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Conmonweairi oF Pewnsvivani (Orrice oF THe Govennon May 4, 2017 “The Honorable Glenn GT Thompson United States House of Representatives 124 Cannon House Office Building ‘Washington, DC 20515 Dear Congressman Thompson I write again to express my deep concem about the ongoing, unpredictable nature of conversations in Washington regarding healthcare reform, Health care coverage is, in many cases, life and death subject. Before today’s expected vote on the American Health Care Act, I urge you to put your constituents before the pressure of your leaders in Washington by voting no. For consumers, your devisions could mean the difference betwee being able to afford health care and being able to keep the lights on in their homes. For states, your decisions could ‘mean the difference between ensuring the most vulnerable people in our commonwealth are able to access long-term services and supports that allow them fo age in place, coverage for essential benefits such as maternity and newborn care, or mental heath and substance use services or offering bare bones benefits to inorder to maximize our state dollars and offset federal cuts. These are decisions that involve billions of dollars and millions of ives, and to make them piecemeal and ‘bind closed doors is the opposite ofa transparent goverament that serves the people. | am particularly concemed that nothing has been done to alleviate the devastation for many ‘older Pennsylvanians, This bill stil jeopardizes health care coverage and affordability for vulnerable older adults It still has the same 5:1 age rating provision, dramatically changes ‘Medicaid, and reduces and then eliminates completely the Prevention and Public Health Fund, ‘which supports the Department of Health and Human Services’ Administration for Community Living grants for falls prevention activities, chronic disease self-management programs, and Alzheimer’s disease prevention and education efforts. Along with several members of my Cabinet, I have writen multiple letters in response to various congressional inquires offering suggestions on how we feel the Affordable Care Act (ACA) can be strengthened. In Pennsylvania, we have willingly admitted that the ACA is not perfect and there have been flaws in its implementation that have contributed to market instability and rate increases. Instead of focusing on efforts to dismantle the law in Washington, we are again indicating our willingness to come to the table with solutions that Pennsylvanians need and want. ‘The Honorable Glenn GT Thompson May 4,2017 Page Two At a minimum, we believe that Congress must focus on minimizing cost shifts to the American people, which is accomplished by continuing financial assistance for older and lower income individuals so coverage remains affordable, We would even take tht one step further and advocate that affordability programs should be expanded to help even more people purchase coverage at affordable rates, In addition, we strongly believe that Congress must continue enforcement of the individual mandate, maintain the prohibition on pre-existing condition coverage exclusions, increase enforcement of special enrollment periods, maintain and/or increase states’ flexibility on federal responsibilities related to health care including the ability to regulate four own markets, and fully fund the risk corridors We are ready to engage in a meaningfl debate about the future of health care but it cannot be one-sided. lurge you to remove yourself from the frenzy that has become the healthcare debate and come home next week to talk to your constituents, and your state, about our needs. At the end of the day, the nature of our representative democracy means that you are atthe forefront of our future on ths issue. The power has been vested in you to bring the people's voice to Washington and to do that effectively, you must hear what we have to say. We remain willing and eager to continue this conversation. Thank you for the continued opportunity to weigh in on this critical Ton fo "TOM WOLF) Governor

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