Affordable Care Act (ACA)

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NVHR strongly opposes repealing the ACA without also implementing replacement legislation to ensure coverage for millions of Americans, including the nearly 5 million living with hepatitis B or hepatitis C. Maintaining quality care for individuals living with hepatitis B or C requires the maintenance of ACA programs and protections until there are meaningful, adequately funded alternatives available. Because so many individuals with hepatitis B or C rely on services provided through Medicaid, NVHR also opposes changing the current Medicaid funding structure to a per capita or block grant model.

Click here for a fact sheet on how the ACA helps people with viral hepatitis.

On January 11, 2017, NVHR sent a letter signed by 54 organizations to all U.S. Senators calling for Congress to maintain key protections and to oppose harmful changes to Medicaid. A copy of the letter is available here.

On March 10, 2017, NVHR sent a letter to all House Representatives opposing the American Health Care Act. A copy of the letter is available here. On March 24, 2017, the House leadership pulled the AHCA from the floor because it lacked the votes to pass.

On June 22, 2017 Senate Majority Leader Mitch McConnell released text of the Better Care Reconciliation Act, which is largely similar to the AHCA.

By slashing federal support for Medicaid and reducing financial assistance to help individuals pay for premiums and out-of-pocket costs, the bill would ensure that fewer people with substance abuse disorders receive treatment for opioid addiction. In turn, this will fuel the surge in overdose and hepatitis-related deaths and the spread of hepatitis B and C. The bill would also exacerbate the difficulties that patients face in obtaining access to the hepatitis C cure, leaving many more people untreated. 

Specifically, the bill would:

  • Allow states to waive Essential Health Benefit requirements, which include prescription drugs, preventive services, and mental and behavioral health services.  
  • Remove annual and lifetime limits on benefits no longer deemed essential in a state, with the potential to impose drastically higher costs for patients living with hepatitis B and C.
  • Limit premium subsidies to those who make under 350 percent of the federal poverty line.
  • Change the benchmark plan for which tax credits are determined to a lower-tier bronze plan, which means a higher share of the costs will be paid by the individual.
  • Eliminate subsidies to help low-income individuals pay for out-of-pocket costs, beginning in 2020.
  • Allow insurers to charge older individuals up to 5 times more than younger individuals.
  • Phase out the Medicaid expansion by lowering payments to states beginning in 2021.
  • Gut Medicaid by imposing a per capita cap funding structure.
  • Provide a major tax cut for the wealthy.

The Congressional Budget Office estimates that the bill would lead to 22 million people losing their health insurance over the next decade.


What You Can Do to Stop the ACA Repeal

Call, email, and/or schedule a District office visit with your Representative or Senator.

  • Members of Congress want to hear from their constituents. You can deliver a powerful message by emphasizing the importance of the ACA to people living with hepatitis B or C in your state.
  • Share your personal stories. Educate your representatives by sharing a personal story about how the ACA’s protections for people with hepatitis B or C have helped you or a loved one.

You can learn more about how the ACA has benefitted people in your state by consulting the state-specific fact sheets prepared by Families USA.

Find your Representative:

Find your Senator:

Call or email your governor.

You can deliver a powerful message to your governor about why maintaining the current Medicaid funding structure is crucial to protecting people with hepatitis B or C.

Find your governor:

For an overview of how the AHCA would affect the Medicaid expansion, you can review this fact sheet from the National Health Law Program.

For an overview of how Medicaid operates in your state, you can review the fact sheets provided by the Kaiser Family Foundation.

Keep asking questions about ACA replacement legislation.
Here are some sample questions to ask about replacement legislation, courtesy of Families USA’s Protect Our Care coalition:

  1. Will everyone who has coverage today still have coverage under your bill?
  2. Will this bill make coverage more affordable for people - lowering their premiums, deductibles and out-of-pocket costs - while not taking away any of their current benefits?
  3. Will everyone who currently gets a health insurance tax credit continue to receive the same amount or more so that they not only “have access to coverage” but can afford it?
  4. Will this bill maintain the current protections for people with pre-existing conditions that are in the current law?
  5. Will this bill guarantee that a woman can’t be charged more than a man for her health insurance simply because she is a woman?
  6. Will treatment for mental health and substance abuse disorders and prescription drugs still be covered at the same level?
  7. Will this bill prevent insurance companies from charging people over 55 more than they are today?
  8. Will everyone that is covered today through Medicaid continue to have coverage without paying more?
  9. Will this bill require large companies and other big employers to continue providing health coverage for their employees?


If you have questions about how to get involved in ACA advocacy efforts, please contact NVHR’s Public Policy Director, Elizabeth Paukstis.