Guest Editorial: Health care bill the wrong answer for Montana
May 21, 2017
Bozeman Daily Chronicle
- May 21, 2017
Just two weeks ago, the U.S. House of Representatives passed a measure to repeal the Affordable Care Act and replace it with a bill that will dismantle Medicaid as we know it, increase health care costs for hundreds of thousands of Montanans, and put coverage at risk for many across the state.
An analysis by nonpartisan Congressional Budget Office of an earlier, but similar, version of the bill indicated it would result in more than 20 million Americans losing coverage by 2026 and many more facing steep increases in out-of-pocket costs for insurance. While the elimination of protections to those with preexisting conditions garnered significant media attention, this is just one of many problems with the bill that could have a devastating impact on Montanans’ ability to access health care coverage.
First, the House GOP bill proposed damaging and long-lasting changes to the overall Medicaid program with deep cuts in federal Medicaid dollars. The bill proposes to cap federal funding over time, thus shifting over $800 billion in Medicaid costs to the states. Right now, the Medicaid program ensures that when states face higher Medicaid costs — say due a health epidemic or during an economic downturn — the federal match rate is maintained. This helps ease the burden on states to continue to provide health coverage, even during difficult circumstances.
If this bill becomes law, Montana would see a shift of more than $3 billion in Medicaid costs to Montana, which we know our state cannot afford. So the state of Montana will be forced to make devastating decisions: cutting critical health services, cutting the number of people served, and/or cutting the reimbursements to hospitals and other health care providers.
Historically, rural states like Montana have relied heavily on Medicaid to provide for health care. Today, more than 240,000 Montanans (nearly one in four) receive coverage through Medicaid. Nearly half of these enrollees are kids. Montana’s children’s Medicaid and CHIP program, collectively called Healthy Montana Kids, covers over one-third of children in the state, and 35 percent of births in Montana are financed through Medicaid.
Children, seniors, low-income pregnant women, and people with disabilities all rely upon Medicaid for affordable coverage. Medicaid provides critical health services for those battling mental health or substance abuse illnesses. It allows schools to help pay for wheelchairs and health services for children. It helps keep rural hospital doors open.
Also the bill to repeal the ACA effectively ends Montana’s bipartisan Medicaid expansion, which extended coverage to more than 77,000 Montanans who would otherwise be uninsured. For years, we heard from Montanans who faced serious health conditions but were unable to access coverage. Montana’s Medicaid expansion is saving lives and spurring economic activity in some of our most rural communities.
Unfortunately, Medicaid expansion is in jeopardy, and rural health care clinics and hospitals will again be put at risk. As more Montanans lose access to coverage, providers will see uncompensated care costs skyrocket putting increased pressure on providers to cut services or close. This hurts entire communities — whether individuals have health insurance or not.
Finally, instead of helping make insurance more affordable, this bill actually makes it more expensive, by scaling back tax credits and subsidies provided to individuals who access coverage through the marketplace. This will have a disproportionate impact on older Montanans and those with lower incomes. Studies show that Montanans who buy insurance from the marketplace could see out-of-pocket costs (such as premiums, deductibles, and copays) increase by an average of $4,606.
We know that Montana is a hard-working state, but too many working Montanans lack access to health insurance. Medicaid plays a critical role in providing coverage for some of our most vulnerable families and neighbors. It is a program that has worked for more than half a century, protecting the health and well-being of hundreds of thousands of Montanans.
Congress can and should consider ways to lower health care costs and continue to expand access to coverage. This bill is not it. It is time for each of us to tell Congress to reject any bill that causes people to lose coverage, caps or cuts Medicaid, ends Medicaid expansion, or takes away protections for those with preexisting conditions.