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House vote on AHCA expected today; NRHA calls for Congress to vote NO on bill


The U.S. House of Representatives’ vote on the American Health Care Act (AHCA) is scheduled for later today. This comes a day after House leadership cancelled a planned vote for last night.

The House Rules Committee met earlier today to discuss the bill before it heads to the floor later this afternoon.

Republicans can only afford 22 defections for the bill to pass. President Trump has warned members that if the bill fails today, the Administration will move on from health care, leaving the Affordable Care Act in place.

NRHA urges members of Congress to protect rural Americans and vote no on the AHCA. The health bill does nothing to improve the health care crisis in rural America, and will lead to poorer rural health outcomes, more uninsured and an increase in the rural hospital closure crisis.

Though some provisions in the modified AHCA bill improve the base bill, NRHA is concerned that the bill falls woefully short in making health care affordable and accessible to rural Americans. For example, the modified bill contains a decrease in the Medical Expense Deduction threshold from 10% to 5.8% in an attempt to assist Americans between the ages of 50 and 64 who would see their premiums skyrocket under the current plan. However, this deduction is not a credit and therefore would be of little use to low income seniors that are in very low tax brackets or do not pay income tax at all. Additionally, the new amendments to freeze Medicaid expansion enrollment as of Jan. 1, 2018, and reduce the Medicaid per-capita growth rate will disproportionately harm rural Americans.

The AHCA will hurt vulnerable populations in rural America, leaving millions of the sickest, most underserved populations in our nation without coverage, and further the rural hospital closure crisisAccording to the Wall Street Journal, the “GOP health plan would hit rural areas hard… Poor, older Americans would see the largest increase in insurance-coverage costs.” The LA Times reports “Americans who swept President Trump to victory — lower-income, older voters in conservative, rural parts of the country — stand to lose the most in federal healthcare aid under a Republican plan to repeal and replace the Affordable Care Act.” 

Let’s be clear – many provisions in the Affordable Care Act (ACA) failed rural America. The lack of plan competition in rural markets, exorbitant premiums, deductibles and co-pays, the co-op collapses, lack of Medicaid expansion, and devastating Medicare cuts to rural providers – all collided to create a health care crisis in rural America. However, it’s beyond frustrating that an opportunity to fix these problems is squandered, and instead, a greater health care crisis will be created in rural America.

Congress has long recognized the importance of the rural health care safety net and has steadfastly worked to protect it. And now, much of the protections created to maintain access to care for the 62 million who live in rural America are in jeopardy. We implore Congress to continue its fight to protect rural patients’ access to care. 

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