The secretly drafted Better Care Reconciliation Act of 2017 is more repeal than replacement of the Affordable Care Act.
The Senate bill has the same shortcomings as the bill the House passed in May. Both propose deep cuts in federal Medicaid funding that would force states to either raise state taxes or drastically reduce health care programs for poor, elderly, disabled and pregnant citizens.
Montana would be especially hard hit by the proposed changes because it now receives a higher federal dollar match for its Medicaid spending than most states. Despite that, Medicaid is already 10 percent of state spending. To back fill the federal funds that GOP lawmakers have proposed cutting, Montana would have to more than triple its spending on Medicaid.
Montana health care leaders responded quickly to the unveiling of the secretly drafted, 142-page Senate bill.
“To protect the future of rural health care, we urge our elected leaders to preserve Medicaid and Medicaid expansion funding and support hospitals and caregivers in their mission to improve the health of their communities,” said Dick Brown, president of the Montana Hospital Association.
Montana nursing homes face even bleaker prospects under the Senate and House health care bills. Montana nursing home operators pleaded with legislators earlier this year to avoid cuts in payments that already fall far short of covering the costs of 24/7 care for frail elders. The final state budget didn’t make most of the threatened cuts, but froze Medicaid reimbursement rates for nursing homes.
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Medicaid is the sole payer for more than 60 percent of the residents of Montana nursing homes.
Under both Senate and House bills, Montana’s present Medicaid coverage of 79,000 very low income adults under age 65 would probably end in summer 2019. Our state Medicaid expansion law (the HELP Act) will be up for renewal in the 2019 Legislature and it contains a trigger that ends the program if the federal government pays less than 90 percent of costs.
Sen. Jon Tester has made his opposition to the Senate bill clear: “It will rip away Medicaid from thousands of Montanans, impose an age tax on folks in their 50s and 60s, make it harder to get coverage if you have a pre-existing condition.”
We call on Sen. Steve Daines to oppose the Senate bill that was written in secret without public input. We challenge Daines to champion Montana’s health care needs by insisting on reforms that actually cut the costs of health care for Americans rather than imposing arbitrary federal caps that will keep Montanans from getting care when they need it.
Senate Majority Leader Mitch McConnell said Tuesday he was delaying a vote until after the Senate's July 4 recess, a reflection of the fact that Republicans did not have the majority needed for passage.
We hope that the Senate will use this time to improve the legislation. If it doesn't, and it makes it to the House, we urge Rep. Greg Gianforte to oppose it.
Montanans need health care that is affordable and accessible. The Senate bill would put care out of reach for many of us.
This editorial was originally published in the Billings Gazette and adapted for the Missoulian.