4 Things to Know About ACA Repeal and Diabetes
Over the past several months, all eyes have been on Congress and the White House, as debate has swirled around the repeal and replacement of the Patient Protection and Affordable Care Act (ACA). As advocates for the nearly 116 million Americans living with or at risk for diabetes, we at the American Diabetes Association® are committed to protecting access to adequate and affordable health care for everyone no matter his or her health status, income, age or employment.
As you may have seen in the news, members of Congress returned home for their annual spring recess without passing legislation in the House of Representatives to repeal and replace the ACA. However, Congress returns to Washington on April 25 and a new vote on ACA repeal could happen within their first week in session.
If you or a loved one is affected by diabetes, here’s what you should know:
1. How it began.
Since December 2016, we have continuously urged Congress to not repeal the ACA without replacing it simultaneously with an alternative plan that does not result in a loss of coverage or benefits for people with, or at risk for, diabetes.
In March, lawmakers introduced the American Health Care Act (AHCA). We were deeply concerned by this legislation, which would repeal key provisions of the ACA and lead to massive losses in coverage for millions of Americans, particularly those who are covered under Medicaid. After the legislation was posted, we sent a letter to the congressional committees considering the bill to express our serious concerns with the proposal.
Further confirming our worries, the Congressional Budget Office (CBO)—an agency that provides nonpartisan analysis on legislation—estimated that the AHCA would cause 24 million people to lose coverage over the next decade. The AHCA would also repeal the Prevention and Public Health Fund, which provides funding for innovative prevention initiatives like the National Diabetes Prevention Program. Repeal of the Prevention Fund would be a drastic step backward for type 2 diabetes prevention.
Despite our serious concerns, the congressional committees moved forward in early March with passing the legislation and recommending a floor vote in the House of Representatives.
2. How the AHCA evolved and changed.
Before it was scheduled for a vote, further last-minute changes were made to the AHCA. Unfortunately, these changes made the bill even worse, gutting key protections for those with diabetes. An amendment to change essential health benefits—which would put people with diabetes at risk of being unable to access the care and services necessary to manage their disease—was accepted.
Another amendment was introduced that would drastically scale back the community rating rule, which stops insurers from raising premiums in certain locations based on a person’s age, gender or health status. Rolling back this rule would give insurers the ability to charge people with diabetes more money for coverage, further undermining the ACA’s ban on discriminatory cost increases for people with pre-existing health conditions.
3. How we raised our voices on Capitol Hill.
Upon review of the AHCA, we determined it would negatively impact people with or at risk for diabetes. Prior to the scheduled floor vote, we moved quickly to alert members of Congress to our concerns and to activate our diabetes advocates. This included sending a letter to all members of the House of Representatives urging a NO vote on the AHCA, and sending an action alert to our advocates urging them to contact their members of Congress to also demand a NO vote. We also partnered with fellow health advocacy groups in a joint effort to urge Congress not to move forward with this legislation.
Then, on the day the AHCA was to be voted on, we issued a statement urging opposition to the bill and expressing grave concerns with the late-hour elimination of key patient protections.
On March 24, the House of Representatives moved forward with consideration of the bill, debating for several hours on the House floor. However, right before a vote was scheduled to occur, the consideration was abruptly postponed and the vote was canceled. It was evident that the bill did not have enough supporters to pass the House.
4. What happens next.
It may have appeared at first that efforts to repeal the ACA were over, and that the law would stay on the books. However, there have been signals in recent days that Congress will again attempt to vote on legislation to repeal and replace the ACA. Congressional leaders have said they are still working to hash out an agreement that could include major cuts to Medicaid coverage and benefits. President Trump also recently said that he wants another shot at health care reform before moving on to other issues.
While the ACA is not perfect, it is imperative that our leaders in Congress do their due diligence. We’re talking about the health and wellbeing of all Americans—present and future-—and we must ensure that any reform efforts do not roll back the clock to a time when people with diabetes could be denied health care coverage or forced to pay exorbitant premiums.
This is why you, our diabetes advocates, should continue to raise your voices and reach out to your representatives in Congress. Tell them what access to reliable, affordable care means to you.