Fear and defiance greet House Republicans’ American Health Care Act

Kathy Paul of the Massachusetts Senior Action Council, spoke on the bill’s damaging effect on seniors during a Monday health care panel. To her right: Dennis Heaphy, of the Disability Policy Consortium, and Brian Rosman, policy director of Health Care For All.

Sen. Edward Markey and other speakers at a Health Care For All panel on Monday morning spelled out the human pain that would be dealt should the Donald Trump and House Republican’s health care bill pass. At the end of last week, the House rushed to pass a bill that would repeal the Affordable Care Act and replace it with a health care policy that is expected to roll back protections on people with preexisting conditions, threaten those dependent on Medicaid and raise prices on seniors and many who are not already healthy and affluent. The Congressional Budget Office estimates the bill, the American Health Care Act, will result in loss of coverage for 24 million Americans by 2026, but has yet to finish its analysis. The House voted 217-213 in the favor of the AHCA.

Many speakers said legislation could bring drastic consequences to them or members of their families. Sen. Markey offered a spot of hope, predicting the bill would collapse in the Senate. Republicans, he said, will have a tough fight to balance more moderate Senate Republicans with demands of the radical Freedom Caucus.

“The bill that passed House representatives is dead on arrival in the Senate of the United States,” Markey said.

The bill will move more slowly in the Senate, where legislators are required to wait for completion of the Congressional Budget Office analysis before voting. Some Senate Republicans said they would write a new bill from scratch. In such a case, Markey said Massachusetts delegation would be sure to oppose any new bill that turns out to be only a watered down version of the American Health Care Act.

“We will not pass ‘Freedom Caucus lite,’” Markey said.

Many also are starting to wage political war against the representatives who passed the bill — each of whose vote was critical to the passage.

The House bill allows states to alter some current protections such as required minimum benefits. Repeal of the ACA could also mean that insurers once again are able to set a lifetime cap on expenses for what are deemed essential health services. Under the bill, states could seek a waiver to permit insurance companies to charge people differently based on their current health — meaning people with pre-existing conditions potentially could be charged more. The federal government would set aside $8 billion to help subsidize people facing large premium increases and established other programs states can opt into to help cover high-risk pools. Health economists have said these policies have a poor track record. Planned Parenthood, which provides a variety of women’s health services including cancer screenings in addition to abortions, would lose significant funding.

Brian Rosman, policy director of Health Care For All, said the repeal and replace is a double blow. He warned attendees at the panel that Massachusetts’s history of so-called Romneycare does not spare it, given that the previous program relied on federal partnering.

A life-or-death question

With the Senate’s actions uncertain, the possibility of any policy that includes a lifetime coverage cap and higher rates for people with pre-existing conditions sparked fears.

Diane Pickles, a volunteer with the American Heart Association, said her son Jake was born with a serious heart condition. It took three open-heart surgeries during the days after his birth to keep him alive. With chronic illness and frequent hospitalizations following, “at age four, Jake was halfway to the million dollar lifetime cap we had on our plan,” Pickles said.

The family since switched health plans and Jake is now 22. Pickles said she fears that when he ages out of eligibility for coverage under his parents’ plan, he may not be able to get coverage for the frequent treatments he needs and the heart transplant doctors have long said will one day be necessary. No parent should have to worry that an insurance company will deem their child to be an unacceptable or unworthy risk, she said.

“Reject any law that allows penalties for pre-existing conditions or [the imposition of] a lifetime cap,” Pickels asked legislators. “His life, like that of so many others, literally depends on it.”

Another speaker said she was diagnosed with cancer at age 10 and requires annual screenings to monitor effects. She currently is a Tufts University student and fears that if she has to change plans due to moving to another state, she would lose her protection based on her childhood diagnosis.

The bill would cap Medicaid funding and likely halt its expansion.

“This bill that just passed is a giveaway of the $860 billion that will be cut from Medicaid and packaged as a tax break for the wealthiest in our society,” Markey said. “The cuts hit the disabled, the poor, the young, and seniors disproportionately. The beneficiaries are the wealthy in our society, disproportionately.”

Among those expected to see higher costs are seniors. Kathy Paul of Massachusetts Senior Action Council said MassHealth meant that when her husband was battling kidney failure and diabetes, she could focus on caring for him, not worrying how to meet hospital costs on a fixed income.

“We [seniors] are not going to just sit back and die so Congress can make their billionaire donors happy,” Paul said.

Dennis Heaphy of the Disability Policy Consortium said that threats to Medicaid have people with disabilities concerned that they will lose access to the care that makes it possible for them to live outside of nursing homes and engage in their communities.

“People with disabilities are scared our rights are being denied,” Heaphy said. “We’re scared they’ll take away everything that enables us to exist in society. … We’re afraid of going back to a pre-Medicaid time when people with disabilities were kept in institutions or locked in their homes or dying.”

Political pain

Save My Care, a health care advocacy group opposed to the Trumpcare bill, this week fueled more than $500,000 into launching a TV and digital ad campaign to lambaste the 24 House Republicans who voted to pass the bill. The ads will run in the representatives’ districts and include statements such as, “[Arizona Congresswoman Martha] McSally voted to raise your costs and cut coverage for millions, to let insurance companies deny affordable coverage for cancer treatment and maternity care, and charge up to five times more for people over 50.”

In response to the House vote, the Democratic online fundraising platform ActBlue established a fund to receive donations that will go to support yet-to-emerge 2018 Democratic challengers in districts represented by congress members who voted for the bill. ActBlue will hold the funds in escrow and then release them to the candidates who emerge from the Democratic primaries for use in their campaigns.

Many politicians have spoken out, including Gov. Charlie Baker, who said the House Republican plan would produce “a massive loss of critical funds for the commonwealth.”

While Massachusetts’ senators oppose ACA repeal, Health Care for All’s Rosman and Robert Restuccia of Community Catalyst called upon residents to call friends and family in other states and urge them to turn out for town halls and contact their senators.