Sens. Durbin, Duckworth to Rauner: Weigh in on Republican Health Care Repeal Bill Before it Is to Late

WASHINGTON, June 27 -- The office of Sen. Richard J. Durbin, D-Ill., issued the following news release:

U.S. Senators Dick Durbin (D-IL) and Tammy Duckworth (D-IL) once again called on Illinois Governor Bruce Rauner to explain how Senate Republicans' plan to repeal the Affordable Care Act (ACA) will affect Illinois families, health care providers, schools, and the state's economy. The senators expressed concern that both the House and Senate Republican repeal bills would take away health care from tens of millions of Americans, including hundreds of thousands of Illinoisans, and increase out-of-pocket costs for seniors, middle-class families, and those in rural areas - all while giving massive tax cuts to wealthy corporations, millionaires, and billionaires.‎ The senators asked Rauner if he would take advantage of a provision in both bills that would allow states to stop requiring insurance companies to cover important benefits like maternity and newborn care, as well as mental health and substance abuse treatment.

Yesterday, the non-partisan Congressional Budget Office (CBO) released its analysis of Senate Republicans' repeal bill. CBO found that, over the next decade, the bill would throw 22 million people off health insurance, including hundreds of thousands of Illinoisans, and slash federal funding for Medicaid, which seniors, children, Veterans, and people with disabilities rely on, by at least $772 billion--or 26 percent. That would be particularly devastating for Illinois, which has a state law that requires the automatic elimination of Medicaid expansion if federal funding is reduced. The Illinois Health and Hospital Association opposes both the House and Senate repeal bills and cautions that these proposals would result in 60,000 job losses in Illinois alone. To understand what is at stake for Illinoisans under the Republican repeal plan, the senators asked Governor Rauner how the already cash-strapped state is prepared to handle the severe funding reductions that would be instituted under these Republican proposals and how Illinoisans would be impacted by‎ these cuts.

"It is not unreasonable to request that a sitting Governor provide input or an analysis about how proposed federal legislation might impact their state, especially when the legislation would impact every single person in this country and one-sixth of our nation's economy. Which is why we have, on multiple occasions, requested information from you about how these bills would impact our state," wrote the Senators. "...we remain deeply disappointed that you have not yet weighed in on behalf of Illinoisans. There is still time to do so, despite the fact that congressional Republicans are attempting to ram these dangerous repeal bills through both the House and Senate as quickly as possible."

In January and March, Durbin and Duckworth urged Governor Rauner to stand by Illinoisans and oppose repeal of the Affordable Care Act. They also called for his concrete recommendations on how to improve the health care system across Illinois. They did not receive a response either time. In June, Durbin and Duckworth, along with every Democratic member of the Illinois Congressional delegation, once again pressed Governor Rauner to stand by Illinoisans and oppose repeal of our health care system. They did not receive a response to this letter either.

Full text of today's letter is available here (https://www.durbin.senate.gov/imo/media/doc/Durbin%20Duckworth%20Letter%20to%20Gov.%20Rauner%20re%20BCRA%206.27.17.pdf) and below:

June 27, 2017

The Honorable Bruce Rauner

Governor of the State of Illinois

207 State House

Springfield, IL 62706

Dear Governor Rauner:

Late last week, Senate Republicans unveiled their bill to repeal the Affordable Care Act (ACA). Dubbed the "Better Care Reconciliation Act" (BCRA), this bill is largely similar to the House-passed American Health Care Act (AHCA). As you are no doubt aware, these proposals would throw more than 22 million people (including approximately one million Illinoisans) off their health insurance, decimate the Medicaid program, increase costs for older Americans and those living in rural communities, impose huge new financial burdens on hospitals (resulting in 60,000 job losses in our state alone), and undermine protections for individuals with pre-existing conditions. All this in order to provide more than $540 billion in tax breaks for big businesses and wealthy individuals. We are writing again, and with fading hope, that you might finally answer some of our questions regarding how these proposals would impact Illinois patients, students, providers, and hospitals.

It is not unreasonable to request that a sitting Governor provide input or an analysis about how proposed federal legislation might impact their state, especially when the legislation would impact every single person in this country and one-sixth of our nation's economy. Which is why we have, on multiple occasions, requested information from you about how these bills would impact our state. As Illinois's current Governor, you must know that the proposed Medicaid changes included in both the House and Senate repeal bills would impact our state disproportionately--as federal Medicaid funding accounts for nearly 70 percent of all federal funding to the state's budget. And yet, despite sending you numerous letters on these topics over the past six months, we have received nothing but silence.

You have a responsibility to outline how this legislation will impact Illinois before it receives a vote in the United States Senate. To clear up any uncertainty regarding how this bill would affect our state, we ask you the following questions again:

If you remain on as Illinois Governor, would you seek state waivers--as allowed under both the House and Senate repeal bills--from the "essential health benefits" requirement, once again allowing insurance companies to deny coverage of mental health care, substance abuse treatment, maternity and newborn care, hospitalizations, and prescription drugs?

If the Medicaid changes included in either the House or Senate repeal bills became law, would Illinois be able to cover the increased costs--in both the short- and long-term--without reducing coverage, restricting eligibility, limiting benefits, or cutting provider payments?

Under both the House and Senate repeal bills, Illinois's Medicaid expansion--currently benefitting 650,000 individuals--would be terminated in 2021. Would the state be able to ensure that these individuals--slated to lose their Medicaid coverage--see no gap in coverage, no diminishment of coverage, and no increased cost-sharing for health care coverage?

If either the House or Senate repeal bills became law--and the dramatic funding reductions for the Medicaid expansion population and the block grant/per-capita cap structure were realized--would the state be financially able to implement its proposed Section 1115 Medicaid waiver? How would the state balance funding new requested authorities under the proposed waiver while maintaining coverage of existing required services under the state's Medicaid program?

How would the Medicaid funding reductions included in both the House and Senate repeal bills impact services provided to children in our schools, including the 280,000 disabled Illinois children with an Individualized Education Plan (IEP) and the 1.5 million children in Illinois who receive health care through the Medicaid program?

How would the Medicaid funding reductions included in both the House and Senate repeal bills impact funding for Illinois's municipally-owned hospitals, health clinics, correctional facilities, and other publically-funded facilities?

How would the Medicaid funding reductions included in both the House and Senate repeal bills impact Illinois's hospitals statewide, especially our critical access hospitals and those in rural and under-served areas?

Which proposals in the American Health Care Act and/or the Better Care Reconciliation Act do you believe will hurt Illinoisans and which did you believe will benefit our constituents?

While we were pleased to see that a bipartisan group of governors from Medicaid expansion states--Ohio, Colorado, Montana, Massachusetts, Nevada, Pennsylvania, and Louisiana--sent a letter to Senate leadership last week, outlining their main concerns and priorities with respect to our health care system, we remain deeply disappointed that you have not yet weighed in on behalf of Illinoisans. There is still time to do so, despite the fact that congressional Republicans are attempting to ram these dangerous repeal bills through both the House and Senate as quickly as possible.

We look forward to your timely response.

Sincerely,