The Children's Dental Health Project's blog
House passes AHCA, threatens oral health coverage for millions
Today, with a narrow vote of 217 to 213, the U.S. House of Representative passed the American Health Care Act (AHCA), a bill that is expected to leave at least 24 million Americans without health coverage and which threatens to reverse much of the progress we’ve made in expanding access to dental coverage and oral health care. The AHCA is the latest iteration of the GOP effort to repeal and replace components of President Obama’s signature health reform law, the Affordable Care Act (ACA).
After multiple amendments aimed at garnering support from both moderate and conservative Republicans, the bill goes to the Senate with provisions that could eliminate health and dental benefits for millions of Americans, including children in both private insurance and Medicaid.
As CDHP has previously noted, the AHCA phases out Medicaid expansion for low-income adults, under which more than 5 million adults gained dental coverage. In addition, the bill limits funding for all Medicaid recipients through either a per-capita cap or state-option block grant, either of which would mean far fewer dollars to provide care for adults, children, and families. Furthermore, the block grant option undercuts long-standing Medicaid benefit requirements for children under EPSDT, which could allow states to significantly limit or eliminate coverage for kids’ oral health services. Currently, more than 37 million children count on Medicaid for comprehensive health and dental care.
The AHCA bill endangers consumer protections and could result in fewer services covered, including children's dental.
The AHCA’s impact on the private insurance markets isn’t much rosier. In addition to increasing premiums and out-of-pocket costs for many Americans, the bill endangers consumer protections and could result in fewer services covered, including dental benefits for children. As has been widely reported, the AHCA effectively allows states to waive protections for people with pre-existing conditions but as CDHP pointed out earlier this week, it also allows states to waive the ACA’s essential health benefits requirements, including coverage of oral health care for children. Furthermore, the elimination of essential health benefits would also likely mean the revival of annual and lifetime dollar limits on coverage, something the ACA did away with.
In short, the AHCA fails to deliver on President Trump’s promise to take care of everyone with better healthcare and lower costs. In fact, the AHCA threatens to pull the rug out from under tens of millions of children, families, and adults. At best, the bill will increase costs and reduce benefits for our most vulnerable populations; at worst, it would leave millions of American families without access to the care they need to learn, work, and thrive.
The bill now moves the Senate. Senate Majority Leader Mitch McConnell has indicated that the bill will not be considered until there is an official score from the Congressional Budget Office (CBO), something the House did not consider prior to their vote. This process is expected to take several weeks which provides an excellent opportunity for CDHP and its partners to educate Senators about the implications of the bill. There is no certainty for the fate of the bill in the Senate; it is incumbent upon advocates to make their voices heard in the coming weeks.
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