Missoulian – June 22, 2017
Only one of the three men in Montana’s congressional delegation had a strong opinion on the Senate version of a Republican health care bill that was debated and altered behind closed doors over the last few weeks.
Sen. Jon Tester, a Democrat, came out in strong opposition Thursday after Senate Republicans finally made the text of the bill public. A few members of the Senate had been working without input or hearings on altering the American Health Care Act, passed by the House in May.
“After no public input, this bill emerged from the shadows, where it was written in secret, with a warning label for rural America,” Tester said in a statement. “It will rip away Medicaid from thousands of Montanans, impose an age tax on folks in their 50s and 60s, make it harder to get coverage if you have a pre-existing condition like high blood pressure, all while cutting taxes for corporations and the extremely wealthy. We need to take steps to make health care more accessible and affordable for every Montanan, but this bill will leave thousands of Montanans without health care and doesn’t address rising costs.”
Republicans U.S. Sen. Steve Daines and U.S. Rep. Greg Gianforte, who was sworn in yesterday, did not offer up opinions on the bill, instead saying they needed time to read through it and solicit opinions.
Daines released a statement saying: “I’m glad to see the draft text of the bill made public for everyone to see. I look forward to hearing directly from Montanans on this legislation.”
Gianforte’s statement said: “I look forward to studying this bill and receiving input from Montanans on its impact. I believe Obamacare needs to be repealed and replaced but my support for any health care reform is based on protecting Montanans with pre-existing conditions, lowering premiums, and preserving rural access.”
Tester has been a strong opponent of the bill, which is meant to replace the Affordable Care Act, President Barack Obama’s landmark health care legislation. The Democrat has advocated for fixing the ACA, while Daines and Gianforte have called for a repeal and replace, long a rallying cry of congressional Republicans.
Daines’ statements have centered around saying he wants a bill that improves access to care and lowers costs for Montanans. Gianforte’s relationship with the bill drove Montana into the national spotlight when, a day before his election, he assaulted a reporter who asked him about the Congressional Budget Office’s assessment of the legislation.
Gianforte said repeatedly during the campaign that he would only vote for a bill that lowered premiums, increased access for Montanans and preserved coverage for those on Medicaid. After his election he said specifically he would not have voted for the House bill, which passed narrowly 217-213. Montana did not have a vote on that since Ryan Zinke had resigned his seat to become Secretary of the Interior and Gianforte was not elected until a few weeks after the vote.
On Saturday in Great Falls, Tester is holding a town hall to discuss the health care bill. The town hall is at Montana Electric Cooperatives’ Association, 501 Bay Drive, and starts at 6:30 p.m. Daines is also holding a town hall, though by telephone, not in person.
Daines has faced criticism for not holding an in-person town hall this year. Montanans can join his event by texting “SenatorDaines” to 828282 or by calling any of Daines’ offices to register.
On Thursday, groups that have been critical of what the Republican health care bill would mean for Montana said the Senate version makes no improvements to what they project to be devastating cuts to Medicaid.
After a preliminary review of the bill, Aaron Wernham, the CEO of Montana Health Care Foundation, said the two main concerns for Montana — the federal enhanced matching funds for Medicaid expansion and the per capita cap on how much the federal government will pay for Medicaid enrollees — are still in the Senate bill.
The Senate bill offers more of a step-down in an enhanced federal match for Medicaid expansion, but the program would still come to an end, Wernham said. Under the House bill, the enhanced match would end in 2020, while in the Senate bill it would be phased out by 2024.
The Senate bill also ties its cap on Medicaid spending to the overall Consumer Price Index, which is generally lower than the medical Consumer Price Index the House bill linked the cap on spending to. That means the cap would be lower, representing a drop in the amount of money coming into Montana for Medicaid.
The Montana Health Care Foundation has focused its analysis of the bill on Medicaid because it serves a vulnerable population, Wernham said.
In 2015 Montana became one of 32 states that chose to expand access to Medicaid to those earning up to 138 percent of the federal poverty level under the Affordable Care Act. More than 79,000 Montanans are covered under expansion.
The Montana Budget and Policy Center has also been an outspoken opponent of the bill.
“Make no mistake: the Senate bill is just as devastating as the widely unpopular House-passed bill and sends us back to a time when health care was out of reach for many in our state,” said Heather O’Loughlin, co-director of the nonprofit. “The bill will end Montana’s Medicaid expansion plan and cut assistance for average Montanans trying to access affordable health insurance, all to pay for massive tax cuts for the wealthiest Americans. This bill could be life or death for many Montanans, as lower-income, rural, older, and sicker Montanans risk losing affordable coverage.”
Compared to the House version, the Senate version of the bill expands tax credits to help offset the cost of buying insurance on marketplaces, but the credits are still below what’s in the Affordable Care Act. The revised Senate bill also cuts off support at 350 percent of the federal poverty line, which hits older Montanans.
The Senate bill raises the amount middle-income people would pay for coverage. For example, a 60-year-old who makes $35,000, which is 300 percent of the federal poverty level, would have to pay 16.2 percent of their income in premiums under the Senate bill. Under the Affordable Care Act, that number was 9.69 percent.