The National Viral Hepatitis Roundtable joins our advocacy partners working in chronic illnesses and disabilities in opposing repeal of the Affordable Care Act without implementing replacement legislation to ensure affordable, meaningful coverage for all, including the nearly 5 million Americans living with hepatitis B and/or hepatitis C.

To that end, we are circulating a sign-on letter for organizations that will be sent to all United States Senators before they vote this week on a budget resolution that will pave the way for repeal.

To sign the letter (text below), please email Elizabeth Paukstis, NVHR’s Public Policy Director, with the name of organization signing the letter. Please note that the letter for organizations and the deadline to sign is Wednesday, January 11, 2017, noon Eastern. Individuals are encouraged to use the letter as a template to weigh in with their own Senators.



January [xx], 2017

U.S. Senate
Washington, DC

Dear Senator:

The undersigned organizations are writing to strongly oppose repealing the Affordable Care Act (ACA) without also implementing replacement legislation to ensure coverage for millions of Americans, including the nearly 5 million living with hepatitis B or hepatitis C. Individuals living with these conditions are among those who have benefited the most from the consumer protections established under the ACA and stand to lose the most without strong replacement programs and protections.  We also write to establish our opposition to changing the current funding of the Medicaid program to a per capita or block grant structure, because it will inevitably result in cuts to services that many individuals living with hepatitis B or C rely on.

Infection with hepatitis B and/or C, leading causes of liver cancer, have been on the rise in the United States. From 2010 to 2014, acute hepatitis C infections increased by 250 percent. The opioid epidemic has largely fueled the rapid spread of hepatitis B and C. Acute hepatitis B infections increased 114 percent from 2006 to 2013 in three states that have suffered from widespread opioid overuse (Kentucky, Tennessee, and West Virginia). From 2006 to 2012, acute hepatitis C infections have increased 364 percent in four states affected by the opioid epidemic (Kentucky, Tennessee, Virginia, and West Virginia). Viral hepatitis is a leading cause of liver cancer, rates of which – unlike other cancers – have steadily climbed since 2003. Since 2012, there have been more deaths due to hepatitis C than all 60 of the reportable infectious diseases combined.

We Oppose Repeal of the ACA without a Simultaneous Plan to Ensure Coverage for Millions of Americans

Individuals living with hepatitis B or C cannot afford uncertainty and disruptions in their health care and treatment while replacement legislation is written, debated, voted upon, and implemented. Successful management of hepatitis B and C depends on continuity of care and uninterrupted access to treatment. Maintaining quality care for individuals living with hepatitis B or C requires the maintenance of ACA programs and protections until there are meaningful, adequately funded alternatives available.

We strongly urge Congress to maintain these key protections in place under the ACA:

Access to insurance for uninsured Americans with pre-existing conditions.

Before the ACA, people living with diagnosed chronic viral hepatitis were often unable to obtain lifesaving health coverage. Continued access to prevention, care, and treatment is crucial for people with pre-existing conditions such as hepatitis B and C.

Continued coverage when a customer becomes ill and needs treatment.

Prohibiting insurance companies from dropping coverage when a person gets sick and needs to use his or her insurance for care and treatment is essential to safeguarding the health of persons newly infected with hepatitis B or C.

No lifetime or annual limits on insurance coverage.

Elimination of lifetime or annual limits on the amount of insurance available to a customer has enabled persons with viral hepatitis to successfully treat and manage their disease, thereby helping to stop the spread of disease throughout communities.

Expanded Medicaid eligibility.

States now have the option to expand Medicaid to cover people with incomes at or below 138 percent of the federal poverty level, including single adults without children. In states that opted for the Medicaid expansion, viral hepatitis prevention, screening, and care are now more accessible to low-income persons.

More affordable coverage.

Under the ACA, the federal government provides financial assistance to many low- and middle-income customers who obtain coverage through their state’s Health Insurance Marketplace. Such assistance includes premium tax credits to lower monthly premiums and cost-sharing reductions that lower customers’ out-of-pocket costs when they need medical care. This financial assistance is critical to ensuring that low- and middle-income persons with viral hepatitis receive core services.

Free preventive care.

All new health plans must now cover certain preventive services without charging a deductible or co-pay. These services include hepatitis B vaccination and hepatitis B and C testing. Continued free coverage of such services is essential to stopping the spread of viral hepatitis and guaranteeing successful treatment.

Support for Community Health Centers.

The ACA has promoted investment in community health centers, which provide primary and preventive care for millions of low-income individuals. These centers are important partners in implementing the CDC’s Viral Hepatitis Action Plan and in expanding the integration of viral hepatitis prevention services, testing, and access to treatment. Continued support for Community Health Centers is critical to ensure that people who have hepatitis B or C and who lack financial resources are not left behind in the battle against viral hepatitis.

We urge you to ensure that policy decisions on the future of the ACA maintain access to affordable care and treatment for individuals living with hepatitis B or C. Strong consumer protections and comprehensive, affordable coverage for this population are critical to improve the nation’s public health and reduce health care spending. The uncertainty of repeal without replace will hurt this population greatly because of the importance of continuity of care for addressing these conditions. Additionally, replacement without strong consumer protections, programs, and funding will result in a health care system that only provides meaningful access for the healthy and leaves individuals with chronic viral hepatitis behind. We are hopeful that any health care reforms proposed under the new Administration and the 115th Congress will provide the necessary protections for those living with hepatitis B or C.

Respectfully submitted by the [XX] undersigned organizations,

The National Viral Hepatitis Roundtable

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