About fifty people gathered Tuesday at the Missoula office of Montana Senator Steve Daines. Their message was loud and clear.
They want Daines to reject the GOP healthcare reform bill under consideration in congress. They say the American Health Care Act would gut Medicaid, leading to billions of dollars in program cuts over the next decade.
Kaiser Health News reports that the AHCA as passed by the House would cut more than $800 billion from Medicaid over a decade.
Missoulian Lisa Davey says that can’t be allowed to happen. Davey explains that millions of America’s most vulnerable, including pregnant women, the elderly and people with disabilities rely on Medicaid for critical services.
“This has incredible impacts on real people," says Davey. "In Montana, we take care of our neighbors. We don’t just let them die because they can’t afford to pay for medical care.”
Davey’s intimately familiar with the Medicaid program. Her son was born when she was only five months pregnant.
“And he weighed just over a pound. He reached his lifetime max payout for insurance before he was a month old," Davey says. "Since then, he’s had Medicaid. In the spring, he had three brain surgeries – back to back. I just got the explanational benefits for that and it was $149,000. Without Medicaid, I’d be bankrupt.”
Davey was not the only one who spoke passionately about protecting Medicaid at all costs during today’s ‘Don’t Cap My Care’ rally in Missoula.
“I’m Jenny Montgomery. This is my son, Heath.”
Heath is an outgoing eight-year-old who has cerebral palsy. Medicaid covered the cost of his power wheelchair and Heath says that chair, "Got me what I wanted and that’s my independence."
Edward O'Brien: “So that chair’s a big deal to you?"
Heath Montgomery: “Yeah, it is.”
Heath’s mom, Jenny Montgomery, says Medicaid covers critically important services for people with disabilities, including personal attendants, "Who’ll come to a person’s home, help them bathe, get dressed, prepare food so that they can go out and go to work" asks Montgomery. "So they can participate in society, earn an income, contribute to our economy. Private insurance isn’t likely to cover that type of personal care, nursing or in-home services and equipment that keep us out of nursing homes.”
Marsha Katz, of the national disability rights organization, ADAPT, agrees. She reminds Republican Senator Steve Daines that, “his party has left a rich legacy of supporting people with disabilities.”
She points out President Nixon signed the Supplemental Security Act which supports low income people with disabilities. President George H.W. Bush signed the Americans with Disabilities Act.
"I’m hoping Senator Daines will not betray the legacy of his party, will not push Montanans under the bus," says Katz. "I’m hoping he’ll stand strong for saving Medicaid and no cuts, no caps."
Senator Daines was not at his Missoula office Tuesday, but he talked about Medicaid and the future of Republican health care legislation briefly with Montana Public Radio News Director Eric Whitney last week.
Eric Whitney: I was given about seven minutes to talk to Senator Daines about healthcare while covering his summit on agriculture in Great Falls last week. We’ve asked him for a longer interview on the topic as the Senate has now begun working on it’s version of repealing and replacing the Affordable Care Act.
Steve Daines: What’s important about Medicaid is, first and foremost we need to protect the Medicaid program for those it was originally designed to serve, that is the very poor, the indigent. Medicaid spending right now, it's exploded, and the question is, do we put at risk, ensuring that we protect those Medicaid was originally intended to take care of as well as seniors that are pre-Medicare eligible up until age 65?
I think whatever we do will ensure two things. One, that we move more of the Medicaid decision-making and administering to the states. That's proven to be a successful model. And two, whatever happens here that you have a transition and a runway such that you will protect those who are currently on Medicaid expansion.
EW: So if you say we need to protect those it was intended for and protect those currently on Medicaid expansion, I think people will hear that and say, 'Oh, he doesn't want Medicaid cuts. He wants to protect those people, so no Medicaid cuts in the Senate bill.'
SD: Well, looking at the House bill and what the Senate is considering, the Medicaid expansion component right now, and ensuring that we have incentives. For example, Medicaid Expansion went up to 138 percent above the federal poverty level. There's not an incentive to increase your income or go to work because if you're one dollar over the Medicaid limit on income, you're off the Medicaid Expansion system.
EW: But you could still get an exchange policy for almost zero dollars a month. Once you're 139 percent above poverty, you get a subsidy to buy a policy in exchange for, in the range of $25 or less a month. So you're still protected.
SD: Well, if you look at the different levels on Medicaid, in other words, let's say it's Christmastime. You want to go work at Macy's for a couple of months to get some extra Christmas cash, you go one dollar over the Medicaid number, now you're thrown in a different system. In other words, you might say, 'Do I want to go through, shift off of this system. You go to this different system.' There's not an incentive to get off the system here and get onto the exchange.
So I think you're going to see we've got incentives, like we did with welfare reform that was done back in the '90s. Just ensures that if you're able-bodied, able to work, we ought to be moving people into that direction instead of being on Medicaid Expansion for a lifetime. And ensuring we protect the original individuals that Medicaid was designed to protect, which is the poor, the indigent, the elderly who are pre-Medicare.
We also had the opportunity to speak with Senator Jon Tester about healthcare last week, when he visited MTPR’s studios in Missoula.
EW:Is there any scenario where you can see yourself voting for a new health care bill, something to repeal and replace the Affordable Care Act?
Jon Tester: If it increases access and affordability, that’s the key and those are the two things. I think that what we saw come the House did exactly the opposite. It decreased access and increased cost. That’s not the direction we should be going. Do I have great faith that the Senate is going to come up with something great? No, but there are examples of folks working together in a bipartisan way and getting some good things done.
(Georgia Republican Senator) Johnny Isaacson, who is chair of the Veterans Affair Committee, I’m ranking member, we’ve worked together to, I think, improve health care for our veterans and we’ve done it in a bipartisan way. If we can get a willing person on the other side of the aisle to really work and improve access and affordability, I think you could come up with something, but really what we should be doing, is we should take the Affordable Care Act – that, by the way helps folks who are working and not making the best of wages, helps folks who have preexisting conditions, helps folks who come up against lifetime costs because they have cancer or something like that, and keep those portions. Those portions are working. Where it’s not working, it’s not working for those folks who are kind of caught in the middle. They don’t get any subsidies, and they’re not so rich they don’t care, and they’re getting hammered with monthly premiums and too high of deductibles.
EW: How do you fix that?
JT: I think at a bare minimum, a no-brainer, let’s put more transparency on insurance companies and pharmaceutical companies. That’s a no-brainer. And then fix it the way you fix any other tough problem, bring in people from hospitals, bring in doctors, bring in patient groups, bring in nurses, bring in policy makers and sit in a room not much bigger than this one, Eric, and talk about the problem and talk about solutions and I think we’ll come up with solutions.
We can do that, but that’s not happening. That’s not happening at all. And as I go around the state and talk to hospitals, doctors and patients about what’s going on in health care, they’re really, really nervous, and so I think it can be fixed, but there’s got to be a willingness to fix it and there’s got to be a willingness to understand that the Affordable Healthcare Act is not perfect, if we work together we can fix some things, and by the way, let’s all take credit, let’s not politicize it and say ‘we did this and you did this and we didn’t’ and whatever, and move forward. But what came over from the House is a wreck. Is a total wreck and if we do anything even close to that in the Senate, it will be a disservice to the people of this country.
EW: You said when you talk to people in the healthcare industry in Montana they tell you they want to keep the reforms in the Affordable Care Act. What about when you talk to people in Montana who are not part of the healthcare industry? My impression is that a lot of Montanans, maybe a majority of Montanans, want it repealed and replaced. Do you hear that too?
JT: Not as much. I’ve had plenty of people come to me and say, ‘look, my premiums have gone up 50 percent over the last couple years and my deductible is so high that it’s ridiculous. It’s gonna cost me $7,000 out of pocket if I get sick. That’s all true. So let’s focus on that group.
I’ve also had several people come up to me, the best story I’ve got is a guy from Butte that came up, about 40 years old, and said I’ve had diabetes issues since I was a teenager, I’ve had mental health issues, I haven’t been able to work. Along came the Affordable Care Act, along came Medicaid expansion, I was able to get my diabetes under control, I was able to see a psychologist and get my mental issues under control, I’ve got a job now and I’m supporting my family. That’s exactly the good part, and the story before about premiums going through the roof, is the tough part. Let’s keep the good, let’s fix the bad.