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Campaign to keep Affordable Care Act starts in WV

Charleston Gazette-Mail photo by Sylvia Burwell Sylvia M. Burwell, U.S. Department of Health and Human Services Secretary and West Virginia native, addresses the crowd during a panel discussion about the Affordable Health Care Act at the University of Charleston Tuesday.
Charleston Gazette-Mail photo by Sylvia Burwell
Sylvia M. Burwell, U.S. Department of Health and Human Services Secretary and West Virginia native, addresses the crowd during a panel discussion about the Affordable Health Care Act at the University of Charleston Tuesday.

CHARLESTON, W.Va. — As Republican congressional leaders and president-elect Donald Trump are considering the repeal of the Affordable Care Act, Sylvia Burwell is trying to show people the benefits of President Barack Obama’s signature health care law.

The U.S. Secretary of Health and Human Services and West Virginia native was in Charleston Tuesday to kick off a public relations campaign to show why the federal law is important and highlight the number of people benefiting from it.

“This isn’t a conversation about a word — Obamacare. It’s actually about real people’s lives,” Burwell said. “We need to have those stories told, and that’s what we are starting here today — no better place than West Virginia.”

The effort to defend the law comes at a time when insurance premiums in public marketplaces are expected to increase and some of the nation’s top insurers are dropping out of the state and federal exchanges that were set up after the law was passed in 2010.

The comprehensive health care law has been a primary target of Republicans for years and played heavily in the presidential election, as Trump called for its repeal and Hillary Clinton suggested it could be reformed.

Burwell laid out some of the successes of the health care law, including reduced Medicare prescription costs, a ban on insurance companies turning down people with pre-existing conditions and ending limits on the amount of treatment someone can have over the course of their lifetime.

She also cited the portions of the law that block additional costs for contraception, limiting out-of-pocket spending under insurance plans and decreasing the number of uninsured adults nationwide from 18 percent to 11 percent.

In West Virginia, hundreds of thousands of people in the state have health insurance for the first time, including more than 178,000 people who have qualified for coverage under the expanded Medicaid program.

Since Trump won the election, he has softened his campaign rhetoric and suggested he will keep parts of the law, including the mandate on pre-existing conditions.

Burwell is taking Trump and other opponents of the law at their word when they say they will keep many of the most popular portions of the law, but she questions whether those pieces can work if the rest of the law is dismantled.

“This is like Jenga,” Burwell said. “That is a lot of what the Affordable Care Act is. It’s like Jenga, where you can maybe move a piece, but when you pull out a key piece, the whole thing is going to tumble.”

One of the reasons insurance companies relented to covering people with pre-existing conditions was because lawmakers also put in the requirement that everyone had to purchase either public, private or employer-based coverage. That compromise is likely to fall apart if the insurance mandate is removed.

To show how the health care changes under Obamacare have helped, Burwell was joined on a panel Tuesday by individuals who have benefited for various portions of the law.

Allen Kennedy, who is self employed, didn’t have insurance for years, but decided he needed it now that he was getting older.

He is now one of the thousands of West Virginians who found out they were covered under West Virginia’s Medicaid expansion. It has allowed him to have surgery on his eyes to remove cataracts that would have stopped him from working, he said.

Kelly Allen, a Morgantown resident and health care employee with West Virginia University, currently can’t be denied insurance because of her immunodeficiency disorder, but she fears that could change.

When she was still on her mother’s insurance, they often got calls threatening to drop her coverage because of her health condition. Her mother kept an attorney on speed dial, she said.

“I knew if I ever had a lapse in my coverage or if I ever hit a lifetime limit, I would essentially be uninsurable for the rest of my life,” Allen said. “So the Affordable Care Act affects me very much.”

 “I don’t want to go back to the way life was before the Affordable Care Act,” she said.

Members of the Obama administration, including Burwell, have recognized the failings of some aspects of the law, including the lack of competition that is a result of major insurers dropping out of the marketplaces.

In the past year, major national insurance providers, like Aetna, have pulled out of numerous states, and in late October, the Department of Health and Human Services released a report that showed that the average premium for a mid-level plan in the market was expected to increase by 25 percent next year.

That number immediately caught fire on the campaign trail as Trump and congressional Republicans held it up as evidence of the law’s failure.

That report, however, did also show that 77 percent of the people enrolled in the individual insurance plans were paying less than $100 per month due to subsidies offered through federal tax credits.

Still, other people with higher incomes shopping on exchanges don’t always qualify for those subsidies.

Obama authored a policy paper in The Journal of the American Medical Association in July that laid out some changes that he believes could improve the system.

The outgoing president called for the remaining 19 states to expand their Medicaid programs, for additional insurance subsidies in the state and federal marketplaces, for policies to rein in prescription drug costs that have increased dramatically in recent years and a Medicaid-like public insurance option for states that have limited competition among private insurers.

That last part was considered in 2010, but was dropped out of the final law.

Obama laid some of the blame for problems with the system at the feet of health care lobbying groups that have sought to stymie change.

“Special interests pose a continued obstacle to change,” Obama wrote in the policy paper. “We worked successfully with some health care organizations and groups, such as major hospital associations, to redirect excessive Medicare payments to federal subsidies for the uninsured. Yet others, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits.”

Burwell was also joined Tuesday by health professionals that have seen a dramatic drop in uncompensated care at hospitals, which ultimately saves those health care organizations money.

Rocco Massey, another panelist, works as the Community CEO at Appalachian Regional Hospital in Beckley, which, like other hospitals throughout the state, has seen millions of dollars in cost savings due to more people being insured.

“At our organization, 100 percent of that money is plowed back into our community,” Massey said. “It all comes back. It comes back in the form of new services. It comes back in the form of new equipment, new buildings. It helps us recruit new physicians back to West Virginia, and it helps us retain nurses.”

Fewer people are using the emergency room as their only form of care, he said. Instead, they are visiting the hospital’s community clinic more regularly for routine and preventative care.

Margaret Grassie, a Charleston resident, was one of those people using the emergency room as her doctor’s office.

As an employee of a small business, she didn’t have insurance before she qualified under the Medicaid expansion. Now, she has been able to afford her daily medication, treatment on her ankle and a monitor for her diabetes.

“Basically, I fell through the cracks,” Grassie said. “And the elevator that brought me up was the Affordable Care Act.”

Reach Andrew Brown at [email protected], 304-348-4814 or follow @Andy_Ed_Brown on Twitter.

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