As the Affordable Care Act repeal-and-replace effort ramps up in the Senate, concern is mounting that a procedural move threatens coverage for tens of thousands of veterans.
The original version of the American Health Care Act gave thousands of veterans access to tax credits to help offset the cost of purchasing coverage on the insurance exchanges. Under the ACA, veterans who were eligible for care through the Veterans Affairs Department, but not enrolled, could take advantage of the tax credit. The revised AHCA that passed the House is silent on whether those veterans will be able to get the tax credit.
The Senate is moving health reform through the budget reconciliation process, which means passage only requires a simple majority, rather than the 60 needed to halt a filibuster. That process comes with some restrictions. In this case, the tax provision has been considered outside the parameters of the reconciliation process.
Democratic senators and a veterans' advocacy group also worry that ending Medicaid expansion, as well as a 6-percentage-point match enhancement for Community First Choice—which pays for home health aides for people with spinal cord injuries, dementia, multiple sclerosis, amyotrophic lateral sclerosis and more—will adversely impact veterans.
If a veteran's medical concerns aren't related to military service, "they're not going to have access to a state veterans' home," said Susan Prokop, senior associate advocacy director at Paralyzed Veterans of America.
Curtailing federal support for Medicaid expansion could also lead states to restrict how many people can get long-term care, Prokop said; such care accounted for more than 21% of all Medicaid spending in fiscal 2015.
Sens. Richard Blumenthal (D-Conn.), Tammy Duckworth (D-Ill.), Jon Tester (D-Mont.), and Bill Nelson (R-Fla.) held a news conference last week to draw attention to the carve-out of veterans from exchange tax credits. The problem is that not all veterans qualify for VA care.
Veterans without service-related disabilities who make more than $35,176 in income with no dependents are not eligible for VA healthcare. For a veteran with two dependents, earning more than $44,629 makes them ineligible.
