As the nation’s leading volunteer eye health organization, Prevent Blindness has consistently advocated for policies that ensure Americans have access to the vision and eye health services they need. We support policies that improve health systems, not undermine them or reduce access to opportunities for early detection and treatment of eye diseases for children or older Americans with pre-existing conditions and chronic illness.

We reiterate our opposition to any attempts to remove the Affordable Care Act (ACA)’s essential health benefits protection, particularly children’s vision benefits. Additionally, we are deeply concerned that weakened protections for individuals with pre-existing conditions will force patients to forgo vision and eye health care, not as a matter of having the ability to make empowered patient choices, but as a result of significantly increased out-of-pocket costs on chronic illness, comorbid disease, or catastrophic care. The proposals in the Graham-Cassidy legislation to convert current federal spending on ACA marketplace assistance and Medicaid expansion exponentially shifts costs to states; thus, limiting states’ abilities to provide benefits and services to certain vulnerable populations, especially adults with chronic disease and aging Americans.

For these reasons, we cannot support the Graham-Cassidy legislation.

On September 13, 2017, Republican Senators Lindsay Graham (South Carolina), Bill Cassidy (Louisiana), Ron Johnson (Wisconsin), and Dean Heller (Nevada) introduced new legislation aimed at repealing and replacing the Affordable Care Act (ACA). This proposal, deemed “Graham-Cassidy,” builds off of previous Congressional attempts to repeal the law, including the Senate’s most recent attempt in July.

Chiefly, the Graham-Cassidy legislation seeks to:

  • Convert current combined federal spending on Medicaid expansion, premiums and cost-sharing assistance for moderate-income consumers, and tax credits into a “block grant” or lump sum payment made to states starting in 2020, 
  • Eliminate the ACA’s 100% federal match for Medicaid expansion starting in 2020 and establish a “per capita cap” Medicaid formula,
  • Remove patient protections that will allow insurance companies to increase premiums for patients with pre-existing conditions, including chronic diseases, and
  • Provide states with authority to request waivers for insurance plans from providing essential health benefits, which under the ACA, include children’s screenings and eye examinations and services that help patients manage their chronic diseases, particularly those from which vision loss is a complication or comorbidity.

The Senate is scheduled to vote on the Graham-Cassidy bill next week. Congressional budget rules that allow the Senate to bypass its traditional 60-vote requirement and approve legislation by a simple 50-vote majority expire on September 30, 2017.

We urge our Senators to work in a bipartisan manner to implement solutions that address our nation’s healthcare challenges.