Thanks for the post, Bonnie.
I forwarded it to our JCCB list.
Carl Jarvis
On 6/8/17, Bonnie L. Sherrell <blslarner@xxxxxxxxxx> wrote:
I received this from Derek Kilmer, the U.S. Congressman from my district.
Bonnie Sherrell
----
Dear Mrs. Sherrell,
Thank you for contacting me about the American Health Care Act. I appreciate
you
taking the time to write and share your thoughts with me.
Too often, the discussions regarding the healthcare are portrayed as
distant
policy conversations in Washington, D.C. The reality, however, is that
these
issues have real consequences for folks in our neck of the woods.  This
is
about people.
This is about the mom I met in Tacoma whose 24-year-old daughter has
bipolar
disorder. Her daughter is now able to have insurance because the Affordable
Care
Act (ACA) enables her to stay on her parents insurance until her
26th birthday. And that insurance policy now treats mental illnesses
the
same as physical ailments because the law now establishes mental health
parity.
This is about the cancer survivor I met who said she never thought she would
be
able to have health insurance because of her pre-existing conditions. She
told
me that she now has insurance as part of the Medicaid expansion and is
getting
the treatments that she needs. She said, This is about life or death for
me.
This is about every woman I represent who no longer has to pay more for
insurance simply because she is a woman. And it s about every person whose
life
may be saved because they now have access to free preventive services like
annual check-ups, mammograms, and cancer screenings.
This is about every staff member at Franciscan, Multicare, Olympic Medical
Center, Mason General, Summit Pacific, Grays Harbor Hospital, Harrison
Hospital,
Jefferson Healthcare, and every other health provider in our region. These
health care providers have saved millions of dollars – and are able
to
continue to be significant employers in our region – because they are
now
more financially viable because they have seen a dramatic reduction in the
number of uninsured patients walking through their doors.
And it s about the more than 20 million people who now have insurance
coverage
– including roughly half a million Washingtonians who did not before
– because of this law.
I wasn t in Congress when the Affordable Care Act was passed. There are
parts of
the law that undeniably represent real progress for the folks I represent.
That
said, there are also improvements that I believe ought to be made. In fact,
I ve
sponsored several bills to try to reduce health care costs for small
businesses,
improve access to primary care, and strengthen care in rural areas. I ve
said
that if there are reasonable proposals to improve the law, I d be open to
supporting such improvements.
Unfortunately, what we ve seen proposed in Congress would send American
healthcare in the wrong direction. The bill passed by Republicans in
Congress on May 4th will effectively dismantle some of the progress made
under
the Affordable Care Act. Their plan, known as the American Health Care Act
(or
the AHCA for short) doesn t pass the test of improving the system. As it
was
written, it will cover fewer people and cost those purchasing insurance
–
particularly seniors – substantially more. 
First, the Republican plan would leave millions of Americans without
healthcare
coverage. The non-partisan Congressional Budget Office estimates that 14
million
fewer people would be covered under the AHCA during the first year alone.
This
number jumps to 24 million in ten years. This would not only hurt the folks
who
lose coverage. It would hurt local healthcare providers who will see a spike
in
uncompensated care. That s why the American Hospital Association and the
American Medical Association have come out in opposition to this bill.
Second, the Republican plan would do real damage to the Medicaid system.
Medicaid provides healthcare to lower-income Americans and their families,
people with disabilities, nursing home residents, children, and others. In
our
state, two-thirds of Medicaid recipients are seniors and people with
disabilities. It s a difference-maker. In Washington state alone 20,000
people
got cancer treatment because of the healthcare they received through the
Medicaid expansion. Unfortunately, the AHCA proposal would cut off funds
for
states to add new enrollees, reduce the amount of Medicaid dollars states
receive for current enrollees, and would lock out those who have a gap in
coverage.
Third, the AHCA would negatively impact women s health services. Millions
of
women rely on Planned Parenthood for primary care visits, cancer screenings
and
other health services. Despite the fact that federal law currently prohibits
tax
dollars being used to fund abortions, the Republican proposal included a
provision prohibiting Planned Parenthood from receiving Medicaid
reimbursements
for any of the care it provides – including mammograms, cervical
cancer
screenings, family planning assistance, and other care. This would impact a
lot
of people, especially lower-income women. One in five women in our country
have
visited Planned Parenthood, with over three-fourths having incomes of 150
percent or less of the federal poverty level.
Fourth, this bill would eliminate the Affordable Care Act s Prevention and
Public Health Fund. This important fund supports approximately 12 percent of
the
CDC s entire budget and helps ensure that Americans are protected from
communicable diseases such as Ebola, Zika, measles, and mumps. We all know
the
CDC is at the frontlines of stopping epidemics before they spread. What s
more,
our state gets $14 million from this fund, with those dollars covering
roughly
50 percent of our state s immunization program. The Republican plan would
zero
this prevention fund out entirely.
Fifth, this bill would allow states to waive the requirements that
insurance
companies cover preexisting conditions. Further, it would allow states to
remove
requirements that insurance companies provide coverage for essential health
benefits, such as mental health and substance abuse treatment,
hospitalization,
prescription drugs, maternity and newborn care. This is a bad policy that
will
likely leave millions of people uninsured or under-insured. That s why
organizations like the American Cancer Society oppose this bill.
Sixth, this bill would impede the progress we ve been making in the fight
against the opioid epidemic and mental health challenges. Currently, as a
result
of the Medicaid expansion, nearly 1.3 million people receive treatment for
mental-health and substance abuse disorders, including 30,000 people in
Washington state who got treatment for substance abuse disorders through
the
Medicaid expansion. Unfortunately, as mentioned, the bill pulls the plug on
the
Medicaid expansion. Beyond that, though, the bill proposes eliminating the
requirement that Medicaid cover basic mental health and addiction services.
That s why the American Psychiatric Association and mental health advocates
have
raised concerns about the bill.
Seventh, the bill would cut health care for working people and those living
paycheck to paycheck in order to give nearly $600 billion in tax breaks to
special interests and the super-wealthy. The AHCA proposes two tax cuts
specifically for the wealthiest Americans. These proposed changes would not
save
$1 – not $1 – for folks earning less than $200,000 per year. In
contrast, if you re a millionaire, you ll get – on average – a
$50,000 tax cut. In fact, according to the Center for Budget and Policy
Priorities, our nation s 400 highest income taxpayers (who earn, on
average,
over $300 million/year) would see an annual tax cut of roughly $7 million.
If
that wasn t enough, the Republican plan would allow insurance companies to
get a
tax deduction for pay and bonuses they provide to their executives over
$500,000. For the life of me, I can t figure out the problem that provision
is
trying to solve.
And finally, this bill would hurt seniors. Changes in the bill would shorten
the
solvency of the Medicare program, hastening the exhaustion of the Medicare
trust
fund by four years. In addition, the Republican proposal changes the law to
allow insurance companies to charge seniors five times more than young
people for healthcare coverage. That s why groups like the AARP have come
out
against it.
I ve heard from literally thousands of constituents who have opposed this
proposal. Thank you for adding your voice.
While the bill has been passed by the House, I am hopeful that it will not
move
forward in the Senate. In the meantime, I believe Democrats and Republicans
should be working together to promote accessible and affordable health
insurance
that works for every family and employer. What s more, the effort to
strengthen our health care system goes beyond the Affordable Care Act. Our
nation still spends too much money paying for unnecessary procedures. We
need to
focus on rewarding value and wellness over volume – not just paying
providers for how much care they provide, but for actually helping to
improve
the patients health.
Congress has real work to do to improve our health care system for doctors,
hospitals, rural providers, and patients. Rather than playing politics,
that
should be the focus. Please know that, as your representative, I ll keep at
it!
I will be sure to keep your thoughts in mind as Congress debates this issue
in
the future. I encourage you to continue to share your views with me on this
topic or any other issue. Thank you for reaching out. It is an honor to
serve as
your representative.
Sincerely,
Derek Kilmer
Member of Congress
