What is the individual mandate?

The Senate is poised to vote on the tax bill (H.R. 1: Tax Cuts and Jobs Act) in the beginning of December. The bill includes a repeal of the individual mandate from the Affordable Care Act, which requires individuals to get health insurance or pay a penalty. The word “penalty” may sound bad, but most Americans are not subject to it – most get coverage through their employers or government programs that meet the mandate’s requirements. (KFF) Additionally, people are exempted from the mandate if the cost of coverage takes up too much of their income. (KFF)

Why should I care about keeping the individual mandate?

The mandate is important to the stability of the insurance markets. If only sicker people and those with pre-existing conditions enrolled in health insurance plans, premiums would increase and the markets could be destabilized. (The Hill) Plus, repealing the individual mandate will result in 13 million more people being uninsured over the next ten years. (CBO)

Bottom line: the individual mandate urges healthy people to buy health insurance in case they need it in the future, which offsets the cost for people who are currently sick or have a pre-existing condition. We need the individual mandate to stay in place.

When people hear about the effects of repealing the individual mandate, they want to keep it. In a Kaiser Family Foundation poll, 55% of Americans said they wanted to repeal the individual mandate. But when presented with facts like the ones above, 1/3 of those supporters changed their minds and wanted to keep the individual mandate.

When people understand what the individual mandate does, they want to keep it.

How can I take action?

There’s still time to tell your Senator not to vote for a tax bill that repeals the individual mandate! Click below to send a letter to your Senators. Also, if you have friends in Arkansas, Nebraska, Colorado, Idaho, South Dakota, Maine, Tennessee, Montana, Arizona, Wisconsin, Louisiana, Oklahoma, Utah, Kansas, Alaska, or Florida, forward this post to them – their Senators are on the fence about voting yes for this bill.

CLICK HERE TO WRITE A LETTER TO YOUR SENATORS

The Medicare system can be a whole new world for people with diabetes. Lots of changes, but some things should not change: the blood glucose meter that your medical professional recommends to you and one that you know how to use – and trust.

The CEO of DPAC, Christel Marchand Aprigliano, gave expert testimony on Capitol Hill on July 20^th, 2017 in support of bill H.R.3271, helping to protect access to accurate meters for people on Medicare using the National Mail Order program. (You can read the written statement from DPAC on this issue submitted for the record here.)

H.R.3271, “To amend title XVIII of the Social Security Act in order to strengthen rules in case of competition for diabetic testing strips, and for other purposes.” would strengthen various safeguards already in the CBP, including the 50 Percent Rule and the Anti-switching Rule.

What is the Competitive Bidding Program?

In 2003, Congress initiated a program that been beneficial for some therapeutic and medical areas, but disastrous for diabetes testing supplies. The Diabetes Patient Advocacy Coalition (DPAC) is asking Congress to fix this program and pass bill H.R.3271 to modify the most debilitating components affecting patients with diabetes.

Under the Competitive Bidding Program (CBP) for Durable Medical Equipment and Supplies, Medicare has paid increasingly less for medical supplies, including Diabetes Testing Supplies (DTS), like glucose test strips and lancets. Although Congress implemented this program to save money and decrease fraud, the CBP has considerably limited beneficiaries with diabetes in their access to diabetes testing supplies. Under the CBP, the most common blood glucose testing systems are now unavailable through mail order to beneficiaries with Medicare.

Patients unable to receive their trusted glucose meters have stopped or severely decreased blood sugar testing, while continuing to administer themselves insulin. Mortality, inpatient admissions, and inpatient costs have increased among the patients affected by this decreased ability in blood testing.

To compound this issue of access, the Diabetes Technology Society recently conducted a study revealing that an alarming 12 of 18 testing systems available to Medicare patients provide inaccurate results. This means that even if patients do get one of the limited testing systems under the CBP, the DTS may still endanger their lives and ability to manage diabetes.

What Needs To Change?

Through focusing on issues of safety, quality, and access, the Diabetes Patient Advocacy Coalition champions public policy initiatives to improve the health of people with diabetes. The current state of the Competitive Bidding Program and National Mail Order program creates glaring problems in each area.

Under H.R. 3271, two beneficiary protections would be strengthened:

• The 50 Percent Rule directly addresses the question of access to DTS. Under the 50 Percent Rule, Congress determined that insurance companies must make 50 percent of all DTS supplies available to beneficiaries before requiring mail order, continuing to allow beneficiaries to have access to DTS they used before the CBP. The Center for Medicare and Medicaid Services (CMS) did not implement this effectively, as the “50 percent of supplies” was only applied to DTS in a supplier’s bid. Additionally, one tenth of the 50 percent of DTS varieties available could fall into a catch-all “other” category – a loop hole meaning that suppliers could essentially make even less inventory available to beneficiaries. Strengthening the 50 Percent Rule would eliminate the “other” category and increase monitoring of suppliers, among other protections.
• The Anti-switching Rule was established to ensure that physicians and beneficiaries maintained access to preferred testing meters. However, this rule is a low hurdle for the CMS and NMO to hop over, as both have made it increasingly difficult to purchase supplies from other suppliers or switch out of NMO. H.R.3271 would strengthen the Anti-switching Rule by changing the refill process to give the beneficiary more choice and knowledge from the supplier, and through codifying this rule.

With these strengthening measures in place, DPAC firmly believes that the access, safety, and quality of patients will dramatically increase under H.R.3271. Through permanently patching the holes in the CBP, this bill helps to decrease the painful and costly long-term effects associated with diabetes and inadequate blood glucose monitoring.

Use the DPAC platform to contact your representatives and ask them to support H.R.3271. If the CBP is not improved, lives hang in balance as safety, quality, and access to diabetes supplies remain ignored.

Click on the image below or the link above to take action.

# FAIL

Let’s cut to the chase, shall we? 

A few years ago, Medicare, in an effort to save money, decided to roll out a nationwide mail order program for diabetes blood glucose testing supplies. DPAC has been providing data and analysis through our #SuspendBidding program that shows that not only is money not being saved, but people with diabetes have higher hospitalization rates and… sadly… higher mortality rates in the test markets where the mail order supplies are being shipped. (You can learn more here.)

Today, under the latest round of the Medicare Competitive Bidding Program, only 11 companies across the country are allowed to provide testing supplies through mail order.

ONLY ONE BLOOD GLUCOSE METER CURRENTLY OFFERED TO MEDICARE BENEFICIARIES THROUGH MAIL ORDER MEETS CURRENT FDA ACCURACY STANDARDS. 

The Diabetes Technology Society recently released a study through their Blood Glucose Monitoring System Surveillance Program which shows that out of 18 blood glucose monitoring systems, representing 90% of the U.S. market when the study was conducted in 2015, only 6 passed the FDA accuracy standards. As stated on the Diabetes Technology Society’s website:

The Diabetes Technology Society Blood Glucose Monitor System (BGMS) Surveillance Program was established because of evidence that cleared BGMSs do not always achieve levels of accuracy matching either: 1) their performance that resulted in becoming cleared by FDA; or 2) international standards of accuracy.  Poor performance of these devices can lead to adverse clinical and economic consequences.  This surveillance program assessed the accuracy of 18 blood glucose monitoring systems (BGMSs) marketed in the USA across a wide range of blood glucose levels in the hands of trained professionals.  These 18 BGMSs represented approximately 90% of the commercially available systems that were used from 2013 to 2015 by diabetes patients and obtained from consumer outlets.

For Medicare beneficiaries, it’s grim. Only one system offered through the mail order program designed by the Medicare Competitive Bidding program passed. All the others?

FAIL.

Only one blood glucose monitoring system and only through one mail order company.

FDA Accuracy Standards

The others? They do not meet the FDA accuracy standards, which is +/- 20% for blood glucose readings of over 75 mg/dl and +/- 15 mg/dl for when blood glucose is 75 mg/dl or less.

What does that mean to people with diabetes?

If you are on Medicare and receive your blood glucose testing supplies through mail order, you run the risk of not having a meter that is accurate. This increases the risk, especially when you take insulin to manage diabetes, that you are dosing insulin based on an inaccurate blood glucose reading.  This increases the risk of hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar).

As people with diabetes age, the risk increases of hypoglycemic unawareness (not being able to feel a low blood glucose level). Imagine checking your blood glucose level with a meter that is part of the FAIL list and dosing insulin or driving or operating heavy machinery. What happens if the meter has been shown to FAIL, giving you a reading that is higher than what an accurate blood glucose system would give you. You run the risk of going into a hypoglycemic state… putting you and the people around you at risk.

Why Would Medicare Pay for a Failed Blood Glucose Monitoring System?

Great question.

Wouldn’t you like to know why they are wasting taxpayer money AND putting our diabetes community at risk by offering mostly meters that FAIL current FDA accuracy standards to those on Medicare?

We should know.

And we think that Seema Verma, the current Administrator for the Centers of Medicare and Medicaid Services, and Tom Price, the current U.S. Secretary for Health and Human Services, should answer that question.

What Can You Do Right Now to Stop the Meters on the FAIL List from being used by Medicare?

1. Send an email message to Tom Price and Seema Verma, asking them why people on Medicare using the mail order program are being offered blood glucose monitoring systems that FAIL accuracy standards. 
2. Share this post with your family, friends, and colleagues via email or other social media means. (Use the easy share buttons below.)
3. Sign up for the latest alerts on this and other important diabetes policy through DPAC.

We must tell the policy makers at Medicare and Health & Human Services that by offering blood glucose monitoring systems scientifically proven to FAIL, they are FAILING the diabetes community. As an immediate first step, they must SUSPEND Medicare’s Competitive Bidding Program and stop offering meters that FAIL.

The Diabetes Patient Advocacy Coalition welcomes Hannah McDaniel as our newest employee. As a DPAC Associate, she’ll help explain the policy issues impacting our community and share ways to raise our patient voices. Hannah is currently studying at Duke University. 

Hi. I am your average, twenty-something college student: idealistic, starry-eyed, and with my whole life in front of me. Type 1 diabetes has presented speed bumps in my life since my diagnosis 8 years ago, but I am thriving and empowered. However, as a patient with diabetes in the face of the Better Care Reconciliation Act (BCRA), I fear policy decisions will limit my ability to live a healthy life because they cut off access to medications, devices, and services I need.

As a young person, I am still feeling out the highs and lows of working through challenges related to both diabetes and healthcare. It’s still relatively new to me. What isn’t new is the passion I feel about fighting against anything that would make life more difficult for patients. Because of those feelings, it’s incredibly important I advocate for people with diabetes like me and for anybody affected by changes in healthcare legislation.

It is vital that all people with diabetes find their voices in the political system, empowering themselves and others affected by pre-existing conditions.

Empowering who? Why us though?

No matter what age, we all acutely understand what it’s like to be patients in a healthcare system that makes decisions considering everything but the patients’ perspectives. For my generation, I feel we need to raise our voices just as loud (if not louder!).

We are the future of this country and we must set the precedent for what advocacy looks like for generations of vibrant, healthy difference-makers to come – those living with diabetes or pre-existing conditions who want to thrive. We must prove to ourselves and them that our drive can make us incendiary for the community of patients affected by healthcare legislation.

In our unique position as young people within this community, we are empathetic to the uncertainty surrounding healthcare legislation for anybody with or affected by pre-existing conditions. We know that policy-makers or insurance companies often don’t attempt to understand our needs; our needs will not be met or even heard if we do not collectively stand up to vocalize them.

What’s different about my generation?

We must join this larger community of advocates, and interject our voices among those who have advocated before. Why? Because we are different. We are not made different by our diabetes or pre-existing conditions, but rather by the ways our newer stories empower us and beg to be told. We are the most qualified voices to speak our own stories into the minds of policy-makers. They must think of us along with the rest of the diabetes community so that they think of all of us as they vote on our medical access, daily lives, and futures.

It scares me to think of denied access to the medicines and services we need under the BCRA. If the BCRA passes, it jeopardizes our quality of life, cutting off coverage under certain plans regarding access to vital diabetes education and services, such as Certified Diabetes Educators. It scares me that under some plans if an insurance payment is missed, we may have no insurance coverage for the six months after. Managing type 1 diabetes costs about $7,900 a year (and that’s without complications or comorbitites; paying half of that out of pocket under the BCRA would be crippling for all generations, including mine.

The policymakers and representatives we need to reach are often blind to the personal ways a single vote changes the lives of 29 million diabetic families across the nation. In this way, they do not represent us.

There’s an easy solution: act, speak, and be heard. We must stop being passive about political advocacy. The clock is ticking today.

Okay, so I do have a voice. What now?

Before hearing about the DPAC mobile app and website, I thought advocacy was something other, more qualified people did on my behalf.

I now know that if I don’t speak for myself and others like me, very few will.

All these new advances in the diabetes world are incredible, but if we can’t access them, do we gain anything? The BCRA forces us to step back in time to having fewer tools than ever available to help us thrive with diabetes.

Now that I can advocate through DPAC, I have emailed and called my senators, signed up for local advocacy, and followed DPAC on social media. The articles DPAC shares on the mobile app updates and educates me on issues relevant to people with diabetes in the safety, quality, and access realms.

I now know what issues to advocate for, and their effect on the patient community. I can feel my voice amplified with each response from my representative or shared post through DPAC. I make a difference.

DPAC is easy, clear advocacy with a tangible response. DPAC speaks for me as a patient, empowering me to find my voice.

Download the DPAC app and follow DPAC on Facebook and Twitter to begin speaking up for the diabetes patient community.

No matter what generation you are, you are more than qualified to advocate.

What’s Next?

The American Health Act, scheduled to be voted upon Thursday, March 23, 2017 to repeal the Affordable Care Act (ACA), is now delayed, as there are not enough votes to pass the bill.

As people with diabetes, we recognize that the ACA was not perfect, but the proposed legislation will be harmful to those in our ever-growing diabetes community.

DPAC gives you the rundown of what’s in the bill as it is currently written and what can happen to those in the diabetes community if it does pass.

What is in the Delayed Republican Health Care Bill?

The news has been filled with chatter over the American Health Care Act, also called Ryancare, or Trumpcare, depending on who you ask.  To understand what this bill is about requires understanding two fundamental things.

First, virtually all Republicans in Congress have promised for many years that they would “repeal and replace” the Affordable Care Act if they ever had control of Washington.  Now Republicans run the show, but they are limited by a second factor.

Republicans do not have the 60 votes needed to pass legislation in the Senate.  That means that they can really only pass legislation through the Senate using a “reconciliation” process that requires just 50 votes.  This process is only allowed for budget-cutting measures.

As a result, the American Health Care Act bill being pushed by House Speaker Paul Ryan would only do a handful of the things that Republicans eventually hope to do.  There has been some discussion of last-minute changes to the bill that would involve more aggressive action on regulations for what health benefits each insurer must offer.

As initially presented, however, the bill had four main provisions.

Eliminate of the Prevention and Public Health Fund

Republicans have long been critical of a nearly $2 billion program started in 2010 to help shift focus from treatment to prevention.  They say it’s an unaccountable “slush fund,” but the program has allocated $72 million in 2017 for research to improve and enhance diabetes prevention and control strategies through the National Diabetes Prevention Program.

What that means to the diabetes community: That allocated money would be eliminated with some shifted to programs like Community Health Centers that Republicans favor.  

Repeal the Medicare Expansion and Cap Payments

Medicaid currently covers around 75 million adults and children around the country, and about 11 million of those joined after the program was expanded in 2010.  Most of these people are living with reduced or small incomes, often under the national poverty level.

Republicans worry that “entitlement” programs like Medicaid, along with Social Security and Medicare, are leading the country to financial ruin.  The prevent that outcome, the Republican health care bill would roll back the 2010 expansion and convert Medicaid to a matching program.

The federal government currently pays 50% to 75% of Medicaid’s costs, with states picking up the rest.  The costs for the federal government can fluctuate based on the cost of health care, how much states are paying, and the number of people in the program.  The Republican bill would eliminate that fluctuation and instead just send states a capped subsidy for every person that state has in the program.

The Congressional Budget Office has said these changes could cause 14 million fewer people to have coverage by 2026.

What that means to the diabetes community:  That means that many low-income diabetes patients could lose health coverage completely. It could also cause real damage to state budgets.   

Health Insurance Market Reforms

One of the most frequent complaints about the 2010 Affordable Care Act is the law’s complicated subsidy scheme tied to income that left many marketplace participants confused about their true out-of-pocket costs.  The Republican bill would eliminate those subsidies and replace them with a more simple age-based system.

The Republican bill would offer a tax credit that ranges from $2,000 for anyone under 30 to $4,000 for anyone over 60.  The New York Times and many others have put together examples of how the change would work out in practice.  One of their examples is a 64-year-old married accountant with diabetes making $65,000.  That person might actually be better off under the new law.  On the other hand, a 28-year old barista would probably be worse off.  The changed subsidy scheme will impact people differently, but most analysis points to more out-of-pocket costs for most people.

This section of the bill would also make a few other changes to the markets.

• It adds an “incentive” for keeping individuals on continuous coverage.
• It would also allow insurance companies to charge older people more.
• The 2010 law says that the oldest patient cannot be charged more than three times the premium of the youngest patient, and that would be rolled back.
• The bill would also create a “Patient and State Stability Fund” that would set aside $100 billion for states to promote innovative solutions to lower costs and increase access. This is essentially a “high risk pool” that has failed in previous attempts.

What that means to the diabetes community: This could result in increased costs for older diabetes patients, those who may lose coverage due to loss of employment and can’t afford COBRA or new plans, and force people with diabetes into highly restrictive risk pool plans that may not cover current diabetes management medications, devices, or services. 

Tax Cuts

The 2010 Affordable Care Act was paid for in large part by a number of tax increases, and the Republicans want to cut them all back.  The Republican bill would eliminate the individual and employer mandates and their associated taxes.  Taxes on health savings accounts, tanning beds, and medical devices would be gone.  Income-based caps on various tax benefits would be removed.

What that means to the diabetes community: Everyone that gets a tax cut would certainly benefit, but that does reduce the funding available to pay for quality, affordable health care.  

No Winners, Only Losers

The United States won’t “win” even if the proposed bill passes. There will be plenty of losers: people with diabetes are at the top of the list. Delaying this vote and working to fix ACA or a better plan to repeal and replace is warrented.

We at DPAC work to elevate the voice of people with diabetes in the policy advocacy areas of safety, quality, and access.

The current American Health Care Act will not provide access to health care for millions of people with diabetes.

This is why until we are sure that any health care measure presented by Congress protects all people with diabetes, we are asking them to delay repealing ACA and listen to their constituents. We hope you will ask them to raise our collective voice. 

What’s Next?

Send Your Message to Congress

Vote No on the American Health Care Act

[button link=”http://act.diabetespac.org/dpac/app/onestep-write-a-letter?2&engagementId=310493″ color=”default” size=”xlarge” type=”” shape=”” target=”_blank” title=”” gradient_colors=”|” gradient_hover_colors=”|” accent_color=”” accent_hover_color=”” bevel_color=”” border_width=”1px” border_color=”” border_hover_color=”” shadow=”” icon=”fa-envelope” icon_divider=”yes” icon_position=”left” modal=”” animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ class=”” id=””]Click Here To Send Your Message Now![/button]

Fence Sitters

No one wants to make a bad decision, especially when it comes to the federal healthcare acts currently being debated in Congress to repeal and replace ACA (Affordable Care Act), which is why there are fence sitters for the bill to repeal ACA. There are currently 28 “fence sitters” – members of Congress who have not publicly stated how they will vote on this bill. Shouldn’t they tell their constituents?

Important Facts and a List of “Fence Sitters”

Assuming all Democrats vote against the legislation, GOP leaders cannot afford more than 21 defections in the House and two in the Senate. – The Hill.com

House of Representatives

• Rep. Ken Buck (Colo.) (leaning towards no as of 3/21)
• Rep. Steve Chabot (Ohio) (leaning towards yes as of 3/21)
• Rep. Paul Cook (Calif.)
• Rep. Dana Rohrabacher (Calif.)
• Rep. Charlie Dent (Pa.)
• Rep. Scott DesJarlais (Tenn.)
• Rep. Paul Gosar (Ariz.)
• Rep. Trent Franks (Ariz.) (new uncertain as of 3/21)
• Rep. Frank LoBiondo (N.J.)
• Rep. Tom MacArthur (N.J.)
• Rep. Bruce Poliquin (Maine)
• Rep. Daniel Webster (Fla.)
• Rep. Mario Diaz-Balart (Fla.) (new uncertain as of 3/21)
• Rep. Neal Dunn (Fla.) (new uncertain as of 3/19)
• Rep. Don Young (Alaska)
• Rep. Mike Johnson (La.) (new uncertain as of 3/21)

Senate

• Sen. Bill Cassidy (La.)
• Sen. Bob Corker (Tenn.)
• Sen. Tom Cotton (Ark.)  – has publicly come out as against on 3/21. 
• Sen. Steve Daines (Mont.)
• Sen. Jeff Flake (Ariz.)
• Sen. Cory Gardner (Colo.)
• Sen. Lindsey Graham (S.C.)
• Sen. James Lankford (Okla.)
• Sen. Mike Lee (Utah)
• Sen. Shelley Moore Capito (W.Va.)
• Sen. Lisa Murkowski (Alaska)
• Sen. Rob Portman (Ohio)
• Sen. Marco Rubio (Fla.)
• Sen. John Thune (S.D.)
• Sen. Thom Tillis (N.C.)
• Sen. Pat Toomey (Pa.)

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What You Can Do Right Now in 5 Easy Clicks!

If you have a member of Congress on the list above, it’s crucial that you let them know that they must not repeal ACA until they have a better plan. 

NOTE: If you DON’T have a member of Congress on the list above, you’re not out of the woods. Many Republicans are voting yes to repeal ACA, not understanding the implications for those in their districts and states. 

 

1. Send a message through the DPAC platform simply by clicking this link.   Ask the representative to issue a public statement on how he/she will vote on the repeal.
2. Call your Congressional Representative’s D.C. office and tell your representative that until there is a plan that protects all voters in your state with pre-existing conditions that will be impacted by the repeal of ACA, they should not vote to approve any repeal. You can use the DPAC Scorecard to get the phone number and other important information.
3. Tweet your Representative using the DPAC Scorecard. Click on the link next to your representative’s name under the “Blank Tweet w/ # People With Diabetes” column. You can add your message about voting NO to repeal ACA.
4. Fax your representatives using Resistbot. While not part of DPAC, you can fax your message to your representatives using a text. Text Resist to 50409 and follow the prompts to send a fax asking the representative to vote NO to repeal ACA through the American Health Care Act.
5. Share this post within your social circle using the sharing links below.

 

Changes to ACA will affect People with Type 1 Diabetes

The 115th Congress and the Trump Administration has made repealing the Affordable Care Act a top priority. For an estimated 3 million U.S. type 1 diabetes (T1D) and millions of other patients, both children and adults, this would be a devastating blow as protections for those with pre-existing conditions, could disappear. 

WE DON’T HAVE MUCH TIME.

DPAC is working with T1DExchange to share stories with Congress about Type 1 diabetes and the impact that proposed changes to the federal healthcare will have on the T1D community. 

If you aren’t familiar with T1D Exchange (and their community site, myGlu.org)…

T1D Exchange

From T1D Exchange‘s Robin Lord:

T1D Exchange is a patient-centered nonprofit organization that focuses on improving care and accelerating novel diabetes solutions.  We see these potential health care changes as a threat to our patient’s ability to receive the best care possible and access lifesaving treatments.   

At T1D Exchange, we believe that we can improve quality of life and reduce the burden of managing Type 1 diabetes by investing in new therapeutic innovations. We use our collective medical and scientific resources to support our T1D community in several ways including: patient and caregiver engagement, representing the T1D population through educational and advocacy activities, and leveraging our data and clinical evidence to support regulatory and reimbursement challenges.

The coverage of pre-existing conditions under the ACA/aka Obamacare has benefitted not only those in the individual insurance market but also those of us who are fortunate enough to have employer-sponsored coverage…no more waiting period to have our pre-existing condition covered.
– A Glu community participant

What YOU Can Do Right Now to Help

DPAC and T1DExchange a asking the Type 1 Diabetes community to share their stories and experiences with Congress right now.

[button link=”http://act.diabetespac.org/dpac/app/onestep-write-a-letter?6&engagementId=302733″ color=”default” size=”xlarge” type=”” shape=”” target=”_blank” title=”” gradient_colors=”|” gradient_hover_colors=”|” accent_color=”” accent_hover_color=”” bevel_color=”” border_width=”1px” border_color=”” border_hover_color=”” shadow=”” icon=”fa-pencil” icon_divider=”yes” icon_position=”left” modal=”” animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ class=”” id=””]Click Here To Send a Message About Protecting People with Type 1 Diabetes to Congress[/button]

We must tell Congress that in order to repeal the Affordable Care Act they must ensure those with pre-existing conditions have continuing protections. Without it, federal health care costs could increase due to complications or lack of access to quality medications, devices, and services.