During a stop Thursday in the heart of the Third Congressional District, Rep. Evan Jenkins, R-W.Va., visited Raleigh General Hospital to talk about the challenges of health care delivery in the southern part of the state.
While his meeting with hospital administrators was closed to the media, Jenkins said they discussed ways the hospital, the largest private employer in the county, can continue providing quality care close to home.
Before West Virginia’s adoption of Medicaid expansion under the Affordable Care Act (also known as the ACA or Obamacare), Raleigh General’s uncompensated care rate had reached $23.25 million in 2013.
Uncompensated care is defined as the health care services provided to patients who are either unable or unwilling to pay.
The following year, after Medicaid expansion was enacted, Raleigh General’s uncompensated care decreased by 55.4 percent, to $10.38 million.
As the health care debate continues in Washington, Jenkins is still firmly in the camp that the ACA has “some fatal flaws.”
“The folks here at Raleigh General, though, feel very strongly about the Medicaid expansion and folks that are coming into their emergency department, at least having some coverage,” Jenkins said. “This is a very challenging issue.”
He said he wants to find a way to preserve and protect access to quality health care, to get individual patients back in charge of their health care decisions.
“I’m for fixing the system, but we’ve got a lot of work to do. The current system is unsustainable.”
The current system has helped insure thousands of West Virginians. From 2013 to 2015, healthinsurance.org reported a 56 percent reduction in the state’s uninsured rate.
Jenkins agreed the rate has decreased, but he said many of these individuals can’t access their health care.
“I can’t tell you how many people who have purchased an insurance policy because they’re required by law to do it, but they have $5,000, $6,000 or $10,000 worth of deductibles they have to pay before they get one dollar’s worth of benefit from the insurance.”
He said people simply don’t have that kind of money to pay for health care.
“They may have an insurance card, and it may be fine in the case of a trauma situation, or a terrible accident where they need emergency care, but are they going for their routine checkups and getting basic health care services and paying their deductibles? Maybe not.”
Jenkins is also critical of the impact the ACA has had on premium increases. He said over the past several years, premiums have increased 169 percent.
“We are tragically on course for 2018 to have another 25 percent on top of that, so we’re talking about almost 200 percent increase in the premiums.”
Some health care officials have suggested the latest increase is attributable to President Trump’s executive order to end reimbursement to insurers for cost sharing reduction (CSR) subsidies, which help individuals below 250 percent of the federal poverty level with the cost of deductibles and co-pays.
“The 25 percent proposed from Highmark was submitted to our Office of Insurance Commissioner before the president made his executive orders,” Jenkins said.
He continued, “I do suspect Highmark was concerned about the uncertainty and factored that uncertainty into their rate-making. But let’s not forget, we’ve already seen a 169 percent increase in West Virginia before President Trump was ever elected president. Now, we have another 25 percent. So the suggestion that these increases were driven just because of who’s sitting in the Oval Office and the discussion about trying to save our health care system, that misses the fact that we had a 169 percent increase already.”
In effort to reach some middle ground, Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., have proposed continued funding of cost-sharing reduction payments to insurers through 2019, continued funding for ACA enrollment outreach, and more state-to-state freedom in shaping their own health care systems.
Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health committee, and the top Democrat on the panel, Sen. Patty Murray of Washington, unveiled their bipartisan plan Thursday, jointly announcing 22 bipartisan co-sponsors to their effort, more than typical for a bill.
Under the proposal, states would have fewer hoops to obtain waivers from Obamacare. Catastrophic coverage would also be allowed, which would increase options to consumers on the marketplace.
“It’s got a long way to go,” Jenkins said. “It has to get out of the Senate. I understand what they’re trying to do, in some form or fashion, to have more flexibility to the states, coupled with money to insurance companies relating to the cost-share subsidy. I have not seen the details of their proposal.”
He said he wants to see the final version if it passes the Senate before he’ll make a decision on it.
— Email: email@example.com and follow on Twitter @WendyHoldren
Jenkins visits Raleigh General, discusses future of health care | News