Medicaid cuts...people will die

Eight years ago, when the Affordable Care Act (ACA) was up for repeal, then-Governor Jim Justice and Senator Capito helped walk the nation back from the brink.

 Justice described the consequences of undoing Medicaid expansion, which covered around 175,000 West Virginians at the time, as “beyond catastrophic.” Capito said that “I have serious concerns about how we continue to provide affordable care to those who have benefitted from West Virginia’s decision to expand Medicaid, especially in light of the growing opioid crisis.”

They were right then and still are today.

Recently, public health experts from Yale University and the University of Pennsylvania calculated the butcher’s bill that would happen if the House version of the budget bill passes as is and it’s pretty awful. They estimate that proposed Medicaid cuts could cause 51,000 premature deaths per year, just to pay for tax cuts for the rich.

That’s more than the combined populations of Calhoun, Tucker, Gilmer, Pleasants, Doddridge, Pocahontas, and Clay counties. Or several thousand more than the populations of either Charleston or Huntington. 

According to the Yale School of Public Health, “The researchers estimate that 42,500 lives could be lost each year from disenrollments in Medicaid and Marketplace coverage and the rollback of nursing home staffing rules. An additional 8,811 deaths are projected from the expiration of the enhanced Affordable Care Act (ACA) Premium Tax Credits, bringing the total to more than 51,000.

To be specific, 7.7 million people would lose Medicaid or ACA marketplace coverage, with a loss of an estimated 11,300 deaths per year. 

Eliminating the Medicare Savings Program would disenroll 1.38 million seniors, at a cost of 18,200 deaths per year. 

Ending nursing home staffing rules could cost 13,000 lives. 

Ending ACA premium tax credits is likely to push another 5 million off, at a cost of over 8,800 preventable deaths a year. 

In addition, the bill’s failure to extend the ACA’s enhanced premium tax credits is expected to push another 5 million Americans into uninsurance, resulting in 8,811 more deaths each year.

This isn’t a matter of random number generation. According to Yale, researchers relied on peer-reviewed studies that “quantifying the relationship between insurance coverage, access to prescription drug subsidies, and nursing home staffing levels with all-cause mortality.” This data was then applied to projections released in May by the nonpartisan Congressional Budget Office.

Recently, Iowa Representative Joni Ernst stirred up controversy by dismissing concerns like these, saying “we are all going to die.”

Maybe so. But working class people don’t have to die prematurely in the tens of thousands every year just to enrich the wealthiest. 

This is totally preventable.

(This appeared as an op-ed in the Charleston Gazette-Mail.)

Good news for and from WV

As Joe Biden might say, "Golly, this could be a significant development" in the ongoing fight over the fate of the Affordable Care Act and the millions who gained coverage through it.

Let's review the last week or so. First, Senate Majority Leader Mitch McConnell was hell bent on pushing through another bad version of ACA repeal and replacement. See my latest rant about that here. Then, Republican defections effectively took that off the agenda. Then McConnell, along with Prince Joffrey President Trump, called for repeal without replacement, another really bad idea. Now, that possibility just got a good bit more remote after WV Senator Shelley Moore Capito issued a strong statement opposing repeal without replacement.

She's not the only one but her decision is crucial. Here's her statement:

“As I have said before, I did not come to Washington to hurt people. For months, I have expressed reservations about the direction of the bill to repeal and replace Obamacare. I have serious concerns about how we continue to provide affordable care to those who have benefited from West Virginia’s decision to expand Medicaid, especially in light of the growing opioid crisis. All of the Senate health care discussion drafts have failed to address these concerns adequately. 

“My position on this issue is driven by its impact on West Virginians. With that in mind, I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.” 

The fight isn't over...but this latest round might be. Congratulations to everyone in WV who worked so hard to make this happen.

I strongly encourage any and all from WV to pick up the phone and call both her local and DC offices and say a big "Thank you!" Here's the link. I'm about to pick up the phone myself.

A major catch

I could be wrong, but The Front Porch program/podcast on WV Public Broadcasting, may actually be getting respectable. This week, we had an actual US senator, WV's Shelley Moore Capito. We talked about black lung, health care, broadband and the new political era here.

Say what?

I guess there will be weeping and gnashing of teeth in some circles today in light of the US Supreme Court's ruling on marriage equality. I tend to be of the opinion that those who are opposed to same sex marriage could maybe just not marry someone of the same sex. I think that would take care of it.

Meanwhile, I found the reaction of some WV politicians to the court's ruling on the Affordable Care Act to be bizarre. Case in point would be Shelley Moore Capito's expression of disappointment that the court upheld. Among other things, she said "Thousands of West Virginians have lost or had to change coverage because of this costly and complicated law."

I'm not sure whether she's referring to the 163,000 working West Virginians who gained coverage through Medicaid expansion or the 26,000 who gained coverage through the exchange or the thousands of young adults who thanks to the ACA are able to stay on their parent's insurance until age 26.

It's about time

For a good while lately, people on my end of the spectrum have been calling on the federal government to step up and assist those parts of Appalachia going through tough times because of the decline of coal. It looks like that is starting to happen, although on a fairly small scale.

I also found it interesting that WV's new senator, who metaphorically could be said to be a high priestess of the "war on coal" cult, is critical of the program, although she doesn't quite come out against it. For mythology buffs out there, her comments seem downright Protean to me.