By Gareth Henderson, Standard Staff
Concerns over the GOP’s health care proposal spread like wildfire over the past week, following the announcement of the bill that Vermont health officials say would lose the state as much as $200 million in annual federal funding, if the current proposal is approved.
That new bill, the American Health Care Act, dubbed by some as “Trumpcare,” seeks to replace the Affordable Care Act, or ACA – one of the stated goals of President Donald Trump.
The ACA was signed into law by former President Barack Obama and included an expansion of Medicaid, the state-federal program that helps low-income people obtain health insurance.
The changes to Medicaid proposed in the bill Congressional Republicans introduced last week are among the most controversial points in the plan. For example, the bill aims to place a cap on Medicaid spending and would use block grants to supply Medicaid dollars to states.
The report this week from the Congressional Budget Office said the GOP plan to replace the Affordable Care Act would result in about 24 million fewer people having health coverage than under the current system. The report estimates 14 million Americans would lose Medicaid coverage.
Under the proposal, after 2020 states could get even fewer Medicaid dollars than they were receiving before the ACA, or Obamacare, went into effect. With that, fewer people would likely be covered by Medicaid – including millions who obtained coverage through the program when the ACA expanded Medicaid eligibility.
“This really is the death knell to the Medicaid expansion,” said U.S. Rep. Peter Welch, D-Vt., on Friday about the bill.
Welch was also worried about community hospitals, which would have to shoulder the cost of care that would not be compensated under Medicaid, due to this new proposal.
“They would go from black ink to red ink as a result of this bill,” Welch said.
Frank McDougall, Jr., the vice president of government relations for Dartmouth-Hitchcock, which operates Ascutney Hospital & Health Center, was also concerned about people losing health insurance coverage under this proposal, including some of the region’s most vulnerable residents.
“Medicaid is the country’s safety net,” McDougall said Monday. “This (bill) really has the potential, in its present form, to disintegrate that safety net.”
He added, “There’s genuine concern throughout our system and through all of our affiliates.”
Welch said the GOP bill has replaced direct subsidies with “tax credits that are completely insufficient to supply people with the health care they need.” The proposal gives a significant tax break to wealthy families, he added.
Welch is also concerned that more uncompensated care could eventually lead to more expensive employer-sponsored health care premiums.
He also said the bill could hinder Vermont’s ability to switch to an allpayer health care system.
Last week, Al Gobeille, secretary of the state’s Agency of Human Services; Cory Gustafson, commissioner of the Department of Vermont Health Access; and Mary Kate Mohlman, director of Health Care Reform held a press conference with reporters to address the impact of the GOP bill.
Under the proposal, Gustafson said, the state would lose as much as $200 million each year in federal funding, starting in 2020. That number is based on preliminary information the state compiled last week.
“These legislative proposals could impact the all-payer model,” Gustafson said in a Monday interview. “We’re paying close attention to that as well.”
Although the impact of less funding through Medicaid looms large, Mohlman said the work toward an all-payer model will continue. “We’re committed to maintaining our level of coverage in the state,” she said.
Windsor County Sen. Dick McCormack, who is on the Senate Health and Welfare Committee, said Medicaid is a major part of health care access in Vermont.
“Ultimately, the states may be the ones left holding the bag,” he said.
This article first appeared in the March 16, 2017 edition of the Vermont Standard.