Is this any way to reform health care?

The U.S. Senate has taken up consideration of a hugely unpopular House bill to repeal and reform Obamacare. Senate leadership plans to hold a vote on the Senate version of the bill by Friday, June 30, 2017. No debate, no hearings, no amendments. And you won't have time enough to read and understand the bill to know how it will affect you and your DD family member. Here is an Action Alert from ACCSES:

June 20, 2017 

ACTION ALERT

Senate Vote on Health Care 

This Action Alert Requires Your Immediate Action!

The Senate health care bill is expected to come to the floor for a vote by next Friday, June 30, with NO debate, NO amendments, and NO committee hearings. While no one has seen the bill, which is being drafted under the guidance of just 13 Republican Senators, it is believed to include cuts to Medicaid spending that are even more extreme than the House-passed American Health Care Act.

We are at the critical stage. It is on all of us to push back and demand that the Senate do its job in the daylight and reject any health care bill that has not been fully vetted. Reach out to your Senator(s) and tell them to vote NO.

Go to the ACCSES Action Center now! Call your Senators’ offices. E-mail them. This is serious.

Kind regards,

Kate McSweeny
Vice President of Government Affairs &
General Counsel
ACCSES

Will Michigan legislators listen to constituents on mental health funding proposals?

Michigan Public Radio aired an interview on 6/7/2017 with Gail Marsh, the mother of an adult daughter with Down Syndrome, and Bob White, the father of two adult sons on the autism spectrum. Both parents have been involved in “Section 298” workgroups and affinity groups for more than a year. These groups were formed after the Governor’s budget proposed to shift mental health Medicaid funding from public Community Mental Health (CMH) agencies to private health plans that currently administer Medicaid medical health plans. They were a response to the strong opposition that met the Governor's proposal. 

People with developmental disabilities are one of the populations served by the mental health system in local Community Mental Health (CMH) agencies.

From the Michigan Radio website, "Parents 'afraid to die' because of fear mental health care system won’t take care of their children" by Stateside staff and Josh Hakala, 6/7/17:

“Tomorrow, state lawmakers are expected to release their final budget for fiscal year 2017-18 for the Department of Health and Human Services.

“That budget will reveal if Republicans have chosen to shift control of mental health funding – which amounts to nearly $2.5 billion in annual Medicaid payments – away from public mental health organizations, and transfer it to private insurers.
...
"Listen to the full interview … to hear more about their children and how they rely on mental health services as well as Marsh's examples of how privatizing ‘doesn't work’ and why White describes it as a form of ‘outsourcing.’"

Here is part of the interview with Gail Marsh on how the legislature has so far ignored much of the public input from the “Section 298 Initiative”. Start listening at about 12 minutes and 30 seconds into the interview. [Note that in this discussion, “integration” of care is about integrating funding for medical and behavioral health services under one administrative roof - the private Medicaid health plans.] The stakeholder workgroups and affinity groups overwhelmingly supported maintaining a public system to provide behavioral health services which include the social services and supports necessary to maintain people served in community settings.

Gail Marsh recently testified at a Michigan House appropriations subcommittee where she heard references to a State Senator’s comment that, “We’ve been dancing around the concept of integration for too long and the legislature needs to force things to happen.”

Here is her response in the interview:

“…I told them, the reason we’ve been dancing around total integration for so long is because it’s not what people want …The job they’ve been hired to do …is not to force unwanted things on their constituents, but to listen to the people who elected them. So, both the House and the Senate…have dismissed the recommendations of the workgroup and the stakeholder affinity groups, which were to maintain a public behavioral healthcare system.”

• Listen to the whole interview here.
• Link to  background information on “Section 298 Initiative” 
• Minding Michigan, is Stateside’s ongoing series about mental health issues is Michigan.
• So far, I have not seen news on whether the budget proposals for MI Health and Human Services have been acted on.

The GOP race to advance repeal-and-replace of Obamacare by July 4th, 2017

If you thought the Republican plan to repeal-and-replace Obamacare was dead on arrival in the U.S. Senate, think again. The House of Representatives passed an extremely harsh and unpopular bill last May that has been heavily criticized. Nevertheless, Senate plans to usher through healthcare reform are underway.

According to Politico, “McConnell whips Senate GOP back in line in Obamacare repeal” by Burgess Everett, Jennifer Haberkorn, and Adam Cancryn, 6/6/2017, Republicans have emerged from meetings this week with increasing optimism that they can pass a bill by the end of June, before the July 4th recess. If and when it is voted on, you may not know what is in it and there will be no public hearings on the bill. There is no legislation written yet for you to look at, but McConnell (R-KY) says that “failure is not an option”. 

Or as Senator Pat Roberts (R-Kan.) puts it,

“We’re in the back seat with Thelma and Louise and we need to get out of the car. So details matter, but we need to get out of the car. That was the pre-eminent message…The upshot is: This has to happen.”

What will happen? No one can say exactly, but here is what might happen:

“Senate Republicans expect their bill to be more generous than the House-passed measure in almost every way: A longer runway for ending the Medicaid expansion, more money for insurance market stabilization to lower premiums and beefed up tax credits for Americans of lower income, senators said. But no decisions have been made on some key policy questions, including on handling Medicaid. Still, it’s almost impossible for the public to assess what precisely Republicans are working on — the GOP is writing the bill behind closed doors and with no committee hearings.” [emphasis added]

If a bill is passed, it will have to be done through Reconciliation. According to the Tax Policy Center, “Congressional budget committees use the reconciliation process to ensure tax laws and mandatory spending programs are revised according to the budget resolution’s revenue and spending targets. The reconciliation process is a way to fast-track revenue and spending legislation into becoming law.” For a fuller explanation, see this from the Tax Policy Center.

The bill will have to go through a number of steps described in the article, though none of them include hearings or sober consideration of a huge change to our health care system with multiple effects on our economy and health.