American Health Care Act Local NC Voting Record

However you feel about the American Health Care Act, here is how local representatives voted.

House of Representatives voting record (May 4, 2017) Burlington and Fayetteville, NC, representatives:

NC 6th Congressional District
Mark Walker voted for this bill

NC 8th Congressional District
Richard Hudson voted for this bill

NC 9th Congressional District
Robert Pittenger voted for this bill

It remains to be seen what will happen in the Senate with votes from Richard Burr and Thom Tillis.

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Some excerpts of the summary of the bill from the Congressional web site: (underlining added by me)

“(Sec. 111) The bill lowers, from 133% to 100% of the official poverty line, the minimum family-income threshold that a state may use to determine the Medicaid eligibility of children between the ages of 6 and 19. In addition, the bill reduces the Federal Medical Assistance Percentage (FMAP) for Medicaid home- and community-based attendant services and supports.”

“(Sec. 112)  Under current law, any alternative benefit plan offered by a state Medicaid program is required to provide specified essential health benefits. The bill eliminates this requirement beginning in 2020. (“Essential health benefits” include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services, laboratory services, preventative and wellness services, and pediatric services.)”

“(Sec. 114)  The bill allows a state to delay or deny an individual’s initial eligibility for Medicaid benefits without providing a reasonable opportunity to submit evidence of a satisfactory immigration status or pending official verification of such status. A state that elects to provide a reasonable period for an individual to provide such evidence may not receive payment for amounts expended on the individual’s medical assistance during that period. ”

“(Sec. 115) With respect to states that did not expand Medicaid coverage under PPACA [ie, NC], the bill: (1) with specified limitations, provides for additional federal funding for certain health care services; and (2) through 2022, increases the applicable FMAP. A non-expansion state that subsequently expands Medicaid coverage under PPACA shall become ineligible for this funding.”

“(Sec. 132) The bill amends the SSAct to establish and make appropriations for the Patient and State Stability Fund to provide funding to states through 2026, including to: provide financial assistance to high-risk individuals so they may enroll in health insurance, stabilize health insurance premiums, promote participation and increase options in the health insurance market, pay providers for services, and provide financial assistance to enrollees to reduce out-of-pocket costs. Funding is allocated to states based on each state’s share of incurred claims and uninsured individuals below the poverty line. To receive funding, states must provide matching funds at a rate that grows from 7% in 2020 to 50% in 2026.”

“(Sec. 133) Health insurers must increase premiums by 30% for one year for enrollees in the individual or small group market who had a break in coverage of more than 62 days in the previous year.”

“(Sec. 134) Beginning in 2020, health insurance benefits no longer must conform to actuarial tiers.”

“(Sec. 135) The bill increases the ratio by which health insurance premiums may vary by age, from a three to one ratio to a five to one ratio. This ratio may be preempted by states.”

“(Sec. 206) This section repeals the penalties for certain large employers who do not offer full-time employees and their dependents minimum essential health coverage under an employer-sponsored health plan (commonly referred to as the employer mandate). The repeal is effective for months beginning after December 31, 2015.”

“(Sec. 207) This section delays the implementation of the excise tax on high cost employer-sponsored health coverage (commonly referred to as the Cadillac tax) until 2025. (Under current law, the tax goes into effect in 2020.)”

“(Sec. 241) The section repeals a provision that prohibits certain health insurance providers from deducting remuneration paid to an officer, director, or employee in excess of $500,000.”

“(Sec. 251) This section repeals the 3.8% tax on the net investment income of individuals, estates, and trusts with incomes above specified amounts.” The full text reads: “Subtitle A of the Internal Revenue Code of 1986 is amended by striking chapter 2A.” From the tax code section that would be struck, 2A, the “specified amounts” requiring a 3.8% Medicare tax on income from investments, estates, trusts is triggered when there is an adjusted gross income (ie, after deductions) above $250,000 for a joint return or above $200,000 for an individual return.

Right Place, Right Time

There was a screening of Democracy for Sale at the Haw River Ballroom last night. It was a portion of the American Divided series. Indeed, it was the portion about North Carolina. As the ballroom quickly filled during the preceding hour, I was reminded of something I read recently about the Women’s March (the portion in London):

“I was there because, otherwise, how can we see one another? When we’re refracted through a political and media culture that treats cooperation as schmaltz, equality as passe, honesty as optional, and dissenters as raging weirdos, how other than by congregating can we believe that we’re not alone?

Also, it is fun. I’d forgotten that about protests. ‘Protest’ was never the right word: indeed, was willfully wrong. It’s a celebration of love among strangers.” [1]

It may not have been a march, but it was wonderful to see people coming together ready to learn more, support better, and be inspired to act.

In fact, because it was a North Carolina story, watching it together, we found ourselves in a participatory audience — there were hisses for the bad guys and cheers for our local good guys.

Afterwards, there was a question and answer panel made up of representatives of the Alamance NAACP, Appalachian Voices, Democracy NC, and one of the creators and executive producers, Lucian Read.

The best part, though, was when the question and answer session was interrupted just long enough to share the update that the ACLU had filed a habeas corpus petition on behalf of those affected by the sudden immigration ban, and a federal judge had granted a stay (albeit limited, and by its nature, temporary). The room erupted in applause.

Perhaps the only place better to hear that news would have been at one of the demonstrations occurring at airports around the country. But, it was far better hearing it there in the Ballroom, among united strangers (and a few friends), than reading it on my laptop at home. At home, I might have let out a little cheer or a gasp, but it would have been nothing in comparison to hearing my clapping multiplied all around me.

“Hope and solidarity literally have more energy, and this is an important thing to remember about human beings, even as that energy struggles to find its structural iteration.” [2]

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[1] Williams, Zoe, “Memo to Piers Morgan: Why do we march? It’s not just protest, it’s about love,” The Guardian, Kindle Edition, January 23, 2017, Comment and Debate.
[2] Williams.