The health care bill unveiled Thursday by Senate Republicans has been out in the open for less than a week, and there are many obstacles to clear before it can become law: an uncertain Senate vote, a return to the House for final approval, a presidential signature.
But in newspapers and on radios and TV stations from Anchorage to Miami, the effects of the bill are already being contemplated. These could vary considerably from region to region, state to state, even family to family. Thirty-one states expanded Medicaid under the Affordable Care Act, though the design of these programs are not the same, and the states that did not choose to expand would still be significantly affected. Clinics in Pennsylvania desperately need funding to battle the opioid epidemic; rural hospitals in Maine rely on Medicaid for survival; Nebraskans struggle to cover rising premiums; and Floridians fear the loss of money to fight the Zika virus.
Yet while context varies, the reception to the bill described in these local news reports is almost uniformly unhappy, a sentiment reflected in the polling numbers for the health care bill approved by House Republicans and in many of the interviews.
“All of them are supposed to be there for us,” said JoAnn Johnson, 80, in an article on the front page of Sunday’s Argus Leader in Sioux Falls, S.D., “and we are lost in this.”
Alabama: Longer Waits
The loss of federal money would require the Alabama Legislature to raise taxes to replace the lost funds, or reduce services. The Republican-controlled bodies have never shown any willingness to increase taxes. That would likely mean cuts to the program, which could extend waiting times for patients, even those with private insurance, and lead to closures of hospitals and primary care practices, particularly in rural areas that count on Medicaid. — Montgomery Advertiser
California: Undoing Medi-Cal Expansion
Now anyone in California can sign up for Medi-Cal if their annual income is low enough: $16,395 or less for a single person or $22,108 or less for a couple. Medi-Cal is free for participants.
The Senate bill recommends slowly undoing the Medi-Cal expansion starting in three years, which could ultimately leave 3.9 million Californians without insurance. — The Los Angeles Times
Pennsylvania: Cuts to Drug Programs
Eliminating the Medicaid expansion would impact drug and alcohol treatment. About 124,000 people covered by the expansion have accessed such treatment. The cut would be especially damaging given the opioid addiction crisis, which is presently killing 13 Pennsylvania residents per day, according to Jennifer Smith, the acting secretary of drug and programs. — Penn Live
South Dakota: ‘You Never Know What’s Going to Happen’
“You work so hard for years, taking care of yourself and whatever, but you never know what’s going to happen,” said [Sharon] Rueschhoff, who voted for President Donald Trump. “What happens when it comes to the worst and you’ve burned through it all? What are they going to do? Throw us in the gutter somewhere?” — Argus Leader
Nebraska: ‘It Was a Big Rip-Off’
One family said this will impact their household.
“My younger brother has autism and before Obamacare we’d tried to keep that a secret, that way it could not prevent us from health care.”
But others saying they just want a replacement for our current healthcare plan.
“We should really repeal Obamacare, it was a big rip off from the get-go,” James Leibhart said. — Nebraska.TV
Delaware: ‘People Will Die’
The effects of the Affordable Care Act rollback will be deadly, especially for those struggling with addiction, according to Delaware law enforcement and elected officials.
Treatment is already hard to come by in Delaware, even for those with insurance, but new health care proposals discussed earlier this week in the United States Senate indicate an even harder hit to those with chronic illness, addiction and mental health diagnoses.
“The bills under consideration by Congress are simply inhumane,” said Dr. Karyl Rattay, director of the state Division of Public Health. “People will die.” — Delawareonline.com
Alaska: Effects on the Poor
The Better Care Reconciliation Act would start cutting Medicaid by the year 2021 if passed. For Alaska, the effects could be enormous as 10.3% of the population is in poverty and 26.4% have no health insurance, according to “Talk poverty”. The Medicaid cut also includes disability services.
Paid Medicare coverage would be cut to 100 days of skilled nursing care. The population of Alaskans 65+ is expected to reach 110,000 people by 2021. — YourAlaskaLink.com
Montana: A Medicaid Gap
More than 79,000 Montanans are covered under expansion, which was previously estimated to largely vanish by 2024 under the House version of the bill. Health care analysts say the Senate version of the bill just pushes back this date and could result in even greater cuts to Medicaid over time, compared to the House version, by resetting the inflationary adjustment in 2026.
Medicaid represents 38 percent of federal funds coming into Montana. The state’s share of Medicaid cost makes up 10 percent of state spending. Previous estimates from the state Department of Health and Human Services show Montana would need an extra $251 million a year to maintain present coverage under reduced federal funding. — Missoulian
New Hampshire: Rising Costs
For families like hers with severely ill members, the Senate proposal has many things not to like - yet last week’s announcement of another health insurer exiting the Obamacare exchange market points to the rising costs many middle class families face getting coverage under that Affordable Care Act. — Union Leader
Michigan: Care for Women
Planned Parenthood has 19 health centers in Michigan. In fiscal 2015, the centers served 63,805 patients for services that includes breast exams, pap tests, prenatal visits, testing for pregnancy and sexually transmitted disease and providing birth control and abortion. — mLive.com
Maine: Cuts in Rural Areas
Rural Maine would be hit especially hard, as the outlying areas of the state are more reliant on Medicaid funding for health services. Rural hospitals would be under more financial stress if the Senate bill were to be approved. — PressHerald.com
Ohio: ‘What Are We Saying?’
She says if this bill passes, it will bring a tremendous burden on her family, not to mention other families supporting elderly loved ones and those who depend on government assistance.
“What are we saying to these people in this country? ‘You don’t matter.’ And I’m sorry, I think it’s sinful, I really do,” [Jeanetta] Russell said. — Cleveland19.com
Virginia: Calls to Slow Down
Virginia legislative budget leaders had a quick response to a new health care plan proposed by Republicans in the U.S. Senate — please don’t do what you just did.
The Republican co-chairmen of the Joint Subcommittee for Health and Human Resources Oversight said Thursday that the Senate’s current proposal “fails to address the inequities in the federal funding allocation between states” for the Medicaid program that Virginia has operated in partnership with the federal government for a half-century. — Richmond News
Ohio: Hidden Extra Costs
Senate Republicans say through their healthcare bill that they want states to take more responsibility for Medicaid, and their bill says it will give them that flexibility.
Yet the bill to dramatically alter Obamacare may actually tie the hands of Ohio in a little-noticed way, costing the state hundreds of millions a year.
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