Health reform needs to make things better
By now it should be axiomatic: Changes in U.S. health insurance laws should lead to more people being covered and better health outcomes.
The first two versions of the U.S. House Republicans’ repeal and replacement of Obamacare went the other way. Version 1.0 of the American Health Care Act died without a vote; version 2.0 deserves to die in the Senate.
Medicaid expansion under Obamacare gave coverage to more than a half-million new enrollees in Washington state alone. The GOP rollback would undo that while robbing local health-care pillars like Providence St. Peter Hospital in Olympia of revenue needed to care for those who are poor.
“Using data compiled by the American Hospital Association, Providence St. Peter and Providence Centralia hospitals can anticipate nine-year Medicaid revenue losses of more than $568 million” through 2026, Providence St. Peter said this week in a statement. “The local impact is going to be very hard on the economy and most importantly on the people who live and get care here.”
Similarly Executives at Harborview Medical Center in Seattle calculated this month that the U.S. House antics could cost that top-flight trauma care facility some $627 million over a decade.
In voting to approve their revised American Health Care Act, Republican congressional leaders didn’t bother to wait for a budget-office analysis to show how truly bad it is. An independent congressional evaluation of the original ACHA estimated that it would result in 24 million fewer Americans covered by 2026.
We were heartened that eight members of Washington’s House delegation voted against the latest version. They included Republican Rep. Jaime Herrera Beutler of Camas and Republican Rep. Dave Reichert of Auburn. All six Democrats in Washington’s House delegation, including Democratic Rep. Denny Heck of Olympia, were opposed.
Herrera Beutler was concerned about the proposed Medicaid cutbacks and impacts on children. Rep. Dan Newhouse, a Republican from Sunnyside, did not vote because he was home with his ailing wife, who since died of cancer. Unfortunately, Rep. Cathy McMorris Rodgers of the Colfax area is part of GOP leadership and went along with the repeal-and-replace charade.
Our state's Democratic Sens. Patty Murray and Maria Cantwell are digging in to fight against the House plan. The question, though, is what can the Senate do to actually improve care, control costs and expand coverage at a time some regions struggle to entice insurers into offer individual-market plans?
In the end, any real solutions will cost money — such as expanding tax credits to assist families of higher incomes who have seen their premiums rise. More people also must buy insurance — in effect, putting all consumers in the pool.
Sen. Susan Collins, a moderate Republican from Maine, wants the upper chamber to start over from scratch. She has been working with a handful of Republicans including Louisiana Sen. Bill Cassidy, a doctor, on an alternative to what ideologues in Senate leadership may produce.
This may be a long shot, but at least opens the door to something more constructive. Relying on markets to curb costs can work. Relying on them to insure more people has not.
This story was originally published May 16, 2017 at 8:50 PM with the headline "Health reform needs to make things better."