Hill Watch: Final FY 2017 Funding and the American Health Care Act

Hill Watch: Final FY 2017 Funding and the American Health Care Act
House passes American Health Care Act; Congress passes FY 2017 appropriations bill
When NCHV sent you an update on the appropriations process last week, the deal for FY 2017 looked like it was on the fast track to passage, but had yet to clear all of its hurdles. Now we can share that both chambers of Congress have in fact passed the legislation (H.R. 244) as we described it, and the President signed the bill on Friday, May 5, 2017.
H.R. 244 provides funding for the remaining portion of FY 2017 for the entirety of the federal government. This bill covers most of the federal government’s funding obligations, but not all. As we have discussed in Hill Watch before, Congress has already agreed on the funding levels for the operations of VA in FY 2017. This earlier agreement covered many of the programs that we consider to be the pillar programs of the federal response to veteran homelessness.
Also last week, the House of Representatives passed the American Health Care Act (AHCA - H.R. 1628) by a narrow margin. This was the first hurdle for this package of reforms as it moves through its own process.
The bill would make several changes to the legislation known alternatively as the Affordable Care Act (ACA) or Obamacare. Current analysis indicates that the bill would not alter any existing policies relating to healthcare eligibility through the U.S. Department of Veterans Affairs (VA). However, as we all know, not every homeless veteran who presents for care is enrolled, eligible, or willing to utilize healthcare services through VA. For these veterans, there are worrying developments.
Most strikingly, the bill would curtail the number of states offering the “expanded” Medicaid package made available under Obamacare. Apart from being deployed in innovative ways (such as being utilized as a funder for supportive housing services) this Medicaid expansion has been shown to reduce the number of uninsured veterans by dramatic amounts. Just recently, the Urban Institute found that uninsurance rates for veterans were 4.8% in states that expanded Medicaid, compared to 7.1% in states that did not. Furthermore, they found that the uninsurance rate among veterans had fallen by 40% since the ACA had come into effect. The changes in law proposed in the AHCA would reverse these trends, and cause these rates to rise again.
Fortunately for these veterans and the programs that serve them, the bill in its entirety (and these Medicaid provisions in particular) are unpopular in both parties of the Senate. As this bill will need to pass the Senate in the same form as the House for enactment into law, it is unlikely that the current form of the bill will be the same as the final form. The current sense of the Senate is that they will write their own bill, which may be unpalatable to the majority coalition in the House.
NCHV will keep you updated as the AHCA progresses through the remaining stages. Please email Joshua Stewart, NCHV's Director of Policy, if you have testimonials you would like to share about the importance of Medicaid expansion in your work or in the lives of homeless and/or at-risk veterans. You can reach him via email at jstewart@nchv.org