#SaveMedicaid The Graham-Cassidy Bill

Posted by The Arc of North Carolina

Chapters, Staff, Board Members, and The Arc community at large:

You’ve recently received a number of Action Alerts from The Arc asking for your advocacy once again to protect Medicaid and the Affordable Care Act (ACA). Because you spoke up and supported colleagues and friends to do the same, we were able to stop previous attempts to repeal the ACA and end Medicaid as we know it.

We need your help again.

The Graham Cassidy bill is the Senate’s current attempt to repeal the ACA and decimate Medicaid after failing to pass a similar bill in July. Here are some of the reasons we’re worried:

Proposed ACA changes:

-          Allows states to waive or alter major protections and benefits within the ACA including mandatory Essential Health Benefits

-          While bans on lifetime and yearly caps would remain in place, states can narrow what types of services someone qualifies for by changing Essential Health Benefits

-          Ends subsidies for low income individuals and families to purchase insurance on the individual market

-          Allows states to charge more based on age

Proposed Medicaid changes:

-          Cuts and caps the Medicaid program and its funding to states. Currently, North Carolina receives approximately $2 from the federal government for every $1 it spends.  The Graham Cassidy bill would break that 50+ year partnership and states would receive a smaller, fixed amount of money rather than reimbursement for actual services delivered.

-          Shifts significant financial burden to states faced with massive funding losses, states would likely alter who qualifies for benefits, what services are covered, and how often you can receive services.  This puts Home and Community Based waiver services –an optional benefit – at particular risk.

-          Creates a block grant of funds for those states that expanded their Medicaid program (NC is not one) which is limited at baseline and will expire over time.

The Senate has until September 30th to pass the bill. Supporters of the Graham Cassidy Bill hope to use “reconciliation instructions,” which expire on September 30th. These instructions would allow the bill to be passed with a simple majority or 51 votes (it can pass with 50 senate votes and Vice President Pence casting the tie breaker), limit debate to 20 hours or less, and prohibit a filibuster.

What can you do?

  1. Call Senators Burr and Tillis (again and again)

The Congressional switchboard is (202) 224-3121 or reach Senator’s Burr and Tillis DC and local offices in the links provided. 

  1. Engage your senators on social media (Use our cheat sheet of social media handles!)
  2. Reach out to your networks and ask them to make calls.  Ask them to share the action alert.

Don’t assume other people are making calls.  We need each of you to share your story and use your voice. 

Sample script to use:

“Hi, my name is _______________________, and I vote in North Carolina.  I’m a ___________ (family member of a person with intellectual and developmental disabilities, an individual with intellectual and developmental disabilities, etc.)  I strongly oppose the Graham Cassidy bill and any attempt to cut and cap Medicaid.”  [Tell your story!]

Talking points you may find useful:

-          Medicaid is often the only payer of community based long term services and supports for people with disabilities. North Carolina’s General Assembly continues to invest in home and community based waiver slots, a cost-effective alternative to segregated institutional care.  These services would be at risk under the proposed plan.

-          Medicaid strengthens the tax base: Many families can remain in the workforce because Medicaid provides modest, community based professional supports for their loved ones with a disability. Medicaid employs thousands of direct support professionals in our state. Many people with disabilities rely on modest supports to keep them in the workforce.

-          Medicaid is flexible-- we don't need a cut or cap to make the program specific to NC.  North Carolina, like many states, has engaged in a robust multi-year effort to modify its Medicaid program outside of original federal guidelines.  That request to make the program our own (called an 1115 Demonstration Waiver), based on significant feedback from hospitals, doctors, families, people with disabilities, mental health or substance needs, and even faith communities, is waiting for approval at the Centers for Medicaid and Medicare (CMS).  We can't implement that "home grown" program if we cut and cap funding.

Additional information you can use: 

-          A letter for the Consortium of Citizens with Disabilities opposing the Graham Cassidy Bill.

-          A chart comparing the Affordable Care Act, the failed Better Care Reconciliation Act legislation, and the current Graham Cassidy bill.

-          Why the Affordable Care Act is important to individuals with disabilities.

-          An overview of block grants and what’s at stake for people with I/DD.

Thank you for your continued support and your tireless efforts.  Representatives are letting us know that your voice is being heard on Capitol Hill.