Friday, June 30, 2017

June 27, 2017
Senator John Hoeven
338 Russell Senate Office Building
Washington, DC 20510

Dear Senator Hoeven:

The undersigned individuals and organizations write to express pressing concerns over the proposed changes to Medicaid and Medicaid Expansion through the American Health Care Act (AHCA). The proposed changes of concern are the per capita caps on the federal contribution to Medicaid to the states, and the effective ending of enhanced federal funding for Medicaid Expansion. A phase-out period for ending the Medicaid Expansion would still have catastrophic effects; millions of Americans could lose coverage in the near term as states are forced to freeze enrollment to curb rising costs, and millions more would lose coverage once the Medicaid Expansion finally ended.

These provisions of the AHCA will severely compromise the ability of North Dakotans to access healthcare, threatening the viability of families and individuals with low and moderate incomes, people with disabilities, the elderly, and children.

Currently, over 114,000 North Dakotans receive health coverage and long-term services through Medicaid and Medicaid Expansion. These two programs have led to North Dakotans seeking more affordable preventative care rather than much costlier acute care, reducing the overall cost of healthcare. They have also reduced the stress on health care facilities that often have to bear the burden of unpaid acute care. Additionally, Medicaid and Medicaid Expansion have positive economic impacts of over $1.6 billion through the employment of individuals in local and rural hospitals and community health care facilities around the state.

Setting a per capita cap on Medicaid or the ending of enhanced federal funding for Medicaid Expansion would each shift significant costs to North Dakota, our taxpayers and healthcare providers because they will shift the responsibility of increased health care costs to the state. Shifting costs to the state could result in cuts to provider payments, program eligibility, services, or all of the above – ultimately harming some of North Dakota’s most vulnerable citizens. Collectively they could cause untold harm to the health care systems that North Dakota and its citizens have worked so hard to develop. As a sign of support, this winter North Dakota’s legislature agreed to continue Medicaid expansion, which was set to expire on June 30.

As groups representing a wide cross section of North Dakota, from business, to healthcare, to consumers, to working North Dakotans, and as individual North Dakotans we encourage you to reject a Senate healthcare bill that includes a per capita cap on Medicaid or reduces federal funding for Medicaid Expansion


The undersigned 36 organizations and 345 individuals as of 8:00 p.m. June 26, 2017 (continues)


The North Dakota Economic Security and Prosperity Alliance (NDESPA)
The Arc of Bismarck
The Arc of Cass County
The Arc of North Dakota
The Arc, Upper Valley
American Lung Association in ND
CAWS North Dakota
Clean & Green Cleaning Service, Fargo
Community Action Partnership of North Dakota
Designer Genes of North Dakota
Ehrens Consulting
Family Voices of North Dakota
Fargo Underground
Great Plains Food Bank
Heartview Foundation
Mid Dakota Clinic PC
Music Therapy in Motion
Native American Development Center
North Dakota Academy of Nutrition and Dietetics
North Dakota AFL-CIO
North Dakota Childhood Trauma Network
North Dakota County Social Service Directors Association
North Dakota District 22 Dem-NPL
North Dakota Farmers Union
North Dakota Human Rights Coalition
North Dakota United
North Dakota Women's Network
Prairie St. John's, Fargo
Protection & Advocacy Project
Sacred Pipe Resource Center, Bismarck
Schneider Law Firm, Grand Forks
Strengthen ND
Pamela Anderson
John     Andrus
Jacquelyn Aronson
Patricia Aune
Ondine Baird
Carenlee Barkdull
Marlene Batterberry
Jill        Beireis
Wannetta Bennett
Courtney Bergman
Susan   Bergquist
Kathy   Bingeman
Sara     Boger
Jeani    Borchert
Joshua  Boschee
Carol    Braaten
Tricia   Brame
Mara    Brust
Casey   Buchmann
Gladys Cairns
Gladys Cairns
Kaye    Carlson
Janis     Cheney
Barb     Chisholm
Gail      Christianson
Lynn    Clancy
Stacy    Closson
Kathleen Cooper
Owen   Dahl
Thomas            Dahle
Melissa Dalke
Linda   Dalzell
Ashley Decker
Siobhan Deppa
Tina     Dietz
Jay       Dietz
Gretchen Dobervich
Dustin  Dockter
Vivian  Drees
Heather Drees
Jessica  Dryer
Lisa      Durkee
Ann     Ede
Karen   Ehrens
Duane  Ehrens
Anne    Eliason
Patrick Engelhart
Nancy  Englerth
Julie     Erickson
Dixie    Evans
Mary    Everson
Robert  Everson
Christine Fastnaught
Donene            Feist
Rebecca Fell
Keith    Fernsler
Jackie   Flowers
Nichole Fontaine-Vonesh
Martin  Fredricks
Jackie   Frost-Hodny
Scott    Fry
Alissa   Fugazzi
Sabina  Gasper
Rita      Gieser
Karen   Gottschalk
John     Grabinger
Beth     Grahn
Sarah   Griffith
Ron      Guggisberg
Judy     Hager
Robert  Haider
Brittany Hanson
Renee   Hardy
Dean    Harens
Connie Harmel
Constance Harris
Joanne Haug
Mark    Haugen
Joan     Heckaman
Erin     Hell Maser
Tanner Herbert Miller
Marcia Hettich
Kathy   Hogan
Mary Pat Holler Bibel
Rep. Rick Holman
Deb      Igoe
Amy    Ingersoll-Johnson
Jennifer            Jenness
Ruth     Jenny
Patricia Jessen
Katy     Johnson
Deb      Johnson
Eric      Johnson
Diane   Jolin
Clara    Jurivich
Cheryl  Kary
Rita      Kelly
Kate     Kenna
Janice   Kern
Cynthia Kile
Gabe    Kilzer
Bradley            King
Ryan    Klapperich
Miranda Kleven
Kay      Kringlie
Adrienne Larsen
Nicole  Larson
Landis  Larson
Ryan    Larson
warren larson
Matthew Leidholm
Layla   Ligutom
Charles Linderman
Ellen    Linderman
Charles Linderman
Jane     Loscheider
Norton             Lovold
Claire   Lowstuter
Perry    Lundon
Toby    Lunstad
Denise  Luttio
Elsie     Magnus
Brad     Magnuson
Johannes Mahlum
Dorene Malling
Landa  Manders
Ann     Mason
Tim      Mathern
Kristin  Mathern
Deb      Mathern
Scott    Mathern-Jacobson
Reba    Mathern-Jacobson
Molly   Matthews
Rebecca Matthews
Carilynn Maw
Angela Mayberry
Nancy  McKenzie
Christina McNeal
Marcia Mikulak
Kristin  Miller
Alisa    Mitskog
Corey   Mock
Carolyn Monzingo
John     Monzingo
Camie  Mosbrucker
Tara     Muhlhauser
Amanda Myhre
Matthew Nelson
Gayle   Nelson
Karen   Nelson
Marvin Nelson
Kathleen Ness
Senator Erin Oban
Marie   Offutt
Tara     Okpalaeke-Wood
Rick     Olek
Leigh   Olson
Elizabeth Olson
Alice    Olson
Mike     Olson
Kylie    Oversen
Crysta  Parkinson
Julianne Pedersen
Marly   Pedersen
Vicki    Peterson
Krisanna Peterson
Dustin  Peyer
State Senator Merrill Piepkorn
Rachel  Pierson
Christopher Pieske
Christina Pieske
Jessie    Quinn
Michelle Ragan
Mary    Rennich
Doreen Riedman
Larry   Robinson
Rep. Karla Rose Hanson
Wilfred Schill
Debra   Schlief
Lori     Schlieve
Karen   Schneider
Melissa Schroeder
Stacy    Scott
Jerry    Severson
Christine Shaffer
Ellie     Shockley
Patrick Sinner
Katie    Skalicky
Melissa Sobolik
Rosie    Sprynczynatyk
Deborah Stahlberg
Richard Stahlberg
Emma  Steger
Jamie   Stewart
Christine Stiven
Alistair Stiven
Rose     Stoller
Colleen Swank
Debbie             Swanson
Deborah Swanson
Lydia   Tackett
Jennifer Tarlin
Ryan    Taylor
Kevin   Tengesdal
Susan   Thompson
Daniel  Tick
Jamie   Tyson
Ruth     Urdahl
Carrie   Veitz
Brian    Veitz
Katie    Vettel
Emily   Vieweg
Marybeth Vigeland
Emily   Wangen
Nicole Watkins
Renee   Wetzsteon
Gail      Wiley
Laura   Wiley
Leslie   Wilkie
Kari     Wolff
Lauren Woodbury
Jennifer Wray
Cole Edward Young

+ 140 additional individuals who choose not to disclose their names publicly