The Congressional Budget Office reported last week that the Better Care Reconciliation Act, the Senate Republican health care bill, will slash Medicaid by $772 billion over the next decade if passed, according to the New York Times.
While I understand the reality that the Republican Party controls our legislative and executive branches of government and that repeal of the Affordable Care Act is imminent, such action shouldn’t mean cutting Medicaid, as well.
I also understand that the GOP doesn’t respond to sob stories, guilt-trips or public opinion polls.
But, for the record, only 12 percent of Americans approve of the Senate health care bill, according to USA Today, and 84 percent believe it’s “very” or “somewhat” important for the ACA repeal to include funding for the Medicaid expansion.
Nevertheless, there’s still a fiscally compelling rationale for expanding Medicaid—one that might satisfy conservative sensibilities.
With their version of the health care bill, the GOP intends to restructure the Applicable Median Benchmark Plan and the Modification of Applicable Percentage of the ACA. As a result, lower-income and older Americans will, in large part, pay higher premiums and deductibles for their health insurance, since their subsidies won’t cover as much of the cost, according to an analysis by Vox.
Among lower-income Americans, multiple studies, displayed in bulk by the Kaiser Family Foundation, indicate that even slight increases in premiums or deductibles lead to substantial increases in the number of uninsured, which will have an adverse effect, particularly, on rural hospitals.
Since 2010, 79 rural hospitals across the country have closed and 700 more are at risk of closure, according to NPR.
In low-income areas, when residents are unable to afford health insurance, public hospitals are still required to treat their patients, regardless of insurance status, which means they’re dispensing care without receiving compensation.
In areas that are especially poor in both income and health, this system proves to be unsustainable and hospitals close.
This punishes entire communities as jobs are lost, property values decrease, and even schools suffer.
After the closure of Mercy Hospital Independence in Kansas, Republican Senate Vice-President Jeff King began advocating for expanding Medicaid in his state, despite pushback from Republican Governor Sam Brownback, according to the Kansas City Star.
Additionally, in the Senate health care bill, Indiana is included in a group of eight states for which the Medicaid expansion immediately disappears if the federal matching rate drops below that promised by the ACA, according to NPR.
Given that Indiana has more than 1.4 million Medicaid enrollees, the results of constricting the program would prove disastrous for our state.
But even if our hospitals being at risk aren’t motivating enough, the Indianapolis Star reported that after Indiana’s modest Medicaid expansion last year, there was a ten percent drop in ACA enrollees, as well as a one percent growth in overall income due to the expansion.
And, lastly, researchers at the Urban Institute found that not expanding Medicaid in Indiana would result in a loss of $26.5 billion over a ten-year period, compared to the mere $1 billion it would cost to expand it.
I have the utmost confidence that the Republicans in Congress can repeal the ACA without making cuts to Medicaid.
Partisanship, on both sides, should be put to rest as health care is reformed.
If not for people’s general well-being, lawmakers must consider the exposure of hospitals to the risk of closing and the cost to the State and its residents should Medicaid be cut.
thshowal@indiana.edu
