Update - American Health Care Act (AHCA)

Update - American Health Care Act (AHCA)

On March 6, 2017, the U.S. House Republican leadership introduced Affordable Care Act repeal and replacement budget reconciliation bills in the Ways and Means (W&M) and Energy and Commerce (E&C) committees.  Both bills collectively are known as the American Health Care Act (AHCA).  On March 24th, House Speaker Ryan declared that there were not sufficient votes for the bill to pass the House of Representatives and the bill was pulled.

This week, Members of the House of Representatives and the Administration are proposing changes to gain enough support for passage of the AHCA.  A new amendment to the AHCA is making it more likely that a vote by the House of Representatives could happen as early as this weekend. Action is needed immediately. 

The latest proposed amendment would allow states to seek waivers that would allow them to charge higher premiums to people with pre-existing conditions. It would also would allow states to seek waivers from the Affordable Care Act’s requirement to provide essential health benefits, including mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, preventative and wellness services and chronic disease management, and pediatric services.  The combination of these changes would make it nearly impossible for people with pre-existing conditions to find affordable plans that cover basic health care services.  

Update - May 4, 2017 - Today, Members of the House of Representatives voted to pass the American Health Care Act.  The bill now goes to the Senate for consideration. 

Below is an overview of additional key proposed changes:

Medicaid

• States options to innovate using Medicaid waivers would become steadily more difficult. The likely result: long term investments in primary care and care coordination would lose out to short term demands to fill budget holes.  Music therapy services are reimbursed in some states through Medicaid ONLY through the use of waivers and the proposed changes could potentially effect the delivery of services through waiver programs.
• The program will transition to per-capita caps instead of reimbursing per service per person.  This transition is expected to be complete by 2020 and will fully transition the entire nature of Medicaid, severely threatening the Medicaid expansion.
• Reduced federal funding for Medicaid through these caps will likely lead to cuts of Medicaid services that are optional for states to provide – such as Home and Community-Based Waiver Services (HCBS).

Insurance Affordability Provisions & Taxes

• Reduces the subsidies that are currently available to help low income individuals pay for healthcare coverage.  All assistance previously received through subsidies in excess of premium costs will need to be repaid to the issuing entity.
• Creates a new AGE-adjusted tax credit available for individuals purchasing insurance, resulting in higher premiums for seniors, regardless of income.

Individual and Employer Mandate

• The ACA’s Individual Mandate provision will be replaced with a continuous coverage requirement. To avoid a 30% premium surcharge, individuals must prove that they did not have a gap in creditable coverage of at least 63 continuous days during the 12 months preceding coverage; individuals aging out of dependent coverage must prove that they enrolled during the first open enrollment period after which dependent coverage ceased.

The Congressional Budget Office (CBO), has estimated that the AHCA will likely result in as many as 24 million people losing their coverage.  It is important to make your voice heard as this legislation moves forward.

Recommended Action:

We encourage our members and others to exercise your rights and responsibilities as citizens and consider participation in the democratic process in the following ways:

• Call or email your legislators to express your opinions on the Affordable Health Care Act
• Follow your state and federal legislators on social media
• Attend advocacy events in your home district
• Meet with your state and federal legislators in their home district offices
• Invite your legislators to visit your clinical site, as appropriate, so they can observe “music therapy in action”
• Follow AMTA Advocacy activities on social media

The American Music Therapy Association’s Government Relations Department will continue to monitor the American Health Care Act (AHCA) as it progresses.   As new information becomes available, we will update members accordingly.

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