National Coalition on Health Care Urges A Fresh Start on Health Care Legislation

Statement by NCHC President and CEO John Rother regarding the Congressional Budget Office analysis of the American Health Care Act (AHCA)

“We need health care that is more affordable for all, but according to the nonpartisan Congressional Budget Office, the current House plan moves us in the opposite direction.  It is time for a fresh start.”

“The National Coalition on Health Care, a nonpartisan alliance of over 90 patient, payer,  purchaser and provider organizations representing more than 150 million Americans, urges Congress to reject the current House budget reconciliation proposal and pursue a different approach.

According to CBO’s independent analysis, the House plan would have the following real-world results:

  • 21 million fewer Americans with health care insurance in 2020 and 24 million fewer in 2026
  • A 60% lower tax credit for eligible individuals purchasing non-group coverage in 2020
  • An $880 billion cut in federal support for state Medicaid programs over the next ten years- effectively shifting these costs to states, their taxpayers, providers and beneficiaries

We also know from an earlier Centers for Medicare and Medicaid Services Office of the Actuary analysis that the House plan’s repeal of the 0.9% increase in the Medicare payroll tax for certain high-income taxpayers would mean three fewer years until the Medicare Hospital Insurance Trust Fund’s projected insolvency.

“These outcomes would impose very high costs on American families and block ongoing reform initiatives that move us toward a more affordable system.  We are particularly concerned that $880 billion in cuts due to reduced federal support for Medicaid expansion states, changes to Medicaid’s financing structure and cuts to home- and community-based services would imperil many positive delivery reforms that hold promise for a better performing, lower cost health system. Changes of this magnitude are also likely to disrupt the ability of physician practices, hospitals, nursing homes, community health centers, and mental health and substance abuse treatment providers to remain open and furnish needed care for patients with all types of insurance.

NCHC advocates a fresh approach to fixing what’s broken in American health care. After taking reasonable steps to stabilize the non-group market (the proposed State and Patient Stability Fund represents one worthwhile idea), Congress should focus on addressing the underlying causes of high health care costs:

  1. waste and unnecessary care,
  2. the high costs of prescription drugs,
  3. the lack of coordinated care for high-cost patients,
  4. Inadequate support for primary care, resulting in avoidable specialty care, hospital stays and institutionalization,
  5. lack of investment in population health.

“These five factors drive high costs without adding value, and are a more constructive focus for efforts to move our health system toward better performance and more affordable costs for everyone. NCHC is ready to work with the Congress and the Administration on an economically sustainable and politically achievable plan.”


  The National Coalition on Health Care (NCHC), the oldest and most diverse group working to achieve comprehensive health system reform, is a 501(c)(3) organization representing more than 80 participating organizations, including medical societies, businesses, unions, health care providers, faith-based associations, pension and health funds, insurers and groups representing consumers, patients, women, minorities and persons with disabilities. Member organizations collectively represent – as employees, members, or congregants – over 150 million Americans.


Some members of NCHC do not, or cannot, take positions either on specific legislation, strategies or on any policies outside their respective mission areas. However, all that can, do endorse broad policy positions in support of comprehensive health system change.

Effort to Stabilize Market Means Little if Coverage, Affordability Disrupted

Statement by John Rother, President and CEO of the National Coalition on Health Care

“We are pleased that the Department of Health and Human Services is considering regulatory and administrative steps to assure stability and affordability in the non-group and small group markets.  In the weeks ahead, with its member organizations, NCHC will evaluate how the specific provisions of this regulation impact affordability and stability.

“But no market stabilization effort can succeed if policymakers disrupt existing coverage arrangements rather than improving on them.” 

Read the full statement here.

NCHC Declares Opposition to Elimination of State Option to Expand Medicaid

WASHINGTON –This Tuesday morning, National Coalition on Health Care announced its opposition to the repeal or defunding of the state option to expand Medicaid in a letter submitted to the Senate Finance Committee and the House Energy and Commerce Committee leadership.

“Repealing or defunding the state option to expand Medicaid would endanger states’ progress in reforming their health systems, weaken health care access for vulnerable populations and detract from recent bipartisan federal legislative achievements,” stated NCHC President and CEO John Rother.

Read the full press release and letter here, or find the official copy of the letter on the Policy Correspondence page.

NCHC Applauds Important Steps in Mental Health Before the House of Representatives

“NCHC applauds the House of Representatives, especially Chairman Fred Upton (R-MI) and Ranking Member Frank Pallone (D-NJ) of the House Energy and Commerce Committee, for the important steps taken today to address mental health and substance abuse in the 21st Century Cures legislation.  These issues are among the greatest public health challenges facing our country today, adding not only to the costs of health care, but destroying families and communities.  And although we oppose the bill’s reductions to the Prevention and Public Health Fund, we are encouraged that Congress has found a path forward on these critical behavioral health issues.

“We are also pleased to see the inclusion of provisions that reform the Hospital Readmission Reduction Program and encourage interoperability of electronic medical records.”

Read full press release here.

NCHC Urges Congress to Preserve Provider Payment Testing and Expansion Authority

WASHINGTON – In a letter submitted Tuesday evening, the National Coalition on Health Care, the nation’s largest and most broadly representative alliance of health care stakeholders, called on Congress to preserve the Department of Health and Human Services’ flexibility to test alternative models of provider payment in Medicare and Medicaid and expand those that are successful.

A rollback of HHS’ capacity to test and expand new payment models would fracture the bipartisan consensus behind MACRA and make health care less affordable over the long term.” said John Rother, NCHC’s President and CEO.  “Instead, NCHC and its members hope to work with Congress and the administration to ensure that the testing and expansion authority, now housed at the Center for Medicare and Medicaid Innovation, is preserved and deployed as effectively as possible.”

Read full press release here.


Broad Stakeholder Coalition Presses Lawmakers to Move Forward with Chronic Care Bill

“By bringing down barriers to better care for the chronically ill in both Original Medicare and Medicare Advantage, this draft bill promises to spur delivery and benefit innovation across the health care system. The National Coalition on Health Care calls on the Finance Committee, and then Congress as a whole, to move forward expeditiously with meaningful chronic care legislation.

“Better chronic care is fundamental to ensuring health care affordability in the United States. NCHC and its members have long advocated for a strong legislative response, beginning with chronic care in Medicare. We commend the leadership and dedication of the Finance Committee, Chairman Hatch, Ranking Member Wyden, Senator Warner and Senator Isakson, and their staffs.

“Of course, the details of all these policies will be crucial; NCHC and its members will continue to work with Congress to ensure the strongest possible bill. But Senators Hatch, Wyden, Isakson, and Warner have given their fellow lawmakers a remarkable opportunity: to demonstrate that bipartisan commitment can produce constructive solutions to health care affordability challenges. Congress should take that opportunity…and with the cost of care steadily climbing, they should take it soon.”

Read full press release here.


NCHC CEO John Rother Calls MACRA Implementation a Win for Affordability

“Today’s final rule on MACRA implementation is a milestone in the shift away from volume-based, fee-for-service physician payment. It represents an important victory in ongoing efforts to improve the affordability of Medicare and health care generally.

“But with costs climbing in Medicare and system-wide, Congress should build on MACRA and make bipartisan chronic care legislation a top priority.

“NCHC will be examining the details of today’s regulation—and if necessary advocating for improvements.  But we know two things already:  First, physicians and other health professionals will face significant incentives to embrace new models of care and delivery. Second, due to statutory barriers, clinician practices and provider organizations are denied the tools needed to optimally respond to those incentives.

Read full press release here.

Medicare Enrollment Bill Takes Steps to Address Coverage and Affordability Gaps

Statement by National Coalition on Health Care President and CEO John Rother on the introduction of H.R. 6184, the Medicare Enrollment Protection Act, by Rep. Bob Dold (R-IL) and Rep. Kurt Schrader (D-OR)

“Medicare’s enrollment procedures can be confusing…and every year some beneficiaries inadvertently miss crucial deadlines to sign up for Part B. Missing this deadline can mean an increase in Part B premiums for the remainder of the beneficiary’s time on Medicare – a substantial shift of Medicare’s costs onto the enrollee.  Or it can create coverage gaps that may render ongoing care for chronic or other conditions unaffordable.

Read full press release here.

Examining Selected Proposals in ‘A Better Way to Fix Health Care’: Coverage Policy and Health Care Innovation (Part 2)

In our blog post on July 14, we talked about some of the provisions in the House Republican Health Care Task Force’s health reform proposal — entitled “A Better Way” — that NCHC believes would modernize and improve the Medicare program for beneficiaries and taxpayers alike. In later posts, we will turn a critical eye toward their plans for the children, seniors, and low-income adults who depend on Medicaid and CHIP.  But today, we identify some elements of the Task Force’s coverage and innovation proposals that represent good starting points for future dialogue.

As an organization, NCHC has long been committed to finding common ground solutions to our health care challenges. And  “A Better Way” does provide some room for future conversation. The Task Force report opens with the following quote: “Americans deserve an accessible and affordable health care system that promotes quality care and peace of mind. It should empower patients and support innovation.”  We could not agree more with these goals.  After all, the National Coalition on Health Care was established to support efforts for better and more affordable coverage for all Americans, and we too believe our health care system should focus on patient-centered, high quality health care.

Read the full blog post here:


Examining Selected Proposals in ‘A Better Way to Fix Health Care’

On June 22, the House Health Care Reform Task Force, led by House Speaker Paul Ryan, released their blueprint describing how the House Republican caucus’ hopes to reform our country’s health care system, entitled “A Better Way to Fix Health Care.” There is much in their approach that we at NCHC do not support.  To name just a few examples, there is nothing particularly appealing about proposals to roll back federal support for Medicaid and CHIP, raise Medicare’s eligibility age or shutdown the Centers for Medicare and Medicaid Innovation’s crucial work on alternative payment models.  We’ll have more to say on these issues in later blog posts.

But there are ideas in the package that, properly developed, could improve our health care system. So we begin today by taking a close look at a few constructive proposals included in the report’s Medicare section.

Read the full blog post here: