NALC Legislative Dept
Senate Majority Leader Mitch McConnell (R-KY) introduced the Better Care Reconciliation Act this week, following seven years of promising the repeal of the Affordable Care Act (ACA, also known as Obamacare) and after weeks of negotiations following the House of Representatives’ passage of the American Health Care Act (H.R. 1628), a bill that the Senate said it could not and would not pass.
The Senate’s legislation, which is different from what the House passed in May, is expected to be voted on in the Senate next week before senators depart Washington, DC, for the July 4 recess. Following that vote, the Senate and House bills will need to be reconciled before a single bill heads to President Donald Trump’s desk for a signature. Both measures are projected to increase the number of Americans who are uninsured by about 23 million.
With Senate floor action expected next week, all letter carriers should contact their senators and urge them to oppose this attack on middle-class workers and their families.
Among the defining characteristics of the legislation are provisions to deregulate insurance companies, which would allow them to charge older and sicker Americans more for health insurance, and to eliminate the individual mandate to buy health insurance and the mandate for larger companies (with 50 or more employees) to provide employer-sponsored health coverage.
Ending the individual mandate would undermine the individual insurance market and the Obamacare health care exchanges, while ending the employer mandate would help non-union companies drop coverage to gain an advantage over unionized firms.
Over time, the bill would cripple Medicaid by cutting hundreds of billions of dollars from the federal-state program that covers tens of millions of disabled Americans, poor children and the elderly in nursing homes, a program that was expanded by the ACA to cover more of the working poor. Such a move would force states to deny coverage to millions of low-income Americans.
In addition, the bill would reduce tax credits for health premiums purchased on health care exchanges and repeal virtually all of the taxes on high-income Americans and health insurance companies, all of which helped to fund Obamacare’s expansion of health insurance to more than 20 million American families.
The bill also would give all 50 states the opportunity to drop benefits required by the ACA, such as maternity care, emergency services and mental health treatment. While it retains protections for patients with pre-existing conditions (insurers must accept everyone and charge the same rates), the legislation would allow states to waive insurance requirements. This waiver includes rules governing which benefits must be covered, thereby allowing states to drop coverage on troublesome, expensive conditions. Reducing coverage requirements is a convenient way for lawmakers to promise continued pre-existing conditions protection without actually having to deliver it—insurance companies could simply choose not to cover chronic ailments that afflict millions of Americans.
Enactment of this legislation would result in a massive tax cut for the wealthiest Americans. The only Obamacare tax preserved is the so-called “Cadillac-tax,” an excise tax on health benefits above a certain value that is expected to raise insurance premiums for letter carriers and other middle class workers.
With Senate floor action expected next week, all letter carriers should contact their senators and urge them to oppose this attack on middle-class workers and their families. The number for the Senate switchboard is 202-224-3121.