Republicans gloat over healthcare-local impacts

Local people will be hurt by this legislation, what comes next

Marianne McGee, MA/ABS

While Republicans gloated and Democrats sang na na na songs after the Republicans barely passed the American Health Care Act (AHCA), real people are wondering how this will impact their lives and what to do next!  Moreover many Representatives openly admitted they had not read it, nor had they give federal staff time to analyze its costs in terms of money and human lives.

Rather than act responsibility by improving the existing Affordable Care Act (ACA) or legislate Single Payer Insurance, they finally were able to barely pass a lame substitute through the House of Representatives, which does not replace the ACA, which is still the law of the land.  The greatest irony of the day was watching Trump congratulate the Australian official for having a better health care system, which is a single payer program!

While many people wanted mandatory coverage removed, they also wanted affordable coverage and policies that will cover preexisting conditions, most of which they are unlikely to receive under this legislation which is hopefully, never going anywhere.  While there are many horrible aspects to this bill, the most deadly danger is the list of diseases and conditions NOT considered to be preexisting, so people will not be protected.  Here is a partial list of uncovered diseases according to Senator Sherrod Brown:

AIDS/HIV, acid reflux, acne, ADD, addiction, Alzheimer’s/dementia, anemia, aneurysm, angioplasty, anorexia, anxiety, arrhythmia, arthritis, asthma, atrial fibrillation, autism, bariatric surgery, basal cell carcinoma, bipolar disorder, blood clot, breast cancer, bulimia, bypass surgery, celiac disease, cerebral aneurysm, cerebral embolism, cerebral palsy, cerebral thrombosis, cervical cancer, colon cancer, colon polyps, congestive heart failure, COPD, Crohn’s disease, cystic fibrosis, DMD, depression, diabetes, disabilities, Down syndrome, eating disorder, enlarged prostate, epilepsy, glaucoma, gout, heart disease, heart murmur, heartburn, hemophilia, hepatitis C, herpes, high cholesterol, hypertension, hysterectomy, kidney disease, kidney stones, kidney transplant, leukemia, lung cancer, lupus, lymphoma, mental health issues, migraines, MS, muscular dystrophy, narcolepsy, nasal polyps, obesity, OCD, organ transplant, osteoporosis, pacemaker, panic disorder, paralysis, paraplegia, Parkinson’s disease, pregnancy, restless leg syndrome, schizophrenia, seasonal affective disorder, seizures, sickle cell disease, skin cancer, sleep apnea, sleep disorders, stent, stroke, thyroid issues, tooth disease, tuberculosis, and ulcers.

So, if you do not have continuous coverage and have one of these catastrophic conditions, you are on your own.  Additionally, it is a very small 8 billion dollar fund they have to cover the people who fall into this category with an authorized preexisting condition, which will not go very far given the  outrageous cost of health care now.

Lucresha Renteria, Executive Director of Mendocino Coast Clinics, the local agency most concerned with health care for low income and under-insured people, sent out the following email.  She gives a clear and cogent appraisal of the current situation.

Subject: American Health Care Act Vote and what’s next

The House passed the ACHA Thursday. It received the 217 votes needed to pass, all California House Republicans voted for the act.  

This is the culmination of the Administration’s efforts to “repeal and replace” Obamacare. The first efforts made in March failed to garner the votes needed; through much inter-party lobbying Ryan and Trump were able to make changes in the original proposal and gained the votes needed.

Here are some details about the American Health Care Act (AHCA)

The ACHA will continue to allow children to stay on their parent’s health insurance until age 26. Outside of that similarity to the ACA the other provisions are different. ACHA gives states the option to eliminate the requirement to cover individuals with preexisting conditions providing instead high risk pools- this will result in higher premiums for this population. The AHCA provides $8 Billion over 5 years in aid to states who will set up high risk pools.  It eliminates requirement of the 10 essential benefits; allowing states to decide to make individuals pay more for benefits such as pregnancy care. It also eliminates the tax penalty for not having insurance coverage instead offering tax credits for covered individuals. All these changes will greatly affect our patients and the care we will be able to offer them. In a very dramatic change for us, the AHCA eliminates the federal funding for the Medi-Cal expansion by 2019. About 31% of MCC Medí-Cal patients are covered through the expansion program. The program would have to be sustained financially by the State of CA; this is not likely to happen.

Here is the good news- The fight is NOT over. In order for the AHCA to reach the President’s desk for signature it must pass through the Senate. This is highly unlikely to happen in the AHCA current form. The Senate will likely have to make significant changes to the Act in order to get the votes for approval. This means much negotiation back and forth between the House and Senate. This means it won’t happen quickly, the cost of AHCA had not been calculated yet. Once a price tag is put on it the Senate will be tasked with making sure the costs and potential losses of coverage to millions of Americans can be justified. The 2018 election is coming up and anyone up for reelection is sensitive to keeping their communities happy. Many Town Hall meetings in Republican districts have shown the community support of coverage of pre existing conditions and other benefits of Obamacare. Hopefully this will pressure the Senate to amend the AHCA significantly.

In any case Community Health Centers are being counted on to provide much needed care to our communities. We are a vital part of the healthcare network. Our patients need to know we are still here and their coverage is not disappearing anytime soon.

I will keep you alerted of advocacy efforts we need to make and ask that you talk to your friends and family across the state so we spread our influence as far as possible.

Thank you for all you do for the health of our community.

Lucresha Renteria, Executive Director                                                                                                                                                                                         Mendocino Coast Clinics, Inc.

As Ms. Renteria so aptly pointed out, this is not the end of the battle.  Perhaps it is the beginning of the end of this draconian reign of terror as it has gone too far.  Perhaps the Democratic Representatives will gather some courage and give the American people what most of the rest of the world has, universal coverage.  It is time for elected representatives to stop sniveling over the loss of the election, start listening to the people and take care of our most basic needs, not those of the dominant global corporate interests!