NDRN Slams House Health Care Bill

Stethoscope and a blackboard with the word "Healthcare" written in chalk

by Andy Jones
May 7, 2017

Over the outcry of disability rights advocates nationwide, the United States House of Representatives voted 217-213 on May 4 to pass the American Health Care Act, rolling back most of the new protections for people with disabilities enacted under the 2010 Affordable Care Act and imposing substantial cuts to Medicaid.

“The Members of the House who supported this legislation should be ashamed that they sanctioned discrimination against people with disabilities, forced isolation and segregation on this community, and treated people with disabilities like second class citizens,” said Curt Decker, executive director for the National Disability Rights Network, in a news release. “I call on the Senate to reject this mean spirited legislation.”

Under the ACA, insurance companies are banned from denying coverage to people with “pre-existing conditions,” imposing lifetime caps, and other practices that disproportionately harm people with disabilities. Among its remedies, the ACA requires all insurers to cover a list of 10 “essential health benefits,” including mental health, rehabilitative, and maternity care.

To ensure a funding mechanism for insurance companies to provide expanded coverage, the ACA imposed tax penalties on individuals who opted out of obtaining insurance, and business without employer-provided coverage and 50 or more employees.

To ensure the tax penalties weren’t too burdensome, the ACA created a network of exchanges for people between 100 and 400 percent of the federal poverty line to obtain subsidized health insurance and expanded Medicaid to cover everyone up to 138 percent of the federal poverty line, although the Supreme Court later gave states the power to opt out of this Medicaid expansion.

To attract the support of the Freedom Caucus, which mostly voted against the first version of the ACHA that the House failed to pass in March, the version that passed May 4 allows states to opt of the essential health benefits and pre-existing conditions provisions, among other civil rights protections, according to a New York Times summary. As a replacement, states that opt out would have to fund a separate high-risk insurance pool that critics argue is grossly underfunded.

The tax penalties would be eliminated. The exchanges would be dismantled and replaced by $2,000 to $4,000 a year tax credits to assist with obtaining coverage, based on the person’s age, not health care needs.

The Medicaid expansion would be eliminated and state Medicaid funding would be capped either by a set allotment per beneficiary, or as a block grant, resulting in an estimated $880 billion over 10 years. Planned Parenthood would receive no federal funding. Medicaid’s Community First Choice Option, which provides funding incentives for states to move people from institutional to more integrated settings, would be scrapped.

Statements can also be read here from the Consortium for Citizens with Disabilities, the ARC, ADAPT, and the Leadership Conference on Civil and Human Rights.

Disability Rights Washington is the designated protection and advocacy agency in Washington and a member of the National Disability Rights Network.