Welcome to the California State Rural Health Association!

Let your Federal Legislators know that you oppose passage of the Senate's "Better Care Reconciliation Act".  This Bill could become law in a few days if the Senate passes it and the House accepts all provisions, avoiding a Conference Committee.  See comparison of ACA, House and Senate Bills by National Public Radio below.

Don’t take my health care

If you don’t like what is going on with health care, you need to become involved with CSRHA and other organizations that support nonpartisan grassroots efforts to make sure that rural’s voice is heard. There has never been a more important time for health care and rural health care.  In the early 1970’s health advocates pushed for healthcare as a “right” not a “privilege”.  Fifty years later, we are seeing what is perhaps the biggest reduction in access to health care since the 70’s.

The article on the right gives you a summary of the provisions of the Senate "Better Care Reconciliation Act".  A CBO score has not yet been released but the provisions of the bill are devastating for Medicaid and our most vulnerable citizens.  Check out The Kaiser Family Foundations website to get great information on ACA repeal.  http://kff.org/health-reform/

We can’t afford to leave our voice to someone else.  We urge you to let your elected officials know how you feel about the repeal of “ObamaCare”.    If you are not a member of CSRHA, we urge you to join.  Your support allows us to do more to Advocate, Collaborate and Educate.

Now is the time to be LOUD!
Your voice is needed!

The Senate’s Health Care Bill was released today.  This bill, much like the House Bill, has major cuts to the Medicaid program that will have devastating impacts on rural health.   This Bill could become a law in just a few days if the Senate passes the Bill and the House votes to accept all the provision, thereby avoiding a Conference Committee.  Call your Senators and House Representatives and let them know passage of this bill would impact rural residents and communities. 

All Things Considered – National Public Radio.  The following information was published on the NPR website on June 22, 2107.

Comparison of Bills to the Affordable Care Act

People under 26
Affordable Care Act (Obamacare) : Can get insurance through a parent’s plan or buy independently.
House Bill: American Health Care Act: Stays the same.
Senate Draft: Better Care Reconciliation Act: Stays the same.

 

Adults under 65
Affordable Care Act (Obamacare): Can buy insurance on health exchanges, with tax credits and subsidies if they meet income requirements up to 400 percent of poverty level. Cost of insurance is based on tobacco use and age, with the people nearing 65 paying no more than three times what the youngest pay. Premiums can’t cost more than 9.5 percent of income. Those with very low or no income qualify for Medicaid.
House Bill: American Health Care Act: Will see tax credits to pay premiums based on age, not income, and that max out at $4,000, much less than under the ACA. The oldest people under 65 can be charged five times more than the youngest, and maybe more depending on state rules. Medicaid cut after 2020.
Senate Draft: Better Care Reconciliation Act: The oldest people under 65 would pay five times more than young people. Subsidies to help pay for insurance would end at incomes of 350 percent of poverty level, with adults 59-64 paying up to 16.2 percent of income. Medicaid would be cut starting in 2021.

 

Low-income nursing home residents
Affordable Care Act (Obamacare): Skilled nursing care covered by Medicare up to 100 days. Medicaid is available based on income.
House Bill: American Health Care Act: Skilled nursing care covered by Medicare up to 100 days. Medicaid services could be cut as states see federal funding decline.
Senate Draft: Better Care Reconciliation Act: Skilled nursing care covered by Medicare up to 100 days. Medicaid coverage for long-term care could be cut as federal payments to states decline.

 

People with preexisting medical conditions
Affordable Care Act (Obamacare): overage cannot be denied or cost more.
House Bill: American Health Care Act: States can get permission to let insurers charge more for some preexisting conditions, and to exclude some people altogether. States would have access to federal money to help those with expensive policies or conditions.
Senate Draft: Better Care Reconciliation Act: Insurance companies would be required to accept all applicants regardless of health status. But the draft bill would let states ask permission to reduce required coverage, also called “essential health benefits,” which would give insurers some discretion over what they offer in their plans, and possibly change what they can charge consumers.

 

People who go to Planned Parenthood
Affordable Care Act (Obamacare): Federal programs reimburse for most Planned Parenthood services.
House Bill: American Health Care Act: A one-year block will be placed on federal reimbursements for care provided by Planned Parenthood.
Senate Draft: Better Care Reconciliation Act: A one-year block will be placed on federal reimbursements for care provided by Planned Parenthood.

 

People with disabilities
The majority of Medicaid dollars go to people with disabilities.
Affordable Care Act (Obamacare): May qualify for Medicare and also Medicaid.
House Bill: American Health Care Act: Services covered by Medicaid could be cut as federal funding to states declines over time.
Senate Draft: Better Care Reconciliation Act: Services covered by Medicaid could be cut as federal funding to states declines over time. The cuts would be larger than those in the House bill.

 

People who use mental health services
Affordable Care Act (Obamacare): Covered by all plans under essential health benefits.
House Bill: American Health Care Act: Could lose coverage in states that get waivers from covering essential health benefits.
Senate Draft: Better Care Reconciliation Act: Medicaid would not be required to cover mental health after 2019. For other types of insurance, requirements could change in states that request a waiver.

 

Working poor on Medicaid
Affordable Care Act (Obamacare): Thirty-one states and the District of Columbia offer expanded Medicaid coverage.
House Bill: American Health Care Act: Federal funding for Medicaid expansion phases out, potentially affecting millions of people who are currently enrolled under the expansion.
Senate Draft: Better Care Reconciliation Act: Federal funding for Medicaid expansion phases out between 2021-2023. In addition, eight states would have a trigger clause — if the federal matching rate declines below the ACA-promised rates, the expansion goes away immediately. That would affect Arkansas, Illinois, Indiana, Michigan, Montana, New Hampshire, New Mexico, and Washington. Further reductions would start in 2025.

 

The wealthy
Affordable Care Act (Obamacare): Pay extra taxes to support ACA.
House Bill: American Health Care Act: Ends ACA taxes on corporations and cuts taxes for the wealthy by about $592 billion.
Senate Draft: Better Care Reconciliation Act: Similar to the House bill; would repeal ACA taxes on corporations and the wealthy that pay for insurance subsidies.