Rep. Mark Takano, Veterans’ Affairs Committee Democrats Send Letter to CBO Regarding AHCA

Washington, DC -- Representative Mark Takano (D-CA) and fellow Democrats on the House Committee on Veterans' Affairs sent a letter today to the Congressional Budget Office asking the agency to carefully consider the impact on veterans of the American Healthcare Act, the Republican bill to repeal the Affordable Care Act. Every Democrat on the committee, including Ranking Member Tim Walz, signed onto the letter drafted by Rep. Takano, who serves as the committee's Vice Ranking Member.

"House Republicans made significant last minute changes to the AHCA and rushed it to a vote without allowing for expert feedback or waiting for a final analysis from the nonpartisan Congressional Budget Office. Even after Democrats raised the fact that the AHCA would prevent 7 million veterans from receiving any subsidies for the purchase of insurance on the private market, 217 Republicans voted to put these veterans and their families at risk. We should have had a complete analysis of the impact of the bill before the House voted on it. Instead, Speaker Ryan and President Trump chose a short term political win over protecting our veterans. It is essential that CBO analyze the full impact of the AHCA on veterans before the Senate takes any action on it," said Rep. Takano.

In order to write a bill that could pass the Senate without Democratic votes, Republicans designed the AHCA to comply with the Senate's rules regarding budget reconciliation. These rules mean that a subsection of the AHCA that prevents Americans eligible for low-cost government healthcare services, including care from the Veterans' Administration, are not eligible for tax subsidies when purchasing insurance on the individual market. While the initial text of the AHCA included language that would have in turn exempted veterans who are eligible for, but not enrolled in, healthcare from the VA from this provision, that exemption was incompatible with reconciliation rules, and thus was removed from the final text passed by House Republicans.

"We were loud and clear about the disastrous impact AHCA could potentially have on millions of veterans when the bill was brought up for debate in March. Unfortunately, House Republicans failed to listen to our warning, and as a result, if this deeply flawed legislation passes as it is written, millions of veterans and their families could have diminished choice in where to seek care. The CBO can play a vital role in identifying the full impact to veterans prior to moving forward," said Ranking Member Tim Walz.

The letter led by Rep. Takano asked the CBO to specifically evaluate the impact of the AHCA on veterans, their spouses, and their children, including their access to tax subsidies, and whether the AHCA would cause a spike in demand for VA care that the Veterans' Administration is not prepared to meet. Since the Affordable Care Act became law, the uninsured rate for veterans has dropped by 40 percent, and many of those veterans and their families would likely lose coverage under the Republican bill.

The letter was signed by Reps. Takano, Walz, Brownley, Kuster, O'Rourke, Rice, Correa, Sablan, Esty, and Peters. The full text of the letter is included below:

May 12, 2017

The Honorable Keith Hall

Director

Congressional Budget Office

Ford House Office Building, 4th Floor

Second and D Streets, SW

Washington, DC 20515-6925

Dear Director Hall:

As the Congressional Budget Office (CBO) works to complete its analysis of H.R. 1628, the American Health Care Act, we ask that you include a thorough evaluation of the impact the legislation would have on healthcare affordability and coverage for our nation's veterans, their spouses, and dependent children. These men and women have served our nation bravely, and it is essential that Congress and the American people know and understand the impact of the proposed legislation on veterans.

As Members of the House Committee on Veterans' Affairs, we are particularly concerned about the applicability of tax credits for veterans who are eligible for, but not enrolled in, VA care. The pending legislation denies tax credits to individuals who are eligible for certain types of health coverage, including Medicare, Tricare, and others. We are concerned that this prohibition also applies to veterans eligible for VA care, even if they are not enrolled. As first published by the Rules Committee, H.R. 1628 included a special rule for these veterans. Page 97, line 21, laid out the special rule by affirmatively guaranteeing that veterans who are eligible for, but not enrolled in, VA care would still be eligible for tax credits to help them afford coverage.[1] The subsequent Walden-Brady Amendment #4 replaced the section on refundable tax credits with new language that omitted the clear protection for veterans.[3]

It is a common misconception that all veterans receive their health care through the VA. In fact, of the more than 20 million veterans, only 9 million are enrolled in VA care. The Commission on Care, a bipartisan, independent commission, estimated that 7 million veterans are eligible for, but not enrolled in, VA care.[3] A 2014 CBO report found that number could be closer to 8 million.[4] If these veterans are prevented from receiving tax credits to help them afford coverage, it could create an incentive for them to enroll in VA care. A sudden influx of this magnitude would severely hamper the VA's ability to provide timely care and have significant impacts on the agency's budget needs.

Additionally, in the first two years following the Affordable Care Act's implementation, the uninsured rate among veterans dropped by 40 percent. More than 400,000 veterans gained health insurance coverage, many through the Medicaid expansion.[5] We ask that you include analysis of the legislation's impact on these veterans and families, particularly the provisions impacting Medicaid expansion and reductions in federal Medicaid funding in the bill.

Thank you for your attention to this matter and your thoughtful, balanced review of this legislation. Should you need additional information, please contact Amanda Eaton in Congressman Takano's office at Amanda.eaton@mail.house.gov or 202-225-2305.

Sincerely,

Mark Takano

Vice Ranking Member

House Committee on Veterans' Affairs

Tim Walz

Ranking Member

House Committee on Veterans' Affairs

Julia Brownley

Ranking Member

Health Subcommittee

Ann McLane Kuster

Ranking Member

Oversight and Investigations Subcommittee

Beto O'Rourke

Ranking Member

Economic Opportunity Subcommittee

Kathleen M. Rice

Member of Congress

J. Luis Correa

Member of Congress

Gregorio Kilili Camacho Sablan

Member of Congress

Elizabeth H. Esty

Ranking Member

Disability Assistance & Memorial Affairs Subcommittee

Scott Peters

Member of Congress

[1] - H.R. 1628, the American Health Care Act, March 20, 2017. https://www.gpo.gov/fdsys/pkg/BILLS-115hr1628rh/pdf/BILLS-115hr1628rh.pdf

[2] - Walden-Brady Manager's Amendment #4, March 20, 2017. https://rules.house.gov/sites/republicans.rules.house.gov/files/115/tech_mngr_01.pdf

[3] - Commission on Care: Final Report, June 30, 2016, page 172. https://s3.amazonaws.com/sitesusa/wp-content/uploads/sites/912/2016/07/Commission-on-Care_Final-Report_063016_FOR-WEB.pdf

[4] - Congressional Budget Office Preliminary Analysis of S.2450, the Veterans' Access to Care through Choice, Accountability, and Transparency Act, June 11, 2014. https://www.cbo.gov/sites/default/files/113th-congress-2013-2014/costestimate/s24501_0.pdf

[5] - Haley, Jennifer, Genevieve Kenney, and Jason Gates. "Veterans Saw Broad Coverage Gains Between 2013 And 2015". 2017. Web. 8 May 2017.http://www.urban.org/research/publication/veterans-saw-broad-coverage-gains-between-2013-and-2015/view/full_report

Read this original document at: https://takano.house.gov/newsroom/press-releases/-rep-mark-takano-veterans-affairs-committee-democrats_send-letter-to-cbo-regarding-ahca