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GOP health insurance bill troubles some advocates


The Herald-Dispatch

CHARLESTON, W.Va. — Health care advocates in West Virginia are urging the state’s congressional delegation to oppose the House GOP’s proposed replacement plan for the Affordable Care Act, citing concerns over how the bill will affect West Virginians, especially those who gained health insurance coverage under Medicaid expansion.

“This draws a line in the sand for our congressional delegation,” said Stephen Smith, West Virginia Healthy Kids and Families Coalition executive director, Tuesday during a press conference in Charleston. “It says, ‘Are you with Washington or are you with West Virginia?’ Because there are no two ways about it: This is absolutely going to hurt West Virginia children and families.”

One member of the congressional delegation, Republican Sen. Shelley Moore Capito, as well as Gov. Jim Justice also expressed concerns about the health overhaul proposal, which House Republicans on Monday unveiled to repeal President Barack Obama’s health care legislation.

The GOP plan would repeal the law’s unpopular fines on people who don’t carry health insurance and would replace income-based subsidies the law provides to help millions of Americans pay premiums with age-based tax credits that may be skimpier for people with low incomes. Those payments would phase out for higher-earning people.

Perry Bryant, president of West Virginians for Affordable Health Care, said one of the flaws of the ACA was it did not do enough for high-income people, but to take away from low-income people was not the way to fix the issue. He said health savings accounts aren’t the answer either.

“Health savings accounts are great for those with disposable incomes,” Bryant said. “But if your choices are pay the electric bill or pay for future health care costs, there’s no choice. You are going to keep the electricity on This bill all the way through is slanted toward more affluent people with higher incomes to the detriment of low-income West Virginians and those across the country.”

Mainly, advocates are worried about the bill’s overhaul of Medicaid expansion.

The bill would continue the expansion to additional low-earning Americans until 2020. Beginning then, states adding Medicaid recipients would no longer receive the additional federal funds the ACA has provided.

More significantly, Republicans would change the entire federal-state Medicaid program, moving from open-ended federal financing to a limit based on enrollment and costs in each state, a move likely to cause funding cuts.

More than 200,000 West Virginians would be in jeopardy of losing insurance coverage, Smith said, including about 175,000 who received Medicaid when it expanded. That expansion has been funded almost entirely with federal dollars, which the House proposal would reduce.

Renate Pore, health policy director of West Virginians for Affordable Health Care, said the state would lose about $160 million a year.

Joe Letnaunchyn, president and CEO of the West Virginia Hospital Association, said his group isn’t sure yet what the exact fiscal impact would be if Medicaid is rolled back, but fewer people being covered raises red flags. One possible outcome is that hospitals will be required to provide care but not receive any payment for providing some of that care.

“You’re moving back to the same situation we had before, where more people are coming into the hospital setting without coverage or different coverage,” Letnaunchyn said. “That can lead to potential financial vulnerabilities for hospitals, some that are already struggling.”

Justice also has concerns about Medicaid, worrying that the proposal will kick West Virginians off Medicaid “and leave them in the cold.”

“I have my DHHR secretary looking at the specifics of this new proposal and how it will impact West Virginia and what changes and reductions in all of those government regulations to the law could help our people,” Justice said.

Capito joined three Republican colleagues in criticizing the House proposal, saying they won’t support a plan lacking stability for people enrolled in expanded Medicaid.

“We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services,” the four wrote to Senate Majority Leader Mitch McConnell. “We believe Medicaid needs to be reformed, but reform should not come at the cost of disruption in access to health care for our country’s most vulnerable and sickest individuals.”

The other three senators were Rob Portman of Ohio, Cory Gardner of Colorado and Lisa Murkowski of Alaska.

Sen. Joe Manchin, a Democrat, said he’s still reviewing the bill but has “serious concerns” about how it will impact West Virginians.

Rep. Evan Jenkins, a Republican, said he is also still reviewing the bill.

“We must make sure people are protected with a reasonable transition period and that patients and doctors have time to choose the plans that work for them,” Jenkins said in a statement. “Americans deserve access to health care that is truly affordable, allows them to make choices that fit their needs, and keeps Washington out of the doctor-patient relationship – all of which Obamacare has failed to deliver.”

The new bill would cover less than Obama’s law, but popular consumer protections in that law would be retained, including insurance safeguards for people with pre-existing medical problems and parents’ ability to keep adult children on their insurance until age 26, though Smith said even those are watered down.

“The goal of the bill is to cover less people,” Smith said. “As long as that is the goal, there is not going to be a lot for us to agree with.”

House committees are expected to begin voting on the bill Wednesday.

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