Montana Voices: Don’t let U.S. Senate close the door on Montana

Senate Republicans have crafted a plan that will unhinge our nation’s health care system and leave Montana families and the people who care for them scrambling to pick up the pieces.

Dick Brown

To make matters worse, they’ll vote on the bill this week without public input. This commitment to secrecy is more than concerning. It has clouded what should have been a transparent and collaborative process of strengthening America’s health. And it has set an unnerving tone for future Congressional action.

GOP leaders rejected the House plan to allow insurers to charge people with pre-existing conditions more for their health insurance – that’s good news. They also want to beef up tax credits needed to help low-income people purchase insurance – also good news. But there is a lot of devastating news as well, especially regarding the Medicaid program.  

Federal funding for the Medicaid expansion – which has provided health insurance coverage to more than 77,000 Montanans – would be reduced over three years beginning in 2021. Medicaid spending would be capped and allowed to grow at a rate far below the actual growth in medical costs.

These changes would leave Montana lawmakers with two grim choices: take money from elsewhere to fund the program or eliminate the life-saving services currently provided to Montana children, seniors, pregnant women, veterans and other individuals in need.

Also disturbing is that the Affordable Care Act’s taxes, which offset the cost of coverage, would be repealed or delayed. In effect, higher-income Americans will get a $664 billion tax cut paid for by severe cuts in Medicaid’s safety-net programs.

The Congressional Budget Office – Capitol Hill’s nonpartisan budget scorekeeper – concluded the House bill would cut federal Medicaid spending by 25 percent – $834 billion – by 2026. At the same time, 23 million Americans would lose their health insurance coverage, including more than 100,000 Montanans.

The benefits of health coverage are well documented. Uninsured patients are less likely to seek the care they need or maintain their recommended course of treatment. This results in a sicker, poorer and less productive workforce, and more costly care.

Montana Hospital Association data reveals that the Medicaid expansion is working, but that Congress must do more to protect access to care in our rural communities. Hospital profit margins fell 40 percent in 2016, the first year of the expansion, despite anticipated reductions in uncompensated care. Key factors include stagnant reimbursement rates coupled with increased costs for drugs and medical supplies, regulatory compliance and retaining the staff needed to serve the health needs of our communities.

Congress will not tackle health care costs unless they start addressing these issues. Cutting essential services and denying people access to health care and health care coverage will only make things worse.

The long-term solution for health care costs is to continue to move the delivery of care to a system that rewards value and quality – not the number of services provided. These reforms are in motion, but will be undercut if the Senate bill’s drastic coverage measures are adopted.

Montana Sens. Steve Daines and Jon Tester have a monumental decision to make before they head home for the July 4 recess. They need to know that while the Senate closed the door on its health care debate, it cannot be allowed to close the door on Montana.

Dick Brown is president and CEO of the Montana Hospital Association.