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senate republicans win on motion to proceed to health reform debate

First Vote to Repeal ACA Fails

A Senate Republican bill, BRCA, that largely repeals and replaces the Affordable Care Act (ACA) with coverage provisions that would save billions of dollars but swell the ranks of the uninsured was voted down decisively last night, 43 to 57.

On Tuesday, July 25th, Senate Republican leaders began a floor debate on repealing the Affordable Care Act (aka Obamacare).  Senators were divided equally on a motion to begin debate on the Better Care Reauthorization Act (BCRA) and Vice President Mike Pence was forced to cast the deciding vote in his role as President of the Senate, giving Republicans a victory on the motion.

The Senate immediately began consideration of the BCRA.  It si clear, given statements from Republican Senators, that the underlying bill does not have the votes in the Senate to proceed as written, but numerous votes on amendments to the legislation are likely.

Next, the Senate will debate the underlying bill for 20 hours (Tuesday and Wednesday).  Republicans and Democrats will likely offer many amendments for consideration.  At the end, the Republicans will likely vote on a "skinny" version of health reform that repeals the individual mandate and little else.  Then they will vote to conference with the House to resolve differences in the bill.  So the Senate Republicans can likely get a slimmed down version of health reform out of the Senate, but repeal of the Affordable Care Act still remains in question.

healthcare legislation update - June 2017

Senate Republicans Release Draft of Their Health Plan

On Thursday, Senate Republicans released their proposal to replace Obamacare. The plan comes after months of highly-secretive, behind-closed-door meetings. Senate Majority Leader Mitch McConnell has previously indicated he would like to the Senate to vote on the measure next week ahead of the Fourth of July recess, but it’s unclear if the will have the votes to pass the Senate with only 50 votes plus the support of Vice President Mike Pence.

Provisions of the proposed measure include:

The plan would keep the current cost-sharing subsidy payments in place through 2019 and retains the current assistance formula basing aid on income and the cost of an insurance plan. However, the tax credits are slightly less generous, by eliminating subsidies at 350 percent of poverty level - as opposed to 400 percent with Obamacare. It also bases the subsidies off of the bronze level plan, which has higher cost-sharing, rather than the silver-level plan.
The measure would phase out Obamacare’s expansion of Medicaid over three years, starting in 2021. The bill would cap federal spending on the Medicaid program using the per-capita cap - which is similar to the measure that passed the House. However, it applies to a more stringent inflationary measure, using overall inflation, rather than medical inflation, beginning in 2025.
The proposal provides an additional $50 billion over four years to stabilize insurance exchanges, relying on a mechanism Republicans have long criticized as a way to keep insurers in the marketplaces.
The draft bill includes $62 billion allocated over eight years to a state innovation fund for coverage for high-risk patients, reinsurance, and other items.
The plan also includes $15 billion a year in market-stabilizing funds over the next two years and $10 billion a year in 2020 and 2021.
The Senate version, like with its House counterpart, repeals the individual and employer mandates.
The Senate measure sunsets the essential benefit requirements beginning in 2020.

Republicans worked with the Senate Parliamentarian to ensure that the bill complied with the Byrd Rule, which allows the measure to pass under the reconciliation process and requires only 50 vote threshold. The Byrd Rule requires reconciliation legislation only to include budget-related provisions and cannot include language that has limited or no fiscal impact. The reconciliation process also opens Republican Senators up to having to vote on an unlimited number of amendments, which Democrats will offer aimed at making Republicans choose between higher benefits between the poor and working poor or tax cuts.

A Senate-passed bill would then go to the House, which would have the choice of approving the Senate version or negotiating a compromise version. If they choose to renegotiate the measure, it would have to pass both chambers again before sending it to President Donald Trump for his signature.

Please call your Senators TODAY because this bill will still cut millions of people from healthcare, do away with maternity care as an essential benefit in 2020 and will drastically cut Medicaid

Response to JAMA article published

The Journal of the American Medical Association published an article last fall looking at expanding birth center coverage across the United States but did not use any US data to support their assertions. We submitted a response and it was published in the February edition. See our response here.

two things to know this december

  1. As the new Congress prepares to take over at noon January 3, we are hearing more about their plans involving healthcare in the coming months.

    House Republicans are accelerating their discussions over how to use the fiscal 2017 and fiscal 2018 budget resolutions to fast-track legislation with partial Obamacare repeal as a prime target.>>>READ MORE

  2. There are two new appointments for Cabinet positions that you should be aware of. First, President-Elect Trump has nominated Rep. Tom Price (R-GA) to be the next Secretary of the U.S. Department of Health and Human Services (HHS). He will have a big task ahead of him, if confirmed by the Senate, to rework the Obamacare. >>>READ MORE

Make Time Before the Election!

Do you think your legislators know about you and your birth center? If they don’t know you, then how can you expect them to advocate for you?

If the answer to the first question is no, then you MUST call them and have them visit your birth center before the election – and that’s less than a month away!

Don’t have time? We know all of you are busy, but can you deputize that great client of yours or a staff member to make the call (phone numbers below) or send the letter (also below)? >> READ MORE

It's Time to Schedule Legislative Visits to Your Birth Center

Elected officials are largely unfamiliar with the role of birth centers in maternity care today in the United States. It is incumbent on each of us to do our part to educate local, state and federal elected officials from our parts of the nation to ensure that when important issues are raised they have at least a base of understanding


Action Alert June 16, 2016

Have you seen the new guidance from CMS regarding birth centers? It says that it is mandatory... >> READ MORE

Action Alert April 28, 2016

Are you satisfied with the way maternity health care is paid for? Neither are we!

We believe that care that is effective should be reimbursed fairly to improve the quality of care and lower costs.

AABC submitted a proposal to the national working group on alternative payment models. >>READ MORE

Action Alert February 4, 2016

AABC met with the Centers for Medicare & Medicaid Services (CMS) last week in conjunction with ACNM and NACPM. The meeting was very positive.

They would like to know the problems that birth centers are encountering with Medicaid reimbursement.

So click here and tell us your concerns! >> READ MORE

Legislative Alert January 12, 2016

It's a New Year! Now is the time to tell your Congress people about your birth center! It is a new year and a major election year. Even if your Representatives and Senators are not on the ballot, they always like positive media coverage. Wouldn't it be great if they visited your center this year? Good publicity for them, GREAT publicity for you! >>READ MORE

Legislative Alert December 8, 2015

Do you want to see more midwives in maternity shortage areas? Then it's time to call your Representatives and Senators and urge them to co-sponsor H.R.1209, S.628. Why the urgency? Ginger Breedlove, President of ACNM and AABC member is testifying on the Hill on Wednesday, December 9 about the importance of supporting this bill. Let's help support this bill and call NOW!! >>READ MORE


  • The Legislative Committee is working on ways to connect and inform the state chapters that are forming.
  • A DNP student from Frontier Nursing University will be working on updating state birth center regulations and making the information digital and user friendly.
  • The committee has received many new applications and those will be reviewed and sent to the committee chair.


If you are attending the Birth Institute, in Scottsdale, AZ - October 1-4 – you will have two opportunities to learn about legislative issues:

  • Friday, October 2 from 1:00 – 2:00 will be a Legislative Forum covering issues with TRICARE, NAICS classifications, ERISA plans and the Medicaid Survey that members completed.
  • Sunday, October 4 from 10:00 – 11:30 will be Effecting Change in Your State at the Legislative and Policy Levels with a Panel made up of members who are having Successes with State Issues-- like state licensure in New Mexico, improving Medicaid reimbursement in Maryland, removal of physician supervision and integrating licensed midwives into state Medicaid in California and overturning certificate of need laws in Kentucky.

Don’t miss out on learning about these important issues – what you learn can help you be successful in YOUR state!

The following are actions taken by the Legislative Committee during the months of August and September 2015

  • Comments were filed with the North American Industry Classification System (NAICS) on their newly proposed classification of freestanding birth centers. Until this is changed, birth centers are classified as midwives’ offices under NAICS, which can be confusing for payers and others.
  • Comments were filed with Louisiana concerning their revised regulations on birth centers. Louisiana currently does not have licensure or regulations for birth centers.
  • Comments were also filed with South Carolina Department of Health and Environmental Control proposed revisions to regulations for birth centers
  • A letter was sent to the Governor of California urging him not to sign AB1177, which would add the requirement of a signed agreement with a transfer hospital to licensure for that state. There seems to be a trend for special interests to try to add this requirement in other states.
  • AABC believes that communication and planning for transfers between levels of care is key to the safety of mothers and babies, and to the seamlessness of changes in levels of care. What is required, rather than a written agreement, is the willingness on the part of birth centers and transfer hospitals to enter into this process of planning and communication. This process should not be a barrier to access to high quality care in birth centers.

Legislative Alert August 3, 2015

  • Do you want Medicaid MCO's to contract with birth centers? We know you do...find out more here

  • Comments to CMS were submitted on July 27, 2015 regarding Medicaid Managed Care Organizations. Read the comments and a two page handout on the comments.
  • There will be an open forum to discuss legislative topics at the 9th annual Birth Institute on Friday, October 2 from 1:00 – 2:00. If you have topics you would like to discuss, please contact Jill Alliman.
  • The Member Medicaid survey is going through the data cleaning process. Some information that was collected was unclear so an AABC staff member is updating everything. This should be completed by the end of August 2015.
  • Joel Ryan has just finished a letter to TRICARE detailing improving network participation of birth centers with TRICARE. This is being reviewed and will be sent to the Medical Benefits Review Office.
  • An ERISA subcommittee was formed (Steven Hall and Karen Fennell) with the goal of explaining ERISA plans and comparing them to other types of insurance plans to members.
  • AABC had many members attend the ACNM convention and participate in their Lobby Day at the end of June. Hill visitors highlighted the Improving Access to Maternity Care Act of 2015, (S. 628, H.R. 1209) and were able to add new co-sponsors to the bill. This bill would add freestanding birth centers in maternity shortage areas as loan repayment sites for midwives working there.

Legislative Alert June 24 & 27, 2015


A huge thank you to all of you that called your federal legislators this past week!

But the work is not done! The House Appropriations Committee passed the bill (that means AHRQ would be eliminated, CMMI loses $6.8 billion and Strong Start money disappears. READ MORE>

Legislative Alert June 2015

A great bill to support... Health, Equity and Access under the Law (HEAL) for Immigrant Women and Families Act. Tell your legislators that this is important!!

It ensures that all lawfully present individuals have access to affordable health

coverage in the marketplaces, Medicaid and CHIP.

It's Spring! Tell your legislators that it is the perfect time to grow more birth centers

In order for Congress to introduce and pass legislation that is favorable to birth centers, your state and federal Congress people need to know you and have a relationship with you. READ MORE>>

Tell Congress about the importance of Women's History Month

The lessons learned from our past political activities have taught us much about moving forward during difficult times. During the passage of AABC's Medicaid Facility Service Payment legislation and the inclusion of all licensed midwife providers in birth centers, we learned quickly that inviting our elected U.S. Senators and Representatives brought our legislation... READ MORE>

Tell Congress that birth centers are included in Levels of Maternity Care

For the first time ever, birth centers are recognized as a level within the long-accepted regionalization of maternity health services. The original regionalization model of Level I, II, and III previously included only hospitals. The second significant element of this statement is that CPMs and other licensed midwives ... READ MORE >>

© 2016 American Association of Birth Centers | 3123 Gottschall Road | Perkiomenville, PA 18074 | 215.234.8068
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© 2016 American Association of Birth Centers | 3123 Gottschall Road | Perkiomenville, PA 18074 | 215.234.8068
Association Management Software Powered by YourMembership  ::  Legal