As House committees began marking up the American Health Care Act yesterday, the bill was the subject of bipartisan, bicameral criticism. Juliet Eilperin and Mike DeBonis of The Washington Post report that opposition from multiple groups creates a difficult path forward for the AHCA, especially on the short timeline House leaders have outlined for the bill:
The barrage of criticism shows how fraught the terrain of health-care policy is. It also reflects a backlash prompted at least partly by the breakneck speed with which House Republicans are trying to push through their proposal – with little upfront effort to work with interest groups or political factions. “What we’re seeing now is that the political prospects for repealing the Affordable Care Act are as daunting as the effort to pass national health reform,” Larry Jacobs, a political science professor at the University of Minnesota’s Hubert H. Humphrey School of Public Affairs, said in an interview.
Several powerful health industry groups, including the American Medical Association, American Hospital Association and AARP, came out in opposition to the bill, based on projections that it will result in cuts to Medicaid and declines in overall coverage:
Richard Pollack, CEO of the American Hospital Association, voiced similar fears, saying efforts to “restructure the Medicaid program” by shifting it from an entitlement program to one based on a per capita allocation “will have the effect of making significant reductions in a program that provides services for our most vulnerable populations and already pays providers significantly less than the cost of providing care.”
The bill also has been the source of great disagreement within the Republican Party, with some conservative groups and legislators dubbing it “Obamacare Lite.” At the same time, several moderate Republicans expressed concern about the projected negative impacts for millions of Americans and the prospect of the bill becoming even more draconian as it moves through the legislative process.
“My fear is that the bill will go backwards,” said Rep. Tom MacArthur (R-N.J.), a co-chairman of the centrist Tuesday Group who has gotten White House attention of his own: He met Tuesday with Health and Human Services Secretary Tom Price. “If the bill starts going in the reverse direction in order to satisfy certain members of my party, then I’m going to have a problem. I think the federal government has a role to play here, and I’m not looking to just see the federal government undermine the health-care needs of the American people.”
Despite the criticism of the bill, Richard Rainey of Nola.com/The Times-Picayune reports that House Majority Whip Steve Scalise, of Metairie, has pledged that “failure is not an option” for the bill.
House plan would force state Medicaid cuts
States would be responsible for an additional $370 billion in Medicaid costs over the next 10 years under the American Health Care Act, according to a new report by Edwin Park, Aviva Aron-Dine, and Matt Broaddus of the Center on Budget and Policy Priorities. This massive cost shift to states would likely force states such as Louisiana to end Medicaid expansion and could result in additional cuts affecting senior citizens, people with disabilities, children and parents who rely on the program.
Under the House plan, states that wanted to continue enrolling low-income adults in expanded Medicaid coverage after 2019 would have to pay 2.8 to 5 times their current-law cost for each new enrollee. The higher cost would apply both to enrollees who are new to Medicaid and to current enrollees who leave Medicaid for a month or more and then seek to return when they fall on hard times. On top of that, the House plan would also cap the growth of per-beneficiary federal funding for the Medicaid expansion (as well as for the rest of the Medicaid program), shifting additional costs onto states. The combination of these two policies would starve states of the resources needed to continue covering low-income adults.
A hand up for the formerly incarcerated
The Louisiana Department of Corrections and Department of Health have teamed up to ensure that offenders who complete their sentence and transition out of Louisiana’s prisons have health insurance on the first day they reenter the community. According to the agencies’ leaders and a WWL report, the effort is expected to help former offenders — who disproportionately suffer from mental illness, substance abuse disorders, chronic illness, and infectious disease — reintegrate into society and reduce their chances of returning to prison.
“This is a key solution to reducing Louisiana’s high incarceration rate, reducing the state’s recidivism rate, keeping citizens safe, and saving taxpayer money,” said Department of Public Safety and Corrections Secretary James M. Le Blanc. “Nearly a quarter of the state’s offenders have serious mental health issues, and 75 percent have substance use disorders. For every dollar we spend toward treatment in the community, we save six dollars toward criminal justice costs.”
Louisiana’s two-year colleges reorganize to save
The board overseeing Louisiana’s community and technical colleges signed off on several consolidation measures as a way of avoiding layoffs and campus closures after a series of state budget cuts. The system’s financial struggles is yet another example of the critical need for tax reform in Louisiana to ensure adequate funding for state institutions. Danielle Dreilinger with Nola.com/The Times-Picayune reports:
Louisiana two-year public colleges educated more than 131,000 people last year, according to (LCTCS President Monty) Sullivan’s report to the board. The system had its largest graduation class ever, almost 29,000. But over eight years it has withstood 16 budget reductions totaling approximately $82 million, including a recent hit of $2 million, Sullivan said. Tuition has increased accordingly, but students’ ability to pay has maxed out. The board is particularly concerned about campuses in rural areas that have few if any other opportunities for higher education.
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Number of the Day
$10 million – Amount the Louisiana Community and Technical College System Board expects to save with its administrative consolidation set to begin July 1. (Source: Nola.com/The Times-Picayune)