Downriver Sunday Times: Dingell, health care providers warn of local impact of GOP’s latest ACA replacement
TAYLOR – U.S. Rep. Debbie Dingell (D-Dearborn), state representatives and health care providers met Saturday to discuss the impact of the Graham-Cassidy bill, which was on track to face a Senate vote this week.
Senate GOP leaders today announced that there would be no vote on the bill.
The Republican-backed bill sought to remove the mandate that individuals must purchase insurance and that some employers must offer it. It would have taken funds earmarked for Medicaid expansion through the Affordable Care Act and put it into block grants to allow each state to establish its own health system.
It also raised concern for people with pre-existing conditions: While insurance companies would not have been allowed to deny coverage, states could have allowed insurance companies to not cover the costs associated with some conditions.
Dingell said Saturday the bill worried her because it was the most extreme proposal she has seen from the GOP.
“It would increase costs for seniors and the Medicaid program as we know it, and worst of all, it would drastically increase premiums,” Dingell said. “This would gut the protection that people with pre-existing conditions have.”
Dingell said the plan was released only a few days ago, and it eliminated efforts to find bipartisan solutions that would address the elements of the ACA that needed change. She praised Sen. John McCain (R-Ariz.), who opposed the bill.
“Once again we are flying blind without information about the true impact this bill will have on costs, premiums, access to care and the number of people who will lose their insurance,” Dingell said. “Rushing through legislation to reshape the entire health care system in this country, which represents one-sixth of our economy, is bad policy-making at best and I think is just utterly ridiculous.”
Dingell said the bill would have ended Medicaid in its present form by cutting the funding and capping the program, and “completely eviscerates” protection for people with pre-existing conditions.
“Under this bill, states could apply for a waiver that would allow insurers to charge higher premiums based on health status and decline to offer essential health benefits,” Dingell said. “That is what we were trying to fix last time.”
She said under the bill, insurers could have declined to cover essential health benefits, including mental health, substance abuse treatment and maternity care.
She said insurance caps could have drastically impacted care, including treatment for premature babies.
Dingell said a block grant program to pay for Medicare does not include enough money to pay for future health care needs.
“The Center for Budget and Policy Priorities estimates that just Michigan alone stands to lose $10 billion over the next 10 years if this bill were to be enacted,” Dingell said. “This would lead to a rationing of care across the board for seniors in nursing homes, pregnant women, working parents, people with disabilities and children.”
Dingell said health care is the No. 1 issue that elected officials hear about from their constituents.
“Stop with this last-minute madness,” Dingell said. “Stop playing politics with people’s lives and start working with us on a real bipartisan solution to fix our problems now.”
She said the American Medical Association was opposed to the bill, as is Blue Cross Blue Shield, the American Association of Retired Persons, the American Hospital Association and the Association of State Medicaid Directors.
State Rep. Darrin Camilleri (D-Brownstown Township) said if this bill would have passed 700,000 people in Michigan would have lost their health insurance, since the bill would have made the state pay for Medicaid from the block grant allocation, and Michigan does not have billions of dollars to replace the lost revenue.
Camilleri said one of his biggest priorities is protecting the Medicare expansion and making sure people with pre-existing conditions would still have access to health care.
State Rep. Cara Clemente (D-Lincoln Park) said ordinary people who encounter something like cancer would have been hurt by the Graham-Cassidy bill.
“When it comes along and you don’t expect it and then you have absolutely no way to pay for it, it is terrible,” Clemente said. “With the Healthy Michigan program, you were able to go see a doctor without going to the emergency room. It’s not perfect, but it’s a framework that we need to build on. It’s not just for some, but for all.”
U.S. Rep. Debbie Dingell (D-Dearborn, second from left) and state Rep. Cara Clemente (D-Lincoln Park, right) listen as Laura Apel, senior vice president and chief innovation officer of the Michigan Health and Hospital Association, describes how the Republicans’ latest healthcare legislation, the Graham-Cassidy bill would cost the state billions of dollars and eviscerate health care coverage and access to care on a large scale.
Laura Apel, senior vice president and chief innovation officer for the Michigan Health and Hospital Association, said Michigan law governing Medicaid expansion says the state has to save more money than it spends, and if the state loses any federal support, Medicaid as it exists will not be able to continue under state statute, and will be going backwards.
Apel said with the Graham-Cassidy bill, Michigan would have lost billions of dollars through 2026, and in addition to eliminating the Healthy Michigan program, it would have cut into the traditional Medicaid population: people in nursing homes, parents who live below the poverty level and adult children with developmental disabilities. She said mental health program funding would also be negatively impacted.
“We’re going backwards with Medicaid based on what Graham-Cassidy does,” Apel said. “It’s hugely detrimental to Michigan families, people who need health care.”
Laura DePalma of Michigan United, a coalition of advocacy groups, has a pre-existing condition, and she said she has chosen to fight for social justice issues because of her own struggle.
As a professional campaign organizer, DePalma changes jobs frequently, and in 2012, before the Affordable Care Act took affect, her pre-existing condition meant she had to pay for her medication and a hospitalization, which she is still working to pay.
“If we lose ACA, I will be paying for medication, therapy and doctor, and there is no way I can possibly afford that on my income,” she said. “So this is pretty much my life, and I have met many other people who share similar stories.”
DePalma read a letter from Alexis Wyatt of Brownstown Township, who was at an emergency room with her 10-month-old son, Alex, who has severe medical conditions, some still lacking diagnosis. He relies on Medicaid, and Alexis had to quit her job to stay home to care for him.
“It is because of days like today why it’s important,” Wyatt wrote. “Alexander is unpredictable. We have many ER visits, hospital admissions, medicines and health supplies. Without his feeding tube or constant care, he is likely to die. That is why this fight is so important and we need to protect the ACA for kids like Alexander.”
Attendee Kari Snyder of Wyandotte said the ACA saved her mother’s life by providing care when she was laid off from her job after discovering she had breast cancer, which was then considered a pre-existing condition.
“If the ACA wasn’t there, she would have put off the secondary treatment that she needed, and I don’t think she would be alive today, and my two daughters would not know their grandmother,” Snyder said.
Farah Erzouki, ACCESS Public Health coordinator, said since 2003 their clinic helps connect vulnerable clients from under-served communities to a variety of health care services.
“Clients of all ages, those with pre-existing conditions, those with mental health conditions, those who would not otherwise be able to afford coverage and those who wouldn’t be able to navigate the complex health care system that we live in,” Erzouki said. “We have seen first-hand the number of lives that these programs have saved both within and outside of our clinic.”
Linda Atkins, CEO of the Western Wayne Family Health Center, concurred that clients who benefited from the ACA would have been devastated by Graham-Cassidy bill.
“If we had to go back to 50 percent uninsured, we would have a reduction in the number of centers, a reduction in staff to take care of those patients, and that means a loss of programs,” Atkins said.
Atkins said physical health, mental health and substance abuse treatment programs would have been impacted in the bill.
“The opioid epidemic is at a crisis right now,” she said. “We are losing patients due to heroin addiction. The benefit of the ACA is they gave us dollars to run a program to get those patients on medication-assisted treatment. Without those dollars, we would actually have a crisis on our hands. We would have people with nowhere to turn.”
Apel said keeping people healthy lets them be productive in their personal and work life.
“That’s how we are going to be a great state,” she said. “That’s what we really want. That is what we all want to be.”