Senator using another method! You can also fax your Senator (use faxzero.com to find your Senator’s fax number) or use Resistbot to have your texts turned into faxes, mail, or hand-delivered letters. If you’re on social media, make sure to find your Senator’s email address, Twitter handle, and other information through Contacting Congress.
  4. Set up a meeting with your Senator’s staff. Explain to them how harmful the cuts to Medicaid and other changes in this bill will be to their constituents with disabilities.
  5. Lastly, help ADAPT pay for their fines and other legal fees! Forty-three disability rights activists were arrested fighting for our lives. If you’re able, please donate to their legal fund. And spread the word!

Senate Republicans need 50 votes to pass the bill, which means they can only lose two Senators. We need to make sure they lose three! This bill fundamentally changes Medicaid and will disproportionately harm the disability community. This is our fight. Make sure our voices are heard!

Priority Senators:

  • Alabama: Shelby and Strange
  • Alaska: Murkowski* and Sullivan*
  • Arizona: Flake* and McCain
  • Colorado: Gardner*
  • Florida: Rubio
  • Georgia: Isakson
  • Indiana: Young
  • Louisiana: Cassidy*
  • Maine: Collins*
  • Missouri: Blunt
  • Montana: Daines
  • Nebraska: Fischer and Sasse
  • Nevada: Heller*
  • Ohio: Portman*
  • Pennsylvania: Toomey*
  • West Virginia: Capito*
  • Wisconsin: Johnson

* Top priorities