Over the last five months, health care reform debate has dominated in Congress. As this unfolded and potential legislation threatened to negatively impact the Parkinson's community, you spoke up -- sending an impressive 23,000 emails to your lawmakers.

We sat down with Ted Thompson, JD, senior vice president of public policy at The Michael J. Fox Foundation (MJFF), to understand more about what's been happening, where Congress may go from here and how you can continue to play a role in this process.

Editor’s note: This blog was updated on Tuesday, July 25, 2017, after a health care vote in the Senate. 

MJFF: It feels like news stories on health care reform change every hour. What's actually happening?

Ted Thompson (TT): In May 2017, the House of Representatives passed a health care reform bill called the American Health Care Act. The Senate decided it did not want to vote on this bill and started creating its own reform proposal. For the past few weeks, Republican leaders in the Senate have been trying to pass a bill called the Better Care Reconciliation Act (BCRA). A few days ago, we learned lawmakers will not vote on the BCRA in its current form because it doesn't have enough support to pass.

Then, on Tuesday, July 25, the Senate voted to begin debating, and eventually vote on, a health care reform bill.

MJFF: What might happen next?

TT: The Senate now enters an open debate period where it will discuss options, offer amendments and craft the bill. We’re not sure what language will eventually be included. Some senators are considering an option to "repeal now, replace later." This would allow legislators to pass a bill to repeal the Affordable Care Act (ACA), or Obamacare, but it wouldn't go into effect for two years. Congress would use that time to develop a new health care reform proposal to replace the ACA. If the Senate decides to take this route, the House would also need to vote to approve the ACA repeal bill. Only then could it go to the president's desk for his signature and become law.

Support for "repeal now, replace later" is mixed. Some senators are strongly pushing for it and others have spoken out against it. The Congressional Budget Office (CBO), the nonpartisan agency that analyzes legislation, estimates that if the repeal bill is passed and no replacement is established, 32 million Americans will lose health insurance and premiums will double over the next 10 years. 

There have also been reports that some senators may attempt to amend the BCRA and bring it up for a vote. The CBO estimates that 22 million Americans will lose their health care coverage if the BCRA, in its current form, becomes law. 

At this time, it’s hard to say what the Senate plan will look like. We’ll know more in the coming days as the debate process continues. 

MJFF: How would this impact the Parkinson's community?

TT: The problem with the "repeal now, replace later" option is that we have no idea what the replacement would look like. We don't know if it would help or harm the Parkinson's community, and there's no guarantee that the replacement would help patients access care and manage chronic conditions, like Parkinson's. Simply put, it creates uncertainty for patients and care partners, and raises many unanswered questions.

MJFF: How much longer will the debate on health care reform go on?

TT: Members of Congress will soon head to their home states for a summer recess. (The House will break from July 31 to September 4 and the Senate from August 14 to September 4.) Right now, it looks like senators are trying to pass a health care reform proposal before they leave. If that's the "repeal now, replace later" bill, the House would need to approve this in September when lawmakers come back from recess, then it would go to the president for his signature. Once it becomes law, legislators would spend the next two years creating a replacement plan.

If the Senate passes an amended version of the BCRA, the House also would need to approve this bill in September. It could take several weeks or months for representatives to debate it and vote on it. Then it would go to the president's desk to be signed into law.

If nothing is passed before Congress begins the summer recess, the health care reform debate will likely start again in the fall and continue for the foreseeable future.

MJFF: What can the Parkinson's community do?

TT: Talk to your senators! Tell them not to repeal the ACA before a replacement has been created, and urge them to craft a replacement plan that meets your needs. You can find your senators' phone numbers and talking points on the MJFF website.

So far, Congress has not presented the public with many ways to take part in the health care reform debate. There have been no public hearings or opportunities to submit testimony. The only way patients and care partners can be heard is by calling, emailing or scheduling individual meetings with lawmakers.

MJFF: How can people learn more about policy and advocacy work?

TT: Visit the MJFF advocacy page (advocate.michaeljfox.org) to learn more about policy issues impacting our community and find resources to help you take action. (We'll be adding new advocacy tools later this month.) And, join our webinar on August 17 to hear more about the status of health care reform and other policy topics that affect people with Parkinson's.

Register for the August policy webinar.

Call your senators now about health care reform and download an educational handout on the issue.