Hayley Tintle, Scholars Strategy Network. Originally published in Bangor Daily News September 27, 2017.
Our families and communities suffer when people get sick and die younger than they should. Getting health care makes a difference. But good health policies that help people don’t emerge from a rushed process with virtually no expert input, as has happened with the latest effort to repeal and replace the Affordable Care Act.
Sen. Susan Collins is once again a critical vote for GOP repeal efforts. She released a statement Monday evening stating that she opposes “both versions” of the Graham-Cassidy bill. In an attempt to clinch her vote, Sens. Bill Cassidy and Lindsey Graham amended their bill to direct additional federal health care funds to Maine. But those funds aren’t enough to offset the extreme cuts to Medicaid built into the plan, which would be devastating for Mainers’ health and Maine’s economy. Collins is right to join Sen. Angus King in rejecting this bill.
Nearly 80,000 people in Maine have insurance under the Affordable Care Act, including approximately 19,000 who rely on it for treatment of an opioid addiction. According to the Center for Budget and Policy Priorities, Graham-Cassidy could leave nearly 229,000 Mainers with pre-existing conditions out in the cold. In addition to blows to health coverage, Maine stands to lose an estimated $115 million in federal funding by 2026 and $1 billion in the following decade.
Some of the concerns Collins voiced about Graham-Cassidy involved Medicaid.
On “This Week” on ABC News Sunday, Collins discussed Graham-Cassidy’s “impact on the Medicaid program, which has been on the books for more than 50 years and provides health care to our most vulnerable citizens, including disabled children and low-income seniors.” Collins also raised issues about “costs and coverage” and “the erosion of protections for people with pre-existing conditions like asthma, arthritis, cancer, diabetes, and what it would meant to them.” Regarding reproductive rights, Collins asserted that “ it is a mistake to defund Planned Parenthood,” as this bill does, and she surely bristles at a plan that makes no guarantees for maternity coverage or access to affordable contraception.
Noting the peril rural hospitals in Maine would face if Graham-Cassidy were approved, Collins said, “If Medicaid is cut that hospital [Charles A. Dean Hospital in Greenville] will not survive. It’s the biggest employer in town. It has 180 good-paying jobs. So not only would people lose access to health care that they need, it would a devastating blow to the community. You could go all over the state and find that would be true.”
Not expanding Medicaid, a decision which Mainers could rectify in November, has already caused hospitals harm. As the Maine Center for Economic Policy notes, in most Maine counties, hospitals are the biggest employers. Half of Maine’s hospitals operate in deficit, and only one-third have more than one month’s cash in hand. Hospitals employ a large number of Mainers, and these deficits have a huge effect on local economies, especially in rural areas lacking good jobs. States that expanded Medicaid have fiscally stronger rural hospitals.
As Amy Fried of the University of Maine in Orono recently noted, compared to states like Maine that didn’t expand Medicaid, those that did have people with “better coverage, less financial stress, improvements in health, better prevention, and more opioid addiction treatment.”
Graham-Cassidy is not a bipartisan effort, there is no full Congressional Budget Office analysis of its long-term health care or economic implications. Graham-Cassidy decimates Medicaid, revokes coverage from more than 80,000 Mainers and removes protections from individuals with pre-existing conditions. It annihilates all the gains made for women and girls under the Affordable Care Act.
The chaotic nature of the process behind this bill should trouble all of us. Graham-Cassidy was cobbled together by some Republican senators to appease billionaire donors. There has not been enough time to analyze coverage losses or engage in bipartisan debates, and the basic facts of the bill remain hazy.
A better process would involve developing a policy in a committee focused on health care, with time for input from experts, stakeholders and citizens, and then allowing discussion and amendments from other senators. We would all be well-served by restarting the bipartisan effort led by Sens. Lamar Alexander and Patty Murray to improve the Affordable Care Act.
Given all this, a “no” vote on Graham-Cassidy is the best way forward for Maine.
Hayley Tintle is a public policy fellow at the Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.