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Don’t destabilize our health care, economy by repealing ACA

(Jan. 20, 2017) — The following letter was sent this week to Washington’s congressional delegation. It was signed by dozens of organizations throughout the state that are deeply concerned that congressional threats to repeal the Affordable Care Act, block-grant the Medicaid system, and undermine Medicare through the use of vouchers would erode and undermine the healthcare for millions of Washingtonians, destabilize the system, and increase health care premiums for all.

Dear Members of the Washington Congressional Delegation:

Photo by David Sachs / SEIUWe, the organizations here throughout Washington State, are deeply concerned by Congressional threats to repeal the Affordable Care Act (ACA), block-grant the Medicaid system, and undermine Medicare through the use of vouchers. These efforts would erode and undermine the healthcare for millions of Washingtonians, destabilize the system, and increase health care premiums for all.

There are over 2.896 million individuals in Washington State who are currently enrolled in coverage through Medicaid, Medicare and the Affordable Care Act:

• Over 205,000 individuals enrolled in the Exchange

• Over 1,531,400 individuals enrolled in Medicaid

• Over 1,174,700 individuals enrolled in Medicare

Since the passage of the Affordable Care Act, our Washington State’s uninsured rate dropped from 14 percent to 5.8 percent, an unprecedented drop. Any effort to repeal, eliminate or reduce these federal health coverage programs would harm the health of millions in Washington, throw the system into chaos, and remove the stability and protections provided by Medicare, Medicaid, and the Affordable Care Act.

Repealing or undermining the Affordable Care Act, Medicaid, or Medicare will bring an unbearable cost and harm to our population’s health, and cause ripple effects across the state economy:

• 775,000 Washingtonians stand to lose their health coverage if Congress votes to upend ACA and Medicaid expansion coverage.

• In 2015, an estimated 51,196 jobs were saved or created as a result of the Affordable Care Act Medicaid expansion, which will be at risk across the state.

• Uncompensated care in hospitals as a percent of total revenue dropped approximately 50 percent between 2013 and 2014, which saved unnecessary costs and improved the health of Washingtonians.

• The state and the people covered stand to lose $3.0 billion in FY18 and $3.2 billion in FY19 including loss of tax credit subsidies and loss of funding for the Medicaid expansion population.

• Seventy percent of Qualified Health Plan enrollees in the Exchange received federal advance premium tax credits. In 2016, on average 115,265 people per month received tax credits totaling over $300 million, and 69,577 people per month received cost-sharing reductions totaling over $64 million due to deductible and other out of pocket costs exceeding their capacity to pay, which protected enrollees from bankruptcy and allowed their health coverage to be more affordable.

• Approximately 3.1 million Washingtonians with private health coverage (including 597,000 children) and 1.2 million Washington seniors on Medicare will lose guaranteed access to free preventive care, like blood pressure screenings, immunizations, and cancer screenings – a protection applying to all Washingtonians under the ACA.

• Thousands of seniors and people with disabilities could lose comprehensive drug coverage if the Medicare donut hole is re-opened as a result of repealing the ACA. This will leave Washington’s seniors and people with disabilities with a gap in prescription drug coverage and cause them to be forced to pay thousands more in drug costs.

• Seniors and people with disabilities in Washington have saved approximately $296 million on drug costs thanks to the ACA’s closing the Medicare donut hole. In 2015 alone, approximately 75,000 seniors and people with disabilities in Washington saved on average $978 on drug costs.

There is no one replacement or small fix that can be made without harming individuals, families, children, and seniors. For example, repealing the ACA would roll back the improvements in prescription drug coverage and undo cost-saving measures that have increased Medicare’s sustainability for seniors and people with disabilities. Additionally, if proposals to cut Medicaid funding through block grants or per capita caps become a reality, millions of Washingtonians will be at risk of
losing part or all of their health coverage.

Washington state receives around $43 billion in funding when the total federal assistance for our state’s Medicaid program, Children’s Health Insurance Program, and federal subsidies for the Exchange are combined.12 Washington cannot make up federal cuts with state money. There is no way we can replace tens of billions of dollars in federal cuts over time, and the immediate loss of federal dollars to coverage under the ACA, Medicare or Medicaid would result in millions of Washingtonians losing their coverage. For example, repealing just the ACA would cause a loss of over $3 billion each year for ACA coverage expansions, cut federal assistance for drug costs relief for those in Medicare, threaten over 51 thousand jobs in Washington, and put the health of Washingtonians at immediate risk.

We urge the Washington State Congressional Delegation to invest in and improve our federal health coverage programs, not repeal the Affordable Care Act, not cap the Medicaid program through a block-grant or per capita cap, not privatize or “voucherize” Medicare. Such proposals would cause millions of Washingtonians to lose access to health care, cut billions of federal dollars that flow to our state, and ultimately lead to increased health costs for everyone.


1. AFGE Local 3937
2. African-Americans Reach and Teach Health Ministry
3. American Federation of Teachers, Washington
4. Asian Pacific Islander Coalition – King County
5. Cedar River Clinics
6. Children’s Alliance
7. Circle of Friends For Mental Health
8. Columbia Legal Services
9. Congregation Kol HaNeshama
10. Country Doctor Community Health Centers
11. Doctors for America, Washington State Chapter
12. Economic Opportunity Institute
13. End of Life Washington
14. Faith Action Network
15. Former Representative Seth Armstrong
16. Foundation for Healthy Generations
17. HealthPoint
18. IAM 751 Retirement Club
19. International Community Health Services
20. Interpreters United Local 1671/AFSCME Council 28
21. Islamic Civic Engagement Project
22. Jewish Federation of Greater Seattle
23. League of Women Voters Washington
24. Legal Voice
25. Main Street Alliance
26. Mary Mahoney Professional Nurses Organization
27. Metropolitan Democratic Club of SEATTLE
28. Midwives’ Association of Washington State
29. Molina Healthcare
30. NAMI Washington
31. National Multiple Sclerosis Society
32. National Physicians Alliance, Washington State
33. Neighborcare Health
34. Northwest Health Law Advocates
35. Odessa Brown Children’s Clinic
36. One America
37. Our Revolution Washington
38. Physicians for a National Health Program, Western Washington
39. Planned Parenthood Votes Northwest and Hawaii
40. Pride At Work, AFL-CIO
41. Project Access NW
42. Puget Sound Advocates for Retirement Action (PSARA)
43. Retired Public Employees Council of Washington
44. Sea Mar Community Health Centers
45. Seattle Indian Health Board
46. SEIU6 Property Services Northwest
47. Service Employees International Union, 775
48. Service Employees International Union, Healthcare 1199NW
49. Sound Mental Health
50. Teamsters Joint Council, Local 28
51. Teamsters, Local 117
52. United Food and Commercial Workers, Local 367
53. WA Federation of State Employees / AFSCME Council 28
54. Washington Advocates for Patient Safety
55. Washington Chapter of the American Academy of Pediatrics
56. Washington Community Action Network
57. Washington Dental Service Foundation
58. Washington Healthcare Access Alliance
59. Washington State Alliance for Retired Americans – Education Fund
60. Washington State Association of the UA Plumbers & Pipefitters
61. Washington State Coalition for Language Access
62. Washington State Coalition of Mental Health Professionals and Consumers
63. Washington State Labor Council, AFL-CIO
64. Washington State Nurses Association
65. Washington State Society for Clinical Social Work

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