HARRISBURG, Pa. (AP) - Democratic Gov. Tom Wolf’s administration and Pennsylvania’s hospitals slammed a Republican plan in Congress to replace former President Barack Obama’s health care law and on Tuesday described broad ripple effects that would shift health care costs to states, hospitals and the poor.
Wolf said it would leave fewer people insured and hurt coverage for the elderly, the disabled and people seeking addiction treatment in the midst of a drug epidemic. He urged Pennsylvania’s members of Congress - which includes the nation’s third-biggest delegation of Republicans - to reject the bill.
“This is a bad plan that would leave thousands of Pennsylvania seniors and families unable to afford access to basic medical care coverage,” Wolf said in a statement.
The Hospital and Healthsystem Association of Pennsylvania said the proposal would jeopardize gains in coverage and improvements to access to care made under the 2010 Affordable Care Act, or Obamacare.
Tuesday’s criticism came a day after Republicans unveiled the bill. The first House committee votes were scheduled for Wednesday.
Overall, the hospital association and governor said the Republican bill threatens coverage not only for more than 1 million Pennsylvanians who gained it under the existing law, but for another 2 million on Medicaid.
In Pennsylvania, 2.7 million of the state’s 12.8 million residents are on Medicaid, or more than one in five. That includes children, nursing home patients and the disabled. Some 700,000 are covered under the law’s expansion of income guidelines to cover low-income working adults. Meanwhile, more than 340,000 Pennsylvanians qualified for a tax subsidy to help pay for a 2017 policy through the government’s Healthcare.gov insurance marketplace.
The hospital association said the bill’s proposed tax credits do not match the support currently provided for the working poor through Healthcare.gov’s subsidies. It also said the GOP bill would renege on a deal hospitals had accepted in the 2010 law by leaving intact cuts to Medicaid reimbursements while dropping the federal government’s financial commitment to a Medicaid coverage expansion.
Wolf’s secretary for the Department of Health and Human Services, Ted Dallas, said ending the Medicaid expansion would leave Pennsylvania with a $2.1 billion budget hole, or about 7 percent of the state’s proposed $31.5 billion budget this year.
The bill would end the more generous federal Medicaid match for new expansion enrollees starting in 2020. The expansion covers working adults who earn up to 138 percent of the federal poverty level, or about $16,640 a year.
Imposing new cost-sharing provisions or limits on the program’s benefits would not make up for the loss of federal funding and, without a new source of revenue, the state would have to start cutting off people from the Medicaid expansion rolls, Dallas said.
A more fundamental change to Medicaid, said Dallas, would be the bill’s imposition of a limited, per-beneficiary amount based on enrollment and costs for all enrollees.
“It would have devastating consequences for a state like Pennsylvania, which is graying and getting older,” Dallas said.
Wolf’s insurance commissioner, Teresa Miller, said the Republican bill does nothing to stop the increasing cost of health care and could further destabilize insurance markets. Even if premiums are lower, cost-sharing provisions will be unaffordable when someone does need medical care, Miller said.
“If you’re wealthy and healthy, then you’re going to do well,” Miller said. But, she said, “when people go to get care, that’s when you’re going to get hit.”
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