Update on Health Care Reform from AADE

I would like to share the attached Update on Health Care Reform from the AADE. This process health care reform process is now moving rapidly in the Senate toward an uncertain outcome which is likely to limit access of many people living with diabetes to self-management education, medical nutrition therapy, medical care diabetes testing supplies and medication including insulin.    

Linda Tilton


From: Ashley Urisman [mailto:aurisman@aadenet.org] Sent: Wednesday, July 26, 2017 11:08 AM To: Kurt Anderson Subject: Update on Health Care Reform




As an ardent advocate on behalf of diabetes educators and diabetes patients, you’re no doubt anxiously following the latest developments surrounding health care reform legislation currently under scrutiny in the US Senate. To help clarify what may happen next, ADDE’s DC Advocate, Deborah Outlaw, referred us to this piece form Vox, laying out the next steps Republicans will likely take in an effort to pass this Health Care Reform Legislation.


The team at AADE’s DC Advisory Firm, Baker Donelson, has also prepared a brief analysis of the week’s Senate activities, below:


Senate Votes to Begin Debate on Health Care Reform; Status of Final Bill Remains Unclear


Motion to Proceed on House-Passed American Health Care Act


On July 25, 2017, by a vote of 51 to 50, the Senate approved a motion to proceed to consideration of the House-passed American Health Care Act (AHCA). The successful vote to open debate follows days of negotiations aimed at winning over holdout Republican Senators. All 48 Democratic Senators were joined in opposition by Senators Susan Collins (R-ME) and Lisa Murkowski (R-AK). Vice President Mike Pence broke the tie in favor of beginning debate.


Senate Majority Leader Mitch McConnell (R-KY) emphasized the procedural vote as a first step towards repealing and replacing the Affordable Care Act (ACA), framing it as an opportunity for Senators to offer amendments. Prior to the motion to proceed, it was unclear which bill the Senate would ultimately vote on, with potential options including a Repeal-and-Delay bill (closely matching the 2015 reconciliation bill), the latest July 20 draft of the Better Care Reconciliation Act (BCRA), or an alternate “skinny repeal” package that would primarily target the ACA’s individual and employer mandate provisions. Leadership has indicated interest in pursuing whichever approach seems most likely to garner the minimum 50 votes.


First Bill under Consideration: Repeal-and-Delay


Immediately following the vote on the motion to proceed, Senate Majority Leader Mitch McConnell (R-KY) introduced the Obamacare Repeal Reconciliation Act (ORRA) of 2017 as a substitute amendment. This bill, known as “Repeal-and-Delay,” was introduced on July 19 as an updated version of the 2015 reconciliation bill. The bill would retroactively eliminate the ACA's penalties for the individual and employer mandates and immediately repeal the ACA's taxes and fees. After a two-year delay, the bill would repeal the ACA's premium tax credits, Cost-Sharing Reductions (CSRs), and Medicaid expansion.


On July 19, the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) released estimates of the ORRA, projecting that it would reduce federal deficits by $473 billion over the 2017 – 2026 period. They also projected that relative to current law the bill would increase the number of uninsured by 17 million in 2018, 27 million in 2020, finally reaching 32 million by 2026. The CBO also predicted that, relative to current law, premiums in the nongroup market would increase by roughly 25 percent in 2018, reach about 50 percent in 2020, and almost double by 2026. These projections, which anticipate a comparatively greater impact than the CBO's estimates on the House-passed AHCA and previous Senate-proposed BCRA, would, according to the CBO's analysis, occur because eliminating the ACA's mandate penalties and subsidies while retaining the market reforms would destabilize the nongroup market.


Senate Health Care Reform Outlook


As of this writing, it remains unclear which final health care bill the Senate will vote on and whether any of the options can garner the 50 votes needed for passage. Senators Collins, Shelly Moore Capito (R-WV), and Murkowski (R-AK) issued statements in opposition to the Repeal-and-Delay bill last week, and Senator John McCain (R-AZ) voiced his opposition today, suggesting that this approach faces an uncertain path moving forward. In addition, Senators Collins, Rand Paul (R-KY), Mike Lee (R-UT), and Jerry Moran (R-KS) had previously issued statements in opposition to the BCRA, with multiple others indicating significant concerns. Leader McConnell can only afford to lose two Republican Senators while still assuring passage (assuming Vice President Pence breaks a tie).



We hope this helps answer some of the questions you may have! Please do not hesitate to reach out if you have any additional questions! 



Ashley B. Urisman

Advocacy & External Affairs Coordinator

American Association of Diabetes Educators

200 W Madison, Suite 800

Chicago, IL 60606 (312) 601-4865 (Direct) diabeteseducator.org | Follow us:       


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