Republican Health Plan is really an Attempt to Dismantle Medicaid

The Republican health care plans brought forward by both the House and now the Senate are actual attempts to dismantle the Medicaid program. Both plans cut Medicaid spending by hundreds of billions of dollars over the first ten years. It will amount to trillions of dollars in the decade following. The federal change will push state budgets to either pick up the tab or cut services to their frail populations.

The CBO scored the Senate health care plan yesterday. An estimated 22 million more people would be without coverage by 2026. 15 million fewer covered by Medicaid alone as a result of reducing $772 billion over the first ten years. That is a dramatic drop in safety net coverage for low-income families, elderly, and people with disabilities. Late yesterday, the Senate added an amendment to put a 6-month “wait period” if someone misses premium payments or lapses coverage. Today, the Kaiser Family Foundation said premiums would go up 74% to its comparable plan under current law. That would be coupled with a reduction in federal subsidies to help people afford the policy.

To summarize the Senate Republican plan, it would demolish safety net coverage by way of Medicaid cuts. It would then raise premiums and out-of-pocket expenses for individuals while lowering subsidies. The people who no longer are covered by Medicaid would need to purchase their own – more expensive – coverage. If they can’t afford to pay, they’ll be put on a 6-month hold for coverage. Because of that 6-month hold, people may become more sick or even die. How in the world is that policy worth striving for in this country?

Those who are unable to afford the more expensive health care coverage will likely forgo treatment until it’s too late or end up in the emergency room where they can’t be denied service by law. If these individuals are unable to afford insurance, what makes you think they can afford emergency room care? Thus, the hospital will need to take on that debt. This was exactly what they faced pre-Medicaid Expansion and is why hospitals strongly supported its passage. This is a disaster for rural hospitals like Jamestown where they estimate to lose $1.5 million if Medicaid Expansion is repealed according to their CEO K.C. DeBoer.

I’ve stated before the Medicaid cost shift from the federal government to state budgets -whether it is capped or a per capita payment – would be disastrous for North Dakota. I do not believe we will be able to afford the commitment in the long term which will result in loss of coverage for elderly, children, and people with disabilities. It will also diminish payments to nursing homes and rural hospitals potentially leading some of them to close.

Medicaid spending caps are insufficient and unworkable. – The National Association of Medicaid Directors

At this moment AARP of North Dakota, the Long-term Care Association of North Dakota, organizations focused on people with disabilities, along with other associations including pediatricians have publicly opposed the Senate bill. I heard from a reliable source that the North Dakota Medical Association and the North Dakota Rural Hospital Association will be issuing a joint statement opposing this particular bill also. Will the public outcry by professionals move Senator John Hoeven to oppose the bill? As I write this, Senate Majority Leader Mitch McConnell has announced they will delay the vote until after the July 4th recess. Perhaps Senator Hoeven should consider holding a town hall during that week to hear more from his constituents about the real impact on their daily lives.