Thursday, June 29, 2017

Danville paper looks at how the proposed health law would affect the local community

Danville's newspaper, The Advocate-Messenger, broke down and localized the potential impacts of the latest health bill in Congress.

Reporter Bobbie Curd first walked her readers through the Senate bill, noting how it compares to the House-passed health bill and the Patient Protection and Affordable Care Act, then showed how the proposed changes to Medicaid could affect Boyle County.

About 1.4 million people are covered by Medicaid in Kentucky, 470,000 of them through the expansion of the program to people who earn up to 138 percent of the federal poverty line. As of May 2017, Medicaid covers 8,517 people in Boyle County, Curd reports.

Under the repeal-and-replace bill passed by the House, the extra money for Medicaid expansion would end in 2020. Under the Senate bill, current funding would remain the same until 2021, but would be cut back to the traditional Medicaid level over the following three years.

In Kentucky, the federal government pays about 70 percent of costs for traditional Medicaid recipients and 90 to 95 percent for expansion members.

Both bills would cut federal support for traditional Medicaid, through spending limits that wouldn't keep pace with health-care costs. Experts say these cuts will cause states to either raise taxes, cut eligibility or cut benefits in order to maintain their programs.

Local health professionals and lawmakers in Boyle County told Curd what these changes to Medicaid would mean for their community.

County Public Health Director Brent Blevins said people who lose health coverage would have to resume using the emergency room and the health department. “You’re going to see people showing up needing primary care or specialized care that we don’t have,” he said. “Most of ours is preventative care, so where are those people going to go?”

Sarah Hempel is the office manager for her husband Dr. Rick Hempel, a geriatrician in Danville. She told Curd that the need for primary care is so great that they have had to “drastically change their practice” -- seeing 30 to 40 patients a day, making it hard to give quality care.

New doctors “won’t even go into primary care anymore,” she said. “There’s a huge primary-care shortage in this area — it almost has to be a calling,” she said.

Dr. Jeremy Stich of Access Med, a direct-care system where insured patients pay a flat monthly fee with no co-payments, voiced concern that the Senate bill was drafted without input from providers.

“It concerned me when it was done by non-clinicians,” he told Curd. “Too many politicians and too many lobbyists involved. It was the same with Obamacare. That hasn’t changed.”

Danville attorney Mark Morgan, who represents disabled people, told Curd, “I was going to three, maybe four funerals a year for clients who had passed away,” he says — direct results of not getting medical care or medicines. “When Medicaid expanded in Kentucky, that stopped happening. It was a day-and-night transformation. Most of the bad outcomes disappeared.”

He added, “I’m fearful that we’re going to return to the situation we were in before, sitting across the desk from people who can’t get diagnostic testing, can’t get meds and scripts, and I’m going to be going back to funerals again.”

Curd points out that affording health care is not just a challenge for the poor, but for the middle class because of the "surging bite of higher premiums and ridiculously large deductibles."

Blevins said the health department sees many middle-class people looking to afford their care: “I think more middle-class people are really struggling these days. These are families who are going to work every day, trying to pay their bills, not living outside of their means, giving to charity when they can, but are still struggling trying to pay medical bills. I think there’s a lot out there like that we don’t realize it.”

Stich added that working families are struggling to afford health care and are "literally faced with losing their home or their kids dropping out of college because they can’t afford it."

Morgan said, “The people we represent say frequently, ‘OK, I won’t get the medicines or go to the doctor,’ and I end up seeing them in the funeral home. And I’m tired of it, and I don’t want to see it any longer. Certainly not so that taxes can be cut for the wealthy.”

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