Congressional budget report worries health care officials

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The Senate is set to review the American Health Care Act next month, and the report set forth by the Congressional Budget Office shows that mostly the “working poor” who are on Medicaid will have to brace for the effects of the healthcare bill.

According to the Congressional Budget Office Cost Estimate, released Wednesday, nearly $834 billion would be cut from Medicaid. If the bill were to pass the Senate as is, $14 billion would be cut in 2018, resulting in about 4 million people losing Medicaid coverage in the country.

According to the California Budget & Policy Center, nearly 35 percent of California’s population relies on Medicaid, known as Medi-Cal.

And for health officials, the bill and the budget report are worrisome, especially for those who benefited from the expansion of Medicaid.

“These are folks that are the working poor and didn’t have insurance for many years,” said Margaret Kisliuk, executive director of Partnership Health Plan Northern Region. Partnership Health Plan is a managed care system for Medi-Cal enrollees in much of the North State and covers Shasta, Siskiyou, Modoc and Lassen counties.

Kisliuk said the expansion of Medi-Cal helped many people in rural areas, including many who are homeless. One of the bigger benefits she saw with Medi-Cal’s expanded coverage was that people could get help for substance abuse and receive mental health services. But if things were to go back to the way they were before the Affordable Care Act, Kisliuk knows more people are going to show up in emergency rooms.

“It really is such a tragedy that we’ve been working to get them coverage,” she said. “To have them lose coverage, it’s such a shame.”

Over the years, the CBO projects that by 2026, an estimated 14 million people will be off Medicaid. Some 6 million people will lose marketplace insurance and 3 million will no longer be covered under employment based insurance. Overall, the change in coverage under the American Health Care Act would leave 23 million people uninsured.

About 28 million people remain uninsured in the country. A study by the Kaiser Family Foundation concluded that this is a portion of the population either deemed ineligible for the Affordable Care Act because of their immigration status or because their states didn’t expand Medicaid, or simply didn’t enroll for insurance.

In conclusion, along with this portion of the population, it could mean 51 million people being uninsured by 2026.

In places like Tulare County, just south of Fresno, nearly 55 percent of the population is on Medi-Cal.

“We have such a high rate of poverty in this county,” said Juliet Webb, director of human services at the Tulare County Health and Human Services Agency.

Webb, who has worked with the county for more than 15 years, remembers what it was like prior to the Affordable Care Act, when people were heading to clinics and emergency rooms to get care. She estimates that nearly 50,000 people enrolled in Medi-Cal when it was expanded by the Affordable Care Act.

“That was a good thing all around,” she said.

The burden on the county clinic lessened and doctors were getting reimbursed for their services, she said. But, the American Health Care Act in its current form is worrisome, she said.

“There’s been so much progress to get the Affordable Care Act implemented,” she said. “It’s better now. It’s much, much better now.”

 

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Congressional budget report worries health care officials

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