Medicaid provides quality and affordable health care coverage for about 1 in 4 Americans, and 3 in 10 people with bleeding disorders. Without Medicaid, many lower-income people living with bleeding disorders could not regularly access the medication, treatment, and care coordination they need to live healthy and productive lives.

Congress is looking to cut federal spending on Medicaid in order to achieve budget savings to spend on other priorities. The cuts up for debate will likely include policies such as:

  • Reducing how much the federal government pays toward the costs of running the Medicaid program. Lower federal funding would leave the states with higher costs – triggering program rollbacks and ultimately forcing an end to Medicaid expansion coverage for non-disabled adults.
  • Imposing “work reporting requirements” as a condition for adults to keep their Medicaid coverage. Medicaid work reporting requirements create red tape that people have to navigate to get and keep their health coverage. But evidence shows that the vast majority of Medicaid enrollees already work or qualify for an exemption, and cutting off health coverage does not encourage people to stay employed.

These policies would cause coverage losses and would threaten access to care for people with high-cost conditions such as bleeding disorders. Community members would be at risk of preventable complications, permanent disability, or worse.

US Senate Updates to Proposed Medicaid Cuts

The draft Senate legislation builds on the restrictions on provider taxes included in the House bill. Specifically, Medicaid expansion states would have their allowable use of provider taxes significantly phased down by 2031 – this significant change could force states to end Medicaid expansion and reduce services and limit eligibility. This is essentially a way to “cut” the federal government matching funds for Medicaid without actually stripping them. Matching funds would still be decreased through the above proposal.

The Senate bill also takes no action to extend the enhanced advance premium tax credits (APTCs) that expire at the end of 2025. (The enhanced APTCs, enacted during the pandemic, make premium subsidies more generous.) Expiration of those enhanced APTCs is projected to cause Marketplace premiums to increase by an average of 75%, resulting in a loss of insurance for 4.4 million people.

Similar to the House bill, the draft Senate text includes provisions to narrow eligibility for tax credits under Marketplace plans and maintains provisions imposing new burdensome enrolment and eligibility verifications.

Here’s what you can do:

1. EMAIL and CALL Your Members of Congress 

Right now, US Senators are debating a bill that would make deep cuts and harmful policy changes to Medicaid and to Marketplace insurance. This legislation (the so-called “One Big Beautiful Bill”) has already passed the House, but it can’t become law without Senate approval. We need to raise our voices to stop the bill in the Senate!

The stakes could not be higher. More than one-third of people in the bleeding disorders community get health insurance via either Medicaid or the Marketplace – insurance that covers essential treatment and medicines. The bill now under consideration in the Senate threatens access to coverage and care for us, and for up to16 million other people from across all walks of life.

Medicaid

  • The Senate should REJECT work reporting and paperwork requirements that make it harder for individuals to get or keep Medicaid coverage. People with bleeding disorders cannot afford to lose coverage due to paperwork!
  • The Senate should REJECT new cost-sharing for adults covered under the Medicaid expansion pathway. Research shows that even modest cost-sharing causes low-income people to forego medically-necessary care, with dangerous consequences to their health.
  • The Senate should REJECT policies that limit funding mechanisms that 49 states currently use to finance some of the states’ share of Medicaid costs. Those limits would cause states to change coverage and reimbursement levels, harming everyone with Medicaid coverage.

ACA/Marketplace

  • The Senate should REJECT policies that would increase premiums for Marketplace insurance. Instead, the Senate should act to extend enhanced tax credits that will otherwise expire this year – and prevent a spike in premiums. 
  • The Senate should REJECT policies that would make it harder for people to get and keep Marketplace insurance.  It should scrap provisions in the House-passed bill that would shorten enrollment periods, increase paperwork, and make re-enrollment harder.

The National Bleeding Disorders Foundation has created an action alert to easily send a message and make a call to your member of Congress. We encourage you to utilize the message template and script from the National Bleeding Disorders Foundation to Fight Cuts to Medicaid and Marketplace Insurance! Thank you for defending the programs that provide essential health insurance for so many in our bleeding disorders community!

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2. DROP BY your U.S. Senator’s local in-district office!

Deliver one clear message: 

“We ask you to stand with the bleeding disorders community members who rely on
Medicaid for access to comprehensive healthcare and reject cuts and administrative
requirements that force eligible constituents to prove they deserve coverage.”

Thanks to HFA, we have a No Healthcare Cuts Playbook to guide you through your visit, it includes:

  • Exactly what to say
  • What to bring
  • Tips to make your visit count
  • A one-page leave-behind for staff

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What is a Drop-By Visit?

A drop-by visit is an unannounced stop at your Senator’s local office. While you may not
meet with the Senator, the visit shows your concern and delivers a message directly to their
staff.

Step-by-Step: How to Conduct a Drop-By Visit

1. Find Your Senator’s Local Office

Senator Dave McCormick has two offices in Western Pennsylvania:

Pittsburgh, PA

310 Grant Street
Suite 2415
Pittsburgh, PA, 15219

Phone: 412-803-7370

 

Erie, PA

17 South Park Row
Suite B-150
Erie, PA, 16501

Phone: 814-240-5213

 

Senator John Fetterman has two offices in Western Pennsylvania:

Pittsburgh, PA

1000 Liberty Avenue
Suite 1811
Pittsburgh, PA, 15219

Phone: (412) 803-3501

 

Erie, PA

17 South Park Row
Suite B-120
Erie, PA, 16501

Phone: (814) 453-3010

2. Prepare Your Message

Your key ask:

“We ask you to stand with the bleeding disorders community members who rely on
Medicaid for access to comprehensive healthcare and reject cuts and administrative
requirements that force eligible constituents to prove they deserve coverage.”

You can also share:

  • How Medicaid impacts you or how you would afford to pay out of pocket for
    marketplace coverage if you did not have access to the insurance you have today
  • That Medicaid is a lifeline for people with chronic and complex health needs,
    including those with bleeding disorders.

3. Bring or email the Leave-Behind

Include:

4. Your Message

  • Be polite and respectful to front desk staff.
  • Say why you’re there: “I’m a constituent, and I want to deliver a message to the
    Senator. Please ask them to protect Medicaid and avoid creating new barriers to
    access.”
  • Ask to speak with a staff member, if available.
  • Leave your materials and thank the staff.
  • Take a photo

After Your Visit:

Fill out the Report-Back Form — it’s how we track your impact and follow up with lawmakers.
Report your Advocacy Action Here. Reach out to Kara at kara@wpbdf.org after your visit as well to let us know how it went! 

And post a photo with #NoHealthcareCuts and tag @hemophiliafed and @WPBDF to let everyone know we are watching—and we are not backing down.

Thank you for our advocacy!