1. CBO score: Delay holding a vote on the measure until the CBO scores the bill and the public has a chance to evaluate it.
2. Impact on veterans: Elimination of Medicaid, as the bill is said to do over time, would have a disproportionate negative impact on veterans. Many military veterans I know fall within the federal poverty guidelines and it would be wrong to leave them behind by eliminating Medicaid.
3. Impact on Nursing Home Residents: It seems cruel to kick nursing home residents off Medicaid. Like most people, our family is working to live on our own for as long as possible. That’s not possible for people with limited means as their health deteriorates toward the end of life. Ending Medicaid would disproportionately impact seniors who rely upon it. It would be just plain mean and not reflective of who Americans are as a society.
4. Essential Health Benefits: Insurance is by design intended to help all policy holders pay for the medical needs of every policy holder. Changing the basic framework of who is covered and at what cost requires more sunlight than it has gotten thus far. I oppose altering essential health benefits established in 2009 without agreement between all parties involved, including insurance companies, medical personnel, hospitals and clinics, and importantly, members of the general public.
Thanks for reading my message. Good luck in your deliberations over Graham Cassidy.
~ Submitted electronically to U.S. Senators Chuck Grassley and Joni Ernst on Tuesday, Sept. 19, 2017
Senator Chuck Grassley’s response:
September 20, 2017
Dear Mr. Deaton,
Thank you for taking the time to contact me. As your Senator it is important for me to hear from you.
I appreciate hearing your thoughts about legislation proposed to replace the Affordable Care Act(ACA), or Obamacare. Obamacare has failed to deliver. While the ACA promised affordable care, Iowans saw their premium payments, copayments, and deductibles steadily rise significantly. While promised to keep plans if they liked them, Iowans lost their plans when Obamacare was enacted. Because of Obamacare’s failures, 72,000 Iowans currently don’t know if they will be able to purchase health insurance for 2018.
I support having the Senate consider the Cassidy/Graham bill. We need alternatives to Obamacare, which hasn’t worked, and that reality has been acknowledged across the political spectrum. Health insurance is much too expensive for too many Iowans. I like that the bill addresses one of the fundamental flaws of Obamacare. It returns power to individuals and states. It’s not perfect, but the bill recognizes that each state has different needs that each state is best equipped to decide how to meet. There’s also a phase-in period and the opportunity to make changes in the future. Keeping Obamacare as is will cause people to go without insurance either because Obamacare has collapsed in a state or face coverage that no one can afford to use.
You can be sure I will carefully consider any legislation that comes before the Senate, and will continue to support access to health insurance for Iowans going forward in my role as senator.
Thank you again for contacting me. Please keep in touch.
Senator Joni K. Ernst’s Response:
September 21, 2017
Dear Mr. Deaton,
Thank you for taking the time to contact me about the Senate’s ongoing work on health care reform. It is important for me to receive direct input from folks in Iowa on policy matters such as this, especially when they affect people on such a personal level.
As you know, the U.S. Senate considered various legislative ideas regarding health care the week of July 24th. Throughout the debate, I shared how the Affordable Care Act (ACA) is failing in Iowa, with choices dwindling and costs rising. Premiums have increased in Iowa up to 110% since the health care law went into effect. With Medica remaining as the only health insurance provider selling individual market plans in every county statewide for 2018, folks in the state’s individual market will endure another massive rate increase. The reality in our state is that continuing with the status quo is no longer an option.
On September 13, 2017, Senators Bill Cassidy (R-LA), Lindsay Graham (R-SC), Dean Heller (R-NV), and Ron Johnson (R-WI) introduced health care reform legislation, known as the Graham-Cassidy-Heller-Johnson proposal. If enacted, this proposal would give states flexibility to innovate and design their individual markets tailored to the specific needs of their state.
This proposal would also reform the Medicaid program to a per capita allotment for its traditional patient population. As you may know, the federal government’s auditor has identified Medicaid as a high-risk program for more than a decade due to its size and growth. Therefore, it is important that we look at reforms, but also focus our Medicaid dollars on the most vulnerable in our society – the elderly, children, and individuals with disabilities.
To learn more about this proposal, Senator’s Cassidy website has more information here.
Further, Chairman Orrin Hatch (R-UT) announced that the Senate Committee on Finance will hold a hearing on Monday, September 25th to discuss the Graham-Cassidy-Heller-Johnson proposal. While I am not a member of the Finance Committee, I will be closely monitoring the committee’s work and look forward to receiving its analysis of this proposal.
Throughout the Senate’s work on health care reform, I have emphasized how we must pursue solutions that enhance competition, increase flexibility, and constrain rising costs. The ACA is unsustainable in Iowa, and it’s critical that we work together to address the evolving needs of our health care system, and ensure folks have a voice in their own health care decisions – and not Washington deciding what is needed in a health care plan.
At this time, I am carefully reviewing the Graham-Cassidy-Heller-Johnson proposal to see how it could affect insurance availability and affordability, as well as provide folks access to health care coverage. It’s imperative I hear personally from Iowans, such as yourself, on their unique experiences in accessing health care, so that we can secure the affordable, patient-centered solutions our state critically needs. I appreciate your feedback at this time, and look forward to hearing from you further as the Senate continues to work on health care reform.
Joni K. Ernst