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Senate sets sights on revamping healthcare


As a coalition of senators prepare once again to roll up their sleeves to begin to wrestle with crafting a health care bill that meets the needs of most Americans, Sen. Kamala Harris has laid out a substantial laundry list of items she said concerns her about the recently passed House version of the American Health Care Act (AHCA).

“The Republican health care bill is a statement that they believe health care is a privilege for the few, not a right for all,” Harris said. “This bill raises costs and threatens access to care for millions of Americans. This bill jeopardizes protections for those with health insurance through their job, putting nearly half of the country back at risk of going bankrupt, if they get a serious illness or injury. It guts Medicaid, and threatens services for children with disabilities. It allows seniors to be charged more, making it harder to retire with dignity. It discriminates against survivors of domestic violence and sexual assault. It limits access to tax credits for Californians to make health care more affordable. And Republicans passed this bill even while admitting they do not know how much it will cost, or how many tens of millions of Americans will lose coverage.”

The organization that represents African American doctors and patients is also on record opposing the newly passed American Health Care Act.

Harris said the AHCA will make detrimental changes to our current health care system. The AHCA is a bad bill. It will hurt the poor, vulnerable, elderly, and indigent. It will do things such as decrease the life of Medicare (Medicaid), increase the costs of medical care for those who can least afford increased insurance payments, and give tax breaks to the richest 1 percent of our nation and insurance companies. Health experts say that if this provision is enacted, costs for people in need of specific essential health benefits will likely face higher premiums.

President Trump campaigned on developing a health care plan that would provide insurance to all. However, the irony of the AHCA is that the bill that was passed last week is projected to cause millions to lose coverage and those with pre-existing conditions face going back in time to when insurance companies are allowed to price them out of being able to secure coverage.

According to AARP, “Medicaid cuts [as a result of AHCA] could impact people of all ages and put at risk the health and safety of 17.4 million children and adults with disabilities and seniors by eliminating much-needed services that allow individuals to live independently in their homes and communities. Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable.”

The National Medical Association (NMA) echoes those sentiments. “We denounce this bill and believe that it is a dire step in the wrong direction,” said a statement released by the association. The NMA President Richard Allen Williams who has been a cardiologist at UCLA for 40 years.

“Medicaid will be wiped out, exposing even more poor Americans, most of whom are Black and Hispanic, to inordinate risk; essential health benefits will be tossed out; and 130 million people, or more than one-third of the American public, have pre-existing medical conditions and would be adversely affected by the new bill. The damage that the new bill will do is even worse than the previous one; we don’t know yet how bad the damage will be until the bill’s provisions are scored by the nonpartisan Congressional Budget Office in about a week.”

The NMA urges Congress to work collaboratively to make appropriate changes to Obamacare; not enact harm on the most vulnerable and poor in our society.

For African Americans, there is a substantial amount at stake said Williams. According to American Progress, the Affordable Care Act (Obamacare) led to a significant drop in the number of African Americans who are uninsured. Williams said Health care reforms associated with the ACA reduced the percentage of uninsured African Americans from 24.1 percent to 16.1 percent between 2013 and 2014.

Nearly 6.8 million African Americans have become eligible for health coverage since the implementation of the ACA due to Medicaid expansion and the financial assistance available to qualified individuals.

Increased funding for community health centers through the ACA will have a substantial impact on the African American community. The ACA has allocated approximately $11 billion to fund community health centers, enabling them to increase the number of patients they serve. Nearly 25 percent of these patients are African American.

ACA provisions provide access to preventive care at no additional cost; this may help curtail African American health disparities. African Americans currently suffer from a litany of health disparities. For example, their infant mortality rate is 2.3 times higher than that of non-Hispanic whites. African American women are more likely to die from breast cancer than the larger U.S. population, even though they are less likely to develop the disease. Access to preventive care can help reduce this disparity, as earlier detection decreases the likelihood of death.

African American women are eligible for additional insurance benefits, which can lead to better health outcomes. The ACA requires that close to 5 million African American women enrolled in private health insurance have access to HPV testing, mammograms, and prenatal care, among many other preventive services, at no additional out-of-pocket cost.

Although African Americans are signing up for the ACA at impressive rates, a large percentage of them remain uninsured.

According to the NMA, a nation-wide organization that addresses the needs of African American doctors and patients, since Obamacare was created more than 25 million who pervious had no health insurance gained coverage. That immediately improved the situation for these residents said Dr. Williams, which represents more than 50,000 doctors. But future improvements are necessary, he added.

“That’s because Obamacare was the legislation that wasn’t used equally across all areas. Some states refused to expand Medicaid. As a result 19 states with some of the poorest and most downtrodden people did not get full advantage of Obamacare,” said Williams acknowledge that while Obamacare was not perfect it was a vast improvement over what existed before.

Williams estimates that under Obamacare 84,000 lives were saved.

“I expect the Senate to show common sense. Because the Senate consist of people who are more inclusive and more judicious and who think before they act,” adding that the House of Representatives were just trying establish a political victory without regard for human lives.”

Explaining that previously the heath care system had flown under the radar for many, Williams says the Senate’s look at the healthcare system gives legislators a chance to redo healthcare and to repair a program that is not perfect but could be improved.

Among the considerations Williams said should be weighed are lowering premiums and getting more younger people involved.

A new system also needs to cover more people than Obamacare did.

One final thought said Williams is the need to take a look at a single payer system, where the federal government pays for health insurance.

Canada and Massachusetts have successfully master such a system.

Highlights of the ‘American Healthcare ACT of 2017:

The AHCA will include age-based tax credits for those who earn less than $75,000, or $150,000 for joint filers.

Modify ACA premium tax credits for 2018-2019 to increase amount for younger adults and reduce for older adults, also to apply to coverage sold outside of exchanges and to catastrophic policies. In 2020, replace ACA income-based tax credits with flat tax credits adjusted for age. Eligibility for new tax credits phases out at income levels between $75,000 and $115,000.

Retain private market rules, including requirement to guarantee issue coverage, prohibition on pre-existing condition exclusions, requirement to extend dependent coverage to age 26. Modify age rating limit to permit variation of 5:1, unless states adopt different ratios, effective 2018. Retain prohibition on health status rating with state option to waive for individual market applicants who have not maintained continuous coverage.

Retain health insurance marketplaces, annual open enrollment periods (OE), and special enrollment periods (SEPs).

Impose late enrollment penalty for people who don’t stay continuously covered. Establish State Patient and State Stability Fund with federal funding of $130 billion over 9 years, and additional funding of $8 billion over five years for states that elect community rating waivers. States may use funds to provide financial help to high-risk individuals, promote access to preventive services, provide cost sharing subsidies, and for other purposes.

In 2020, $15 billion of funds shall be used only for services related to maternity coverage and newborn care, and mental health and substance use disorders.

For 2018-2026, $15 billion is allocated for Federal Invisible Risk Sharing Program (reinsurance) grants to states. In states that don’t successfully apply for grants, funds will be used for reinsurance program.

For 2018-2023, $8 billion shall only be used by states electing community rating waivers to provide assistance to reduce premiums or other out of pocket costs for individuals who are subject to higher premiums as a result of the community rating waiver.

Repeal funding for Prevention and Public Health Fund at the end of Fiscal Year 2018 and rescind any unobligated funds remaining at the end of FY2018. Provide supplemental funding for community health centers.