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Monday, June 26, 2017

Senate bill would cut health care to 'hundreds of thousands' on Medicaid in Louisiana

Posted By on Mon, Jun 26, 2017 at 6:00 PM

click to enlarge U.S. Sen. Bill Cassidy. - CREATIVE COMMONS/GAGE SKIDMORE
  • CREATIVE COMMONS/GAGE SKIDMORE
  • U.S. Sen. Bill Cassidy.

As the U.S. Senate mulls a vote on the GOP's recently released bill designed to gut the Affordable Care Act, Louisiana officials and medical groups are urging senators to consider the potentially devastating impact it could have to people relying on Medicaid's expansion in the state.

In July 2016, Gov. John Bel Edwards approved Medicaid's expansion to include coverage for more than 433,000 people in the state, including more than 100,000 receiving preventive cancer treatment and more than 15,000 women who have received breast cancer screenings. More than 150 people were diagnosed with colon cancer after screenings made possible through recent Medicaid coverage.

Today's report from the Congressional Budget Office (CBO) estimates the Senate's "Better Care Reconciliation Act" would increase the number of uninsured people in the U.S. by 22 million while reducing the federal deficit by $321 billion from 2017-2026 — mostly by cutting spending on Medicaid, which would decline in 2026 by 26 percent compared to projections based on current law. Medicaid would lose more than $770 billion by 2026.

In 2018, 15 million more people would be uninsured under the Senate bill than current law. That jumps to 19 million in 2020 and 22 million in 2026. By 2026, "an estimated 49 million people would be uninsured," according to the report.

In a letter to Louisiana's U.S. Sens. Bill Cassidy and John Neely Kennedy, Edwards says he has "very serious concerns" about the bill, which Edwards says "effectively eliminates" the state's Medicaid expansion program, "resulting in hundreds of thousands of Louisianans losing lifesaving access to primary and diagnostic care."

Edwards says the bill would end force the state to increase costs to keep an expanded Medicaid program up to $250 million a year by 2022, or "end expansion outright," ending care plans for the anticipated 540,000 Louisianans insured through Medicaid by 2020.

The bill also would grant states the ability to cut essential health benefits, which would allow insurers to deny coverage based on pre-existing conditions. According to the Louisiana Budget Project, at least 30 percent of Medicaid expansion enrollees have a preexisting condition.

Cassidy told CNN he's “more concerned” about the Senate plan after the release of the CBO score, though he's still "uncommitted" to a vote. “I mean, just dead, line, uncommitted," he said. "But it certainly makes me more concerned. It makes me want to explore this more.”
In a statement, the National Association of Medicaid Directors Board of Directors denounced the bill and argued that "Medicaid is a successful, efficient, and cost-effective federal-state partnership."

"Medicaid plays a prominent role in the provision of long-term services and supports for the nation’s elderly and disabled populations, as well as behavioral health services, including comprehensive and effective treatment for individuals struggling with opioid dependency," the board said. "Medicaid is complex and therefore demands thoughtful and deliberate discussion about how to improve it."

The board says despite proposed changes that could add, "no amount of administrative or regulatory flexibility can compensate for the federal spending reductions that would occur as a result of this bill."

The Senate bill proposes shifting funding for Medicaid to block grants based on per-capita allotments.

The NAMD board says that any changes to funding Medicaid "must be accompanied by clearly articulated statutory changes to Medicaid to enable states to operate effectively under a cap. The Senate bill does not accomplish that. It would be a transfer of risk, responsibility, and cost to the states of historic proportions."

The American Medical Association also wrote to Senate Majority Leader Mitch McConnell with concerns over Medicaid funding and support, which "limits the federal obligation to care for needy patients to a predetermined formula based on per-capita caps."

"It would be a serious mistake to lock into place another arbitrary and unsustainable formula that will be extremely costly and difficult to fix," the statement says.

Cassidy, however, told Face The Nation June 24 that he believes a block grant-sounding system for funding Medicaid is "better for patients." The bill, according to Louisiana Budget Project's Jan Moller, specifically fails Cassidy's so-called "Jimmy Kimmel test," which the host defined to Cassidy as "no family should be denied medical care, emergency or otherwise, because they can't afford it." (Cassidy's response: "I want to make sure folks get the care they need.")

"This report makes it clear that the Senate's health care bill would be devastating for Louisiana" Moller said in a statement. "The Senate bill plainly fails the 'Jimmy Kimmel test,' as health care would become unaffordable for hundreds of thousands of Louisiana families."

Progressive groups Metairie Indivisible and Indivisible NOLA plan a rally outside Cassidy's Metairie office this week to call on Cassidy to oppose the Senate plan.

"We are asking him to stand strong against enormous party pressure and to vote his conscience against a bill that will harm hundreds of thousands of Louisianans," Indivisible NOLA founder Joyce Vansean said in a statement.

The rally is scheduled from noon-1 p.m. Tuesday, June 27 at 3421 N. Causeway Blvd., Metairie.

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