Alzheimer's Association and Alzheimer's Impact Movement Statement:

September 25, 2017 - Across the country, millions of Americans living with Alzheimer's or other dementias rely on Medicaid services to access quality care. The Alzheimer's Association and Alzheimer's Impact Movement (AIM) are therefore troubled by elements of the proposed Graham-Cassidy Amendment and the impact it may have on this population.

More than 5 million Americans are currently living with Alzheimer's, a progressive and fatal brain disease, and another 15 million are providing care. In its later stages, those who have the disease require an extraordinarily high level of hands-on care, often for years. Medicaid is the only public program that covers these long-term nursing home stays. Medicaid also covers home and community-based services which are critical for people with dementia, particularly in the early and middle stages of the disease.

The proposed changes to Medicaid outlined in the Graham-Cassidy Amendment could have a drastic impact on this vulnerable population, given that more than 1 in 4 seniors with Alzheimer's and other dementias are currently on Medicaid.

The Alzheimer's Association and AIM are also alarmed by the potential impact of this legislation on Americans living with pre-existing conditions, including the 200,000 Americans living with younger-onset Alzheimer's. We strongly urge Congress to enact meaningful protections for individuals with Alzheimer's and other dementias to ensure continued access to affordable health care.

At a cost of $259 billion in 2017, Alzheimer's is the most expensive disease in the country and the only leading cause of death in the U.S. that cannot be prevented, cured or even slowed. Until Americans living with Alzheimer's and other dementias have access to effective treatments and means of prevention, it is imperative that those living with this devastating disease have access to affordable, quality care.

As the legislative process continues, we will continue to work with Congress to protect the needs of and address the complex challenges faced by these Americans. We urge Tennessee Senator Lamar Alexander and Senator Bob Corker to recognize the negative impact this new amendment could have on those affected by Alzheimer's and other dementias.

American Nurses Association Statement:

The American Nurses Association (ANA) stands firmly in opposition of the Graham-Cassidy-Heller-Johnson proposal.

ANA, which represents the interests of more than 3.6 million registered nurses, has serious concerns with the Senate's latest healthcare proposal. Millions of Americans, including nearly 11 million who gained coverage under Medicaid expansion, stand to have their healthcare coverage ripped away under this plan.

"ANA denounces the latest Senate proposal as its worst yet," said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. "This proposal limits care for those that need it most and fuels greater uncertainty in the insurance market. It poses a serious threat to patients' care, especially those that need coverage for illnesses or pre-existing conditions. Patients deserve better and we won't rest until they get it."

As written, the legislation would make deep cuts to Medicaid, ending the Affordable Care Act's expansion and fundamentally changing the program to a per-capita block grant financing system. In addition, the bill would erode critical consumer protections for pre-existing conditions and essential health benefits. Lastly, the proposal would wipe out subsidies for the purchase of private health coverage. The proposal fails to meet ANA's principles for health system transformation.

ANA recognizes the need for legislative action to improve health care for all Americans but urges the Senate to oppose Graham-Cassidy in its current form. Bipartisan solutions are needed to strengthen affordable health care, not destroy coverage for millions of Americans.

For high resolution images of the ANA logo or photos of ANA leadership, please click here.

Rep. Jim Cooper Statement:

U.S. Rep. Jim Cooper (TN-5) today expressed disappointment with Graham-Cassidy supporters U.S. Sen. Lamar Alexander, U.S. Sen. Bob Corker and Gov. Bill Haslam, offering another point of view that aligns with provider, hospital and disease advocacy groups all over America.

"The latest Republican attempt to pass a 'health' bill (their fourth) is the worst yet. Although it can be painted to look good in the next few years, the bill makes false promises that will hurt at least 32 million Americans, and hurt them very soon. How many hundreds of thousands of those victims are Tennesseans?" Rep. Cooper said. "Almost everyone who knows anything about health care is strongly against this bill. Why? This bill is a cynical attempt to buy barely enough Republican votes by bribing Southern states to overlook the horrific national damage the bill will cause with $4 trillion in overall cuts. Southern states will suffer, too. To call this a 'states' rights' approach to health reform is a lie. It is a race to the bottom, with each state competing to be crueler to its citizens by denying them health insurance and health care. America deserves better, much better, and I am working to persuade enough Republicans with a soul to stop this devastatingly partisan attack on all Americans."

Gov. Haslam has described Graham-Cassidy as a "home run" and "flat-out good" for Tennessee, and both senators have expressed their willingness to vote for it. While Graham-Cassidy would briefly reward Tennessee with new funding, Cooper said the Volunteer State would have received the money years ago had its legislature expanded Medicaid.

Cooper highlighted several studies showing that the Graham-Cassidy bill would cause 32 million Americans to lose their insurance; reduce vital federal funding for Tennessee; and increase premiums for people with pre-existing conditions.

"A much better course of action would have been to let our own senator, Lamar Alexander, complete his efforts to craft a bipartisan health reform bill. He has been trying but has been betrayed by his own political party," Rep. Cooper said. "Apparently, now, even he has given up. That is a tragic mistake. Without bipartisanship, Republicans will merely be repeating the mistakes of previous partisan reform efforts, which Republicans have long criticized. By not learning the lessons of history, Republicans are doomed to repeat history's mistakes. This bill simply must be stopped!"

The bill also would allow plans that exclude important benefits like mental health and maternity care. Additionally:

• According to the Commonwealth Fund, 32 million Americans would lose their health insurance after 2026.

• A study by Avalereshows Tennessee would lose $61 billion in federal funding between 2020 and 2036.

• The Kaiser Family Foundationsays that, under the Affordable Care Act, 176,000 Tennesseans will receive a total of $1.3 billion in premium tax credits this year to help buy private insurance. Under the Graham-Cassidy bill, those Tennesseans would lose that assistance.

ACEP Statement:

The American College of Emergency Physicians today urged the leaders of the U.S. Senate not to consider the Cassidy-Graham-Heller-Johnson amendment, saying it would have devastating impacts on millions of Americans. In addition, Dr. Rebecca Parker, president of the organization, said that ACEP cannot support any legislation that does not include emergency medical care as a guaranteed covered benefit in health insurance.

Link to the Letter (PDF): https://t.co/fPJ30310HB

American Cancer Society Cancer Action Network Statement:

The American Cancer Society Cancer Action Network (ACS CAN) sent a letter to Governor Bill Haslam calling on him to oppose a new proposal to repeal and replace the current health care law offered by Senators Graham and Cassidy. Instead, the letter calls on the Governor to support the bipartisan efforts being spearheaded in the Senate by Chairman Lamar Alexander (R-Tenn.) and Senator Patty Murray (D-Wash.) in the Senate Health, Education, Labor and Pensions (HELP) Committee, and by Chairman Orrin Hatch (R-UT) and Ranking Member Ron Wyden (D-Ore.) in the Senate Finance Committee. These efforts, focused on market stabilization and other critical issues, represent a promising first step toward addressing the nation's health care challenges.

In the letter, ACS CAN President Chris Hansen writes, "As drafted the Graham-Cassidy legislation would end Medicaid expansion completely and place a per capita cap on traditional Medicaid, remove funding protections for children and disabled Americans and impose a dramatic reduction in Medicaid support to states over the next decade and beyond."

Medicaid is the critical health insurance safety-net that provided health care coverage to in 2016, including children, pregnant women, families, seniors and individuals with disabilities.

Currently, Tennesseans (infants to age 64) with a history of cancer rely on Medicaid for their health coverage and children (infant to age 19) with a history of cancer are currently covered by Medicaid in the state.

The proposed Graham-Cassidy block grant (which would include both the Marketplace and Medicaid expansion populations) and Medicaid per capita cap (which would affect the traditional Medicaid population) would cut federal funding to Tennessee by approximately $1.6 billion in 2026. In 2027, Tennessee is estimated to lose $3.2 billion in federal funding, because funding for the block grant would be eliminated and states would be left with only inadequate per capita cap funding for their traditional Medicaid enrollees.

The letter goes on to note, "In addition, the bill eliminates the marketplace premium subsidies and cost sharing subsidies effectively shutting down the individual insurance marketplace. Finally, the bill would roll back important essential health benefit protections, and potentially open the door to annual and lifetime caps on coverage, endangering access to critical care for millions of Americans."

As written, the Graham-Cassidy legislation would eliminate existing premium tax credits that Tennesseans use to buy insurance in the private market. As of January 31, 2017, 234,125 Tennesseans enrolled in a Marketplace insurance plan - 32.5 percent of these were new enrollees. A total of 199,239 (85.1 percent) qualified for tax credits. The average monthly tax credit was $529. In addition, 134,449 (57.4 percent) qualified for plans with reduced cost-sharing.

Under the proposal, cancer patients and survivors could lose federal protections against discrimination and higher insurance costs. The legislation could also cause cancer patients to lose access to guaranteed essential health benefits, such as cancer screenings.

The letter continues, "Accordingly, we are urging senators to oppose the legislation because it completely fails to protect cancer patients and millions of other Americans who would lose their coverage and access to affordable health care."

In the letter, ACS CAN also lauds the current bipartisan efforts underway in the Senate focused on stabilizing the health care markets and asks the Governor to urge his Senators "to support this important bipartisan effort, and to oppose the extreme repeal bill now being advanced by Senators Graham and Cassidy."

The letter to the Governor concludes, "ACS CAN stands ready to work with both sides of the aisle to build long-lasting bipartisan solutions both now and in the future."

For a copy of the full letter please visit: http://bit.ly/2hjbVrt

Rick Pollack, President and AHA CEO Statement:

We believe that coverage could be at risk for tens of millions of Americans under the Graham-Cassidy proposal. We continue to urge senators to work in a bipartisan manner to address the challenges facing our health care system.

This proposal would erode key protections for patients and consumers and does nothing to stabilize the insurance market now or in the long term. In addition, the block grant to provide support for the expansion population expires in 2026, thereby eliminating coverage for millions of Americans.

For these reasons, we oppose the Graham-Cassidy plan.

Civil and Human Rights Coalition Statement:

Vanita Gupta, president and CEO of The Leadership Conference on Civil and Human Rights, issued the following statement on the health care legislation released today by Senators Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.):

"This latest attempt by republicans to undermine the Affordable Care Act and destroy Medicaid is mean-spirited and must fail. Instead of seeking a bipartisan path to stabilize the health insurance marketplaces and improve access to care, the Graham-Cassidy bill takes up many of the worst parts of the previous failed partisan attempts to undermine our nation's health care systems. Capping and block-granting Medicaid, repealing the Medicaid expansion, and undermining protections for people with pre-existing conditions would harm working families, especially low-income and communities of color, and is not the path forward that the nation wants.

If senators are serious about improving health care in this country, they should allow the bipartisan process being led by the chair and ranking member of the Health, Education, Labor and Pension Committee - Senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) - to proceed. Ramming through bad legislation to gut the Affordable Care Act and Medicaid because of a ticking countdown is ill-advised, and is playing politics with the health of our people."

The Leadership Conference on Civil and Human Rights is a coalition charged by its diverse membership of more than 200 national organizations to promote and protect the rights of all persons in the United States. The Leadership Conference works toward an America as good as its ideals. For more information on The Leadership Conference and its 200-plus member organizations, visit www.civilrights.org.

Michele Johnson, executive director of the Tennessee Justice Center Statement:

AMA Opposing Statement:

The American Medical Association (AMA) today outlined its opposition to the Graham-Cassidy legislation in the U.S. Senate, citing the loss of affordable health insurance coverage for millions of patients across the country.

"Similar to proposals that were considered in the Senate in July, we believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care," wrote AMA CEO and Executive Vice President James L. Madara, M.D. "We sincerely urge the Senate to take short-term measures to stabilize the health insurance market by continuing to fund cost sharing reduction payments."

The full text of the letter is below and can be downloaded in PDF format.

THA Statement Opposing Legislation:

Last week, U.S. Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) introduced a proposal to repeal and replace the Affordable Care Act and make significant reforms to Medicaid. Given the expectation that the bill will gain sufficient support to move to the U.S. Senate floor for a vote, THA President and CEO Craig Becker has made the following statement regarding the proposal.

"Although we appreciate the senators' effort to seek state-level input and provide greater flexibility, Tennessee's hospitals oppose this proposal. As it stands, the bill includes many of the same issues that were in the Better Care Reconciliation Act (BCRA) that we found to be unacceptable and detrimental to our state.

"Specifically, the potential for disruptions to the individual insurance marketplace, long-term cuts and structural changes to Medicaid funding - with a tremendous burden placed on state budgets, maintenance of steep cuts in the ACA to Medicare providers, and elimination of the Prevention and Public Health Fund, make the proposal a nonstarter for a much-needed healthcare solution.

"As hospitals, we continue to support legislative action to stabilize the individual insurance market and believe Medicaid reform is a separate issue altogether, and should be dealt with at a later date.

"As healthcare providers, we understand the need to re-examine and make improvements to the ACA. However, the Graham-Cassidy proposal falls woefully short. We will continue to reach out to our elected officials to share our concerns and work together to create a viable healthcare solution for all Tennesseans."