- Associated Press - Wednesday, July 5, 2017

HARRISBURG, Pa. (AP) - Questions about the U.S. Senate’s health care legislation dominated an appearance by Pennsylvania’s Republican Sen. Pat Toomey in front of a live audience Wednesday night, as he defended the bill as guaranteeing the survival of Medicaid against accusations that it would deliver devastating cuts.

Toomey cautioned that multiple bills will be required to get it right. He repeatedly insisted that it was unlikely that Congress would simply repeal former President Barack Obama’s health care law without passing a replacement. And he touted a forthcoming addition to the bill that would commit $45 billion over the next 10 years to fight addiction treatment.

Toomey’s appearance in the Harrisburg studios of WHTM-TV came as the legislation awaits a Senate vote. He also took questions on medical marijuana and Republican President Donald Trump, among other topics, but most questions focused on the health care bill he’s defending.

The hour-long question-and-answer session was Toomey’s first this year in public in front of an audience. Dozens of demonstrators crowded outside WHTM’s studio blocked entrances, protesting what they call the bill’s devastating cuts to Medicaid, including attendant care for the disabled, and mocking Toomey’s lack of courage to hold a full town hall-style event.

In Pennsylvania, taking on Medicaid is politically perilous.

The program covers nearly 2.9 million Pennsylvanians, or almost one in four residents. Pennsylvania also is a Medicaid expansion state, and the bills’ contemplation of paring back the 2010 law’s commitments is anticipated to shift billions of dollars in health care costs to the state.

Toomey insisted that the Republican health care bill, which he helped write, is misunderstood. The bill’s cap on Medicaid costs would allow that expense to rise with inflation, although more slowly than the program’s historical growth rate.

“I don’t think it’s very constructive to suggest that an apocalypse will occur from spending more money on Medicaid every year and keeping everybody who is eligible enrolling, no limits to enrollees whatsoever, putting the program on a sustainable path so that it’ll be there for the indefinite future,” Toomey said during the event, broadcast live by WHTM and sister stations in Erie, Altoona and Wilkes-Barre. “I think we’re doing the responsible thing.”

Opposing the bill after it emerged were Democratic Gov. Tom Wolf, the Hospital and Healthsystem Association of Pennsylvania, the Arc of Pennsylvania, the AARP of Pennsylvania, labor unions and groups that advocate for children and the disabled.

Groups advocating for the disabled contend that dollars that help keep the disabled in their homes, cared for by family members, would be newly limited. Children’s groups say the caps would force more than 1 million children on Medicaid in Pennsylvania to compete with the needs of the disabled and elderly.

One question submitted online accused the bill of posing a threat to Medicaid’s promise of helping working adults take care of an elderly parent.

“There’s been a lot of misinformation and inaccurate stories about Medicaid,” Toomey responded. “The category for the elderly, for instance, that’s not changed. We’re going to continue to provide those resources. Medicaid spending is going to grow every year. I am an advocate for giving states more flexibility to find better ways to deliver health care services to low-income people.”

In Pennsylvania, the federal government pays slightly more than half the bill for most people on Medicaid. It pays nearly the whole bill for the more than 700,000 primarily childless low-income working adults who joined Medicaid after Jan. 1, 2015, when Pennsylvania expanded income eligibility guidelines to take advantage of the more generous federal contribution rate under Obama’s law.

Under the Senate bill, the federal government would still commit to funding the Medicaid expansion, albeit at a roughly 52 percent rate in Pennsylvania, compared to the 90 percent long-term rate under Obama’s law.

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