Heller Has “Concerns,” Let Him Know Ours

Nevada Senator Dean Heller has “concerns” about the TrumpDoesn’tCare bill, he’s had “concerns” before, however if the past is any indication we can expect that there will be some ‘change’ in the measure which will assuage his fretting and he will follow the directions from Senate Majority Leader McConnell and vote in favor of the GOP agenda. Thus far Heller has employed his “If it’s good for Nevada, I’ll vote for it” position — rather like the Yoga Headstand, Crow Position, Whatever — it means relatively little, indicating more often his Invertebrate Emulating A Specimen of Subphylum Vertebrata pose.

This health care bill isn’t good for Nevada.  In fact, it isn’t good for anybody.  Somehow, the dismal bit of legislation put forth after the secret sessions is suppose to address the needs of some 608,960 Nevadans who are currently enrolled in the Medicaid program.  These are people who are (1) aged (2) blind (3) low income, about $16,105 annual income for a single person, the income can be a little higher for (4) pregnant women, and (5) children from families in which the annual earnings are 200% of the poverty rate.   Even at the current level, Nevada still isn’t doing a masterful job of getting adequate health insurance coverage for children; we only have 70.6% of our eligible youngsters enrolled — among the lowest rates in the country.   The result of the GOP bill:

“Nevada’s current total Medicaid spending is about $6.4 billion, but the state only pays $1.1 billion of that; the rest is picked up by the federal government (for the population that was already eligible for Medicaid pre-ACA, the state pays a higher percentage of the cost than they do for the newly eligible population; for people who are newly eligible for Medicaid under the ACA, the federal government paid 100 percent of the cost through 2016, and is now paying 95 percent of the cost).

If Medicaid expansion is repealed and replaced with something that cuts federal funding below what the state currently receives, there are concerns that people could lose coverage or benefits could be cut. House Republicans’ proposal to transition Medicaid to block grants or per-capita allotments would almost certainly result in reduced federal funding.”

Any questions?  No matter if the expansion phase out is 3 years, 10 years, 15 years, a cut in funding is inevitably a cut in benefits (a cut in the insurance coverage) for Nevada citizens.

The analysis is terse and to the point:

“The Senate bill would also cap overall federal spending on Medicaid: States would receive a per-beneficiary allotment of money. The federal payments would grow more slowly than under the House bill starting in 2025. Alternatively, states could receive an annual lump sum of federal money for Medicaid in the form of a block grant.

State officials and health policy experts predict that many people would be dropped from Medicaid because states would not fill the fiscal hole left by the loss of federal money.

“The Senate bill creates an illusion of being less draconian than the House bill, but is arguably more so” on Medicaid, said Sara Rosenbaum, a professor of health law and policy at George Washington University.”

“Illusion” is the correct term, there’s an illusion that Medicaid would not be decimated by Republican health insurance and federal budget proposals, accepting this illusion is delusional.  The AARP succinctly summarized the issues with the Medicaid cuts:

“The proposed legislation would also make huge cuts to Medicaid by taking $880 billion out of the program by 2026. How? By, among other things, fundamentally changing the way the program is funded. Under the AHCA, Medicaid funding would move from a federal guarantee to match all legitimate state expenditures on health care and long-term services and supports (LTSS) for eligible beneficiaries, to a capped payment system that would give states a fixed dollar amount per enrolled beneficiary.[i]  Although per-enrollee caps respond to changes in enrollment, they do not respond to increases in health care costs attributable to medical or pharmaceutical innovation, nor do they respond to other changes in the health care environment that could affect per-enrollee spending. Health care costs, we all know, are notorious for their rapid rise. The result: an ever-widening gap between cost and funding.”

Merely, delaying the onset of this “ever widening gap” is a callous statement that tax cuts for the wealthy are of greater importance to Republicans than extending health insurance coverage for Nevada citizens.

Contact Senator Heller at 202-224-6244, or 702-388-6605, or 775-686-5729

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