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We got a reprieve this week when Senate Majority Leader Mitch McConnell delayed a planned vote on the Better Care Reconciliation Act of 2017 (BCRA).  Like the bill that passed in the House, BCRA would repeal the Affordable Care Act, decimate Medicaid, and weaken Medicare. The battle over health repeal is not over. Sen. McConnell continues to work to secure votes of reluctant senators by offering minor changes to the bill; changes that will not ultimately mitigate its harm.

Action During Recess

The July 4th Congressional recess is a critical time for the public to weigh in on both the House-passed American Health Care Act (AHCA) and the BCRA under consideration in the Senate.   


  • CBO reports on even deeper long-term cuts to Medicaid.  Earlier this week, the Congressional Budget Office (CBO) stated that Medicaid would be cut by up to 26% in the next 10 years, by $772 billion.  Yesterday, CBO released a longer-term analysis projecting beyond the 10-year window and found that after 20 years, Medicaid would be cut by 35% under BCRA.
  • Medicaid pays for two-thirds of nursing home care.  There is no other publicly-financed system for covering long-term care needs.  Even people who think they have enough resources to be self-sufficient often have to spend through their savings and rely on Medicaid in order to meet their long-term care needs.  The Center’s Senior Policy Attorney Toby Edelman was quoted in a New York Times article about health reform’s potential impact on Medicaid long-term care coverage. See “Medicaid Cuts May Force Retirees Out of Nursing Homes” Jordan Rau, New York Times, June 24, 2017 (available at:
  • Center’s Trumpcare Op-Ed Published in Maine paper.  Center Executive Director Judy Stein wrote an op-ed published in the Sun Journal based in Lewiston, Maine (linked and copied below):


Sen. Collins is Right to Oppose the Senate’s Trumpcare Bill

Judith Stein
Columns & Analysis 
Thursday, June 29, 2017

The Senate has released the previously secret details of its health care legislation — and they are not good. The Better Care Reconciliation Act of 2017 hurts our nation’s health care system as a whole and our most vulnerable citizens in particular.

Sen. Susan Collins has said she will not support the BCRA, which could ultimately decide the bill’s fate. Here are five reasons why her Senate Republican colleagues should also oppose Trumpcare:

1. The House version was “mean,” and the Senate version is still mean.

In May, the House of Representatives passed the American Health Care Act. It was so severe that President Trump called it “mean” and said the Senate should make it more “generous” and “kind.”

The Senate bill certainly cannot be called “kind.” Like the House bill, it guts Medicaid, which will devastate tens of millions of families, and in particular, older Americans aged 50-64, disabled people and children. The bill also ends the Affordable Care Act’s guarantees of maternity and mental health care. And it will leave millions uninsured.

2. Millions of Americans rely on Medicaid.

The Senate legislation doesn’t just repeal the Affordable Care Act; it completely redesigns and ruins Medicaid. And Medicaid isn't just for low-income Americans. Nearly two-thirds of the program’s spending supports older and disabled adults.

Imagine that you or one of your family members has Alzheimer’s Disease or suffers from a sudden stroke. Nursing home costs could quickly exhaust your savings. In that scenario, Medicaid would be there to cover the rest of your costs. Currently, the program pays for nearly half of Americans’ nursing home costs. This crucial piece of our country’s health care safety net would be in jeopardy under Trumpcare.

Children are at risk, too. In Maine, more than 250,000 people, including 100,000 children, rely on Medicaid and the Children’s Health Insurance Program (CHIP) program. These kids have no other source of health care coverage.

3. Trumpcare is a job killer.

The health care industry constitutes roughly one-sixth of the American economy. A new report from the Milken Institute School of Public Health at the George Washington University and the Commonwealth Fund estimate that repealing Obamacare could cost almost three million jobs by 2021.

This is because a lack of federal funding would cut gross state product by $1.5 trillion between 2019 and 2023, meaning less money to spend on hiring. In addition, consumers will be forced to spend more on their health care and have less disposable income to spend, which will cause losses in a multitude of industries.

Furthermore, a recent report by LeadingAge and the Center for Consumer Engagement in Health Innovation showed that 700,000 home health aides could lose their jobs under Trumpcare. This comes at a time when millions more home care workers are estimated to be needed in the coming decade to support our growing population of aging loved ones.

4. Trumpcare hurts Medicare recipients too.

Nearly 20 percent of Medicare recipients also rely on Medicaid. In Maine, that number is even higher — around 28 percent. According to the Kaiser Family Foundation, more than 60 percent of the 10 million Medicare beneficiaries who receive Medicaid need help with daily self-care activities, such as eating, bathing or dressing, which are important for independent living. Most Medicare beneficiaries who receive Medicaid have a cognitive or mental impairment, such as dementia, which can create the need for support to live safely at home.

The BCRA legislation would wreak havoc for American families when they are most in need. It would also hurt the next generation of Medicare beneficiaries. It repeals a slight payroll tax increase for high-wage earners that would reduce the long-term solvency of Medicare by 2-4 years.

5. The bill hasn’t received anything resembling adequate vetting.

The bill was developed by 13 white, wealthy men in secret with no text, no hearings and no public debate. Public opinion polls show dismal support for the bill, with approval ratings between 17 and 21 percent.

Simply put, this is not a health care bill. There are real issues in today’s health care landscape. We don’t need to add major new problems for families and the economy. The BCRA benefits the few, wealthiest Americans at the expense of most Americans.

The Center for Medicare Advocacy is ready to partner with everyone who will work to make America healthier and protect our care. We look forward to working with Sen. Collins and other lawmakers to develop real health care legislation that will accomplish just that.

Judith Stein is executive director of the Center for Medicare Advocacy Inc., founded in 1986. In 2013, she was appointed to the National Commission on Long-Term Care by Rep. Nancy Pelosi

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