Don’t Let Senate Close the Door on Montana

Montana Hospital Association data reveals that the Medicaid expansion is working

Senate Republicans have crafted a plan that will unhinge our nation’s health care system and leave Montana families and the people who care for them scrambling to pick up the pieces.

To make matters worse, they’ll likely vote on the bill without public input. This commitment to secrecy is more than concerning. It has clouded what should have been a transparent and collaborative process of strengthening America’s health. And it has set an unnerving tone for future Congressional action.

GOP leaders rejected the House plan to allow insurers to charge people with pre-existing conditions more for their health insurance – that’s good news. They also want to beef up tax credits needed to help low-income people purchase insurance – also good news. But there is a lot of devastating news as well, especially regarding the Medicaid program.

An analysis released this week by the Montana Healthcare Foundation projects that the current Senate bill would cut $5.3 billion in federal funds from Montana’s Medicaid program in the next 10 years. At the same time, Medicaid spending would be capped and allowed to grow at a rate far below the actual growth in medical costs.

These changes would leave Montana lawmakers with two grim choices: take money from elsewhere to fund the program or eliminate the life-saving services currently provided to Montana children, seniors, pregnant women, veterans and other individuals in need.

Also disturbing is that the Affordable Care Act’s taxes, which offset the cost of coverage, would be repealed or delayed. In effect, higher-income Americans will receive huge tax breaks paid for by severe cuts in Medicaid’s safety-net programs.

News that the bill would eliminate health care coverage for 22 million Americans resulted in the Senate losing the support it needed to pass the bill this week. However, a revised version is in the works which leaves Montana at risk of gaining a sicker, poorer and less productive workforce, and more costly care.

Montana Hospital Association data reveals that the Medicaid expansion is working, but that Congress must do more to protect access to care in our rural communities. Hospital profit margins fell 40 percent in 2016, the first year of the expansion, despite anticipated reductions in uncompensated care. Key factors include stagnant reimbursement rates coupled with increased costs for drugs and medical supplies, regulatory compliance and retaining the staff needed to serve the health needs of our communities.

Congress will not tackle health care costs unless they start addressing these issues. Cutting essential services and denying people access to health care and health care coverage will only make things worse.

The long-term solution for health care costs is to continue to move the delivery of care to a system that rewards value and quality – not the number of services provided. These reforms are in motion, but will be undercut if the Senate bill’s drastic coverage measures are adopted.

Montana Sens. Steve Daines and Jon Tester will be home for the July 4 recess. They need to know that while the Senate closed the door on its health care debate, it cannot be allowed to close the door on Montana.

Dick Brown, president/CEO
Montana Hospital Association