American Health Care Act, Title 1 Subtitle A (Proposed Health Care Bill)

Perhaps you have seen or are beginning to see #READTHEBILL being circulated. It seems to have begun with Republican leaders who want their constituents to … surprise, surprise… read their proposed healthcare bill. At first glance it seems doable for most people; a mere 132 pages as compared to over 20,000 for the Affordable Care Act (ACA), AKA Obamacare. But let me stop you right there! I am all for people researching and knowing what’s going on (that is the WHOLE reason why I started this blog!) but reading this proposed bill is not for the faint of heart. I had five years of government jargon training while serving as a human resources specialist for the Army. I read A LOT of regulation back then and I was violently thrown down memory lane as a I tried to make sense out of all of the amendments, strike-throughs, etc. The 123 pages of this bill do not stand alone. Be prepared to search for many other bills and through dozens… maybe hundreds of subparagraphs. (Hint: Ctrl + f at the same time will bring up a little search bar on the page you are searching and will make it a bit easier)

After that lengthy warning, I am here to say that I am beginning the work for you! I am no legal mastermind but I can muddle through regulation and make some sort of sense of them. It will take several days and posts to go through this whole legislation, make notes, and translate them into everyday terms. HERE WE GO!

Section 101: The first change out of the gate is to end funding for the Prevention and Public Health Fund at the end of Fiscal Year (FY) 2018, which is September 30, 2018. The ACA approved funding approved through 2025 and even beyond. The Department of Health and Human Services manages the PPHF and its mission is to provide services such as prevention research, health screenings, prevention education and immunization programs.

Section 102: After the first funding cut, we see a bit of balance. Community Health Centers will receive an additional $422 million to the 2.9 billion already allocated in FY 2017. This is the last year they are funded by this bill. On a personal note, I am a huge fan of Community Health Centers. My mom went to one (and she NEVER went to the doctor when I was growing up) and they quite literally saved her life that very day. She has worked hard all of her life but is one of the many Americans who slipped through the cracks of the ACA. These centers treat people who cannot afford healthcare but make too much money to qualify for Medicaid or Children’s Health Insurance Program (CHIP).

Sec 103: This wordy section, which is full of numbers, parentheses, and caveats, discusses federal payment to the States for medical assistance plans. Keeping in mind that there is a formula for this payment which is the same for every state, the actual payments are different each for each State depending upon enrollment in the State medical assistance programs. It emphasizes that State plans are required (and are still required) to allow persons enrolled in the program to receive care from any person, institution, agency, or community pharmacy that are qualified to do so and that persons receiving assistance will be enrolled into a primary care management system. Payments to the States can be used for child services, child/adult protective services, employment/training services, information/referral/counseling services, meal prep/delivery services, and services for the aged, disabled, or those addicted to alcohol/drugs. Funds can also be used for department personnel to attend formal training classes, workshops, etc. Grants from these funds cannot pay for medical care unless it is integral but a subordinate part of a social service (I could see this applying to a helping a homeless person back on their feet via community housing programs with focused care). Also, State child healthcare plans must include a description of how they ensure and monitor the quality and necessity of care to include immunizations and routine check-ups.

The big take away after all of those reminders is that, as proposed, for a one year period immediately after the bill becomes law, no Federal money will be provided for payments directly to or intended to for “prohibited entities.” That includes any 501 (c) (3), AKA non-profits, who are community providers/clinics for abortion or any such entity who receives in excess of $350 million no matter the specialty. The specified exceptions for abortion clinics are when they are performed to save the life of the mother, rape, or incest. I think it is pretty safe to say that this provision is aimed at Planned Parenthood but adding in the $350 million part was a pretty good idea no matter how you feel about Planned Parenthood.

Well, on that very dark note, we have hit the end of Title 1 Energy and Commerce, Subtitle A: Patient Access to Public Health Programs. Up Next: MEDICAID. I know you are super excited to hear about that one…

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