Protect Health Care For Family Farmers

Yet again, U.S. Senate leadership has put forth a seriously flawed plan to overhaul our nation’s health care system. The bill, known as Graham-Cassidy, stands to worsen access to affordable and quality health insurance for family farmers and ranchers.

A vote on the legislation is expected by Wednesday, so we need your help now! Please call your U.S. Senators today at (202) 224-3121.

More information on the bill, its implications, and talking points for your call are below!

Take Action Now

1. Dial the Capitol switchboard (202) 224-3121 ASAP to get ahold of your Senators. (Not sure who your Senators are? Check here.)

2. Relay talking points from this page that resonate in your part of the country, or use this simple messages:

“Hi there, My name is _________ and I’m from __________. I’m calling to urge the Senator to vote against Graham-Cassidy because it will worsen access to affordable and quality health care for family farmers farmers and ranchers. Please have the Senator consider a bipartisan route that improves our health care system. Thank you.”

Bill Summary

Graham-Cassidy would:

  • Eliminate the current system of tax credits and premium subsidies and end the Medicaid expansion, replacing both pieces with a block grant.
  • Institute a per-capita cap on Medicaid.
  • Allow states to waive protections for individuals with preexisting conditions, allowing insurance companies to charge them higher premiums.
  • Allow states to waive essential health benefits requirements.
  • Destabilize the individual marketplace by eliminating the individual mandate, tax credits and premium subsidies.

Farmers Union Talking Points

  • NFU urges Congress to seek bipartisan reform that will increase farmers’, ranchers’ and rural Americans’ access to quality, affordable health insurance. This bill does not achieve that goal.
  • NFU acknowledges the problems within our current system, including rising premium costs, marketplace instability and a lack of funding for rural hospitals. Graham-Cassidy would leave states to fix these problems with less money.
  • After repeated calls for increased transparency and a bipartisan effort, Senate Republicans are once again using a secretive process to force a bill through without public input.
  • Block granting money to states almost always leads to funding cuts. 11 of the 13 health, human services, and housing programs that have been block granted have received funding cuts.
    • Graham-Cassidy cuts healthcare funding by $80 billion (1/3 of current funding) by 2026. No funding is guaranteed after 2026.
  • Farmers and ranchers benefited from the Affordable Care Act’s tax credits, subsidies for out-of-pocket costs and Medicaid expansion. Graham-Cassidy would make it all but impossible to maintain these provisions, much less make any improvements.
  • Graham-Cassidy allows states to waive protections for individuals with preexisting conditions, leaving many farmers and ranchers to face even higher premiums.
    • Two-thirds of farmers and ranchers report having a preexisting condition.
  • A per capita cap on Medicaid will disproportionately hurt rural hospitals, which are more reliant on Medicaid funding than their urban counterparts.
  • The bill would also institute an age tax, allowing insurance companies to charge older customers 5 times what they charge younger customers.

More Background

The Graham-Cassidy healthcare bill is the latest attempt by the Senate to repeal and replace the Affordable Care Act. In 2020, the bill would dismantle the federal health care system and replace it with per capita block grant funding to the states. Under the legislation, states would be responsible to devise and implement their own health care system, using block grant funding for any combination of the following six purposes:

  1. High-risk pools
  2. Marketplace stabilization
  3. Payments to providers
  4. Premium subsidies
  5. Assistance in purchasing health benefits
  6. Wrap-around coverage

As illustrated below, block grant and Medicaid funding would receive annual cuts. By 2026, funding would be cut by $80 billion or 1/3 of current spending.

Each state utilizes the Affordable Care Act’s provisions differently and has different demographic factors affecting healthcare costs. As a result, the Graham-Cassidy bill would affect each state differently. The $80 billion spending cut would include cuts in healthcare funding to 35 states, while allowing for an increase in funding to 15 states. It is important to note that each state will assume an additional administrative burden for implementing its healthcare system independently.

The Graham-Cassidy proposal would allow states to waive protections for individuals with preexisting conditions and would allow the creation of high-risk pools. The bill would allow insurance companies to charge older customers five times the rate offered to younger customers. The proposal also eliminates the guarantee for coverage of essential health benefits, which include the following:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative services
  8. Laboratory services
  9. Preventive services
  10. Pediatric services

The bill would eliminate the individual mandate immediately, likely destabilizing the individual marketplace in the short-term. The CBO has previously reported that elimination of the individual mandate would raise the number of uninsured by 15 million in 2018, increasing market premiums by 20%. With the loss of tax credits and premium subsidies, less healthy individuals will be more likely to drop coverage, destabilizing the marketplace even further.