Medicaid Defense Summer 2017


June 16, 2017


The Honorable Mitch McConnell, Majority Leader United States Senate

317 Russell Senate Office Building Washington, D.C. 20510


The Honorable Charles E. Schumer, Minority Leader United States Senate

322 Hart Senate Office Building Washington, D.C. 20510


Dear Majority Leader McConnell and Minority Leader Schumer: 

We have watched with great interest the recent debate and House passage of

H.R. 1628, the American Health Care Act. While we certainly agree that reforms need to be made to our nation’s health care system, as Governors from both sides of the political aisle, we feel that true and lasting reforms are best approached by finding common ground in a bipartisan fashion.


To that end, we remain hopeful that there is an opportunity to craft solutions to these challenges that can find support across party lines, delivering improvements to result in a system that is available and affordable for every American.


We believe that, first and foremost, Congress should focus on improving our

nation’s private health insurance system. Improvements should be based on a set of guiding principles, included below, which include controlling costs and stabilizing the market, that will positively impact the coverage and care of millions of Americans, including many who are dealing with mental illness, chronic health problems, and drug addiction.


Unfortunately, H.R. 1628, as passed by the House, does not meet these challenges. It calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the


states. Medicaid provisions included in this bill are particularly problematic. Instead, we recommend Congress address factors we can all agree need fixing.


We stand ready to work with you and your colleagues to develop a proposal that is fiscally sound and provides quality, affordable coverage for our most vulnerable citizens.

Download the PDF version of this article.


Bipartisan Governors Letter to Senate Leadership


CONCLUSION: Under a per capita cap, the capped payments to states increase much slower than actual costs, leading to large and multiplying losses for states. Over time, states will lose billions of dollars. Per capita caps are a huge federal cost-shift onto states, which will force states to cut Medicaid services for older adults, persons with disabilities, pregnant women and children in poverty, and other vulnerable populations.

Dowload the article on PDF format.


No Cuts! No Caps!

The new American Health Care Act (AHCA) cuts over $800 billion from Medicaid. The proposed per capita caps and cuts will have devastating and deadly consequences for people w/disabilities & seniors. Join us to educate Congress about what cuts and caps REALLY means.


These are various resources for you to use NOW, in fighting for Medicaid. Just scroll down until you get what you need...


Transparency Re-capping the Key Points:

  • We are increasingly concerned about the rapid Senate timeline for bringing a bill to the floor for a vote
  • Based on current reports, we should prepare for a floor vote the last week of June (the week of the 26th) – we will likely not see the final language of the full bill or a CBO score before then
  • It’s important to keep up pressure on Senators and to ask them for further transparency on this bill - to push back on the secretive, backroom process they’ve undertaken to date – we still have the ability to impact the ongoing negotiations within the Senate over the next two weeks
  • Based on what we know about the emerging Senate bill, it is largely the same as the House bill – despite many Senator’s claims – saying they “oppose the House bill” allows them a pass on answering to the specifics of what the emerging Senate bill includes
  • Among retaining other harmful proposals in the House-passed version of the bill, the Senate bill converts Medicaid funding to Per Capita Caps and phases out federal Medicaid expansion funding

Recapping Transparency Ask


Senators should commit that before they bring a bill to the floor, they will provide enough time for their constituents to:

•       See the final language of their bill so they can see where changes have been made to the House bill

•       Understand – with the benefit of a CBO analysis – how the bill will affect coverage and costs

•       Provide input to their senators on how the bill will affect them


Millions of Americans are worried about losing their health care – they deserve the opportunity to understand how a bill will affect them before the Senate votes.



Transparency Talking Points

  • Out of sight, Republican senators are making a backroom deal on a bill to repeal and replace the Affordable Care Act – without providing the public with the opportunity to provide input, see legislative text or understand what the bill would do. 
  • Remarkably, Senate Republican leadership will reportedly keep the bill text secret until the last possible moment – potentially unveiling both the text and a CBO score mid-way through the debate on repeal, and just hours before members are expected to vote on final passage. This is the same tactic Senate Republicans used for their last vote on ACA repeal legislation in 2015. 
  • Why are Republicans keeping the bill a secret? Probably because it’s largely the same as the overwhelmingly unpopular House bill that would cause 23 million people to lose coverage, raise costs for millions more, cut Medicaid by nearly a quarter, and take away protections for people with pre-existing conditions. 
  • The Senate Majority Whip (Senator Cornyn) has said the Senate bill will do 80 percent of what the House bill does. And everything we know about the bill so far is consistent with that. 
  • Hiding the bill and the score makes it easier to claim that the Senate has fixed the House bill’s problems, even when they actually haven’t – just like House leaders claimed that the Upton amendment fixed their bill and protected people with pre-existing conditions, when it didn’t. 
  • And, it prevents constituents – or doctors, nurses, hospitals, and other experts – from having a chance to weigh in on the bill. That’s also why Leader McConnell aims to bring the health bill to the Senate floor before Senators go home for fourth of July recess, foreclosing the opportunity for constituents to provide input and express their fears and concerns about the proposal. 
  • This is just the latest step in Republicans’ effort to force through ACA repeal through secrecy and speed. For example, there hasn’t been a single Congressional hearing on this legislation, and Senate leaders don’t intend to hold any, in sharp contrast to the development of the Affordable Care Act in 2009, when over 100 hearings were held. 
  • Congressional hearings provide highly-visible moments for experts and opponents to call attention to the impact of a bill. 
  • This is a bill that affects 1/6 of the economy and touches the lives of tens of millions of people. Senators should commit that before they bring a bill to the floor onto the floor, they will provide enough time for their constituents to:

Download the talking points in PDF format.


1385 S. Colorado Blvd. Bldg. A., Ste. 610

Denver, Colorado 80222



Julie Reiskin

Executive Director
720.961.4261 (Direct)
303.567.6582 (Fax)


June 18, 2017

Gardner Office Locations


503 N. Main Street, Suite 426                                     
Pueblo, CO 81003
Phone: (719) 543-1324
Fax: (202) 228-7174



Colorado Springs

102 S. Tejon Street, Suite 930
Colorado Springs, CO 80903
Phone:(719) 632-6706 
Fax: (202) 228-7176



1125 17th Street, Suite 525
Denver, CO 80202
Phone: (303) 391-5777
Fax: (202) 228-7171


Grand Junction

400 Rood Avenue, Federal Bldg., Suite 220
Grand Junction, CO 81501
Phone: (970) 245-9553
Fax:  (202) 228-7173




801 8th Street, Suite 140A
Greeley, CO 80631
Phone: (970) 352-5546
Fax: (202) 228-7172


Fort Collins

2001 S. Shields Street, Building H
Fort Collins, CO 80526
Phone: (970) 484-3502



529 North Albany Street, Suite 1220
Yuma, CO 80759
Phone: (970) 848-3095
Fax: (202) 228-7175



329 S. Camino Del Rio, Suite I
Durango, CO 81303
Phone: (970) 259-1231
Fax: (970) 259-4276



Phone: (202) 224-5941 
Fax:  (202) 224-6524





Senator Bennet Office Locations


Denver Metro Office

1127 Sherman St., Suite 150

Denver, CO 80203

Phone: 303-455-7600

Toll Free: 866-455-9866


Arkansas Valley Office

129 West B Street

Pueblo, CO 81003

Phone: 719-542-7550


San Luis Valley Office

609 Main Street, Suite 110

Alamosa, CO 81101

Phone: 719-587-0096


Pikes Peak Office

409 North Tejon St., Suite 107

Colorado Springs, CO 80903

Phone: 719-328-1100


Northern Colorado - Eastern Plains Office

1200 South College Ave., Suite 211

Fort Collins, CO 80524

Phone: 970-224-2200


Northwest/I-70W Office

225 North 5th Street, Suite 511

Grand Junction, CO 81501

Phone: 970-241-6631


Four Corners Office

835 East 2nd Avenue, Suite 206

Durango, CO 81301

Phone: 970-259-1710  


Washington, D.C. Office

261 Russell Senate Office Building

Washington, DC 20510

Phone: 202-224-5852

Fax: 202-228-5097



Phone: 202-224-5852
Fax: 202-228-5097 


Message for Senator Bennet

Thank you for standing strong on opposing the American Health Care Act and opposing cuts to Medicaid.   Explain why Medicaid is important to you.  In email share your story.

Download the list of locations in PDF.


What is a Per Capita Cap?

A per capita cap is a financing tool that is being proposed to dramatically cut Medicaid funding.
Today, states receive Federal Medicaid funding based on the actual costs of providing services to older adults, persons with disabilities, pregnant women and children in poverty, and others. Under a per capita cap, the Federal government makes a capped payment to the state, and the state does not receive money based on actual costs.

Here’s how it works. Under Medicaid today, for every dollar a state actually spends on Medicaid services, it gets $1 to $3 of Federal support (richer states get $1, poorer states get $3). States are guaranteed continued support for actual costs, even if those costs go up. With a per capita cap, the Federal government makes a limited payment to the state based on a preset formula, which does not increase based on actual costs. Per capita caps have two components which both cause problems.

  1. In the first year of a per capita cap, Congress would set an initial allotment which is supposed to be based on the expected actual costs. Many per capita cap proposals underestimate this amount, so the state already gets a cut in the first year.
  2. More importantly, the initial allotment is increased every year by a preset growth index, such as the consumer price index. The problem is, capped payments based on such a growth index increase much slower than actual health care costs. This means that every year the state’s actual costs grow much faster than the federal support.