Letcher County residents voted overwhelmingly for President Trump largely because of his pledge to re-open the region's coal mines, but many are now worried about what will happen to their health insurance if Congress passes legislation that makes cuts to Medicaid, Laura Bicker reports for BBC News.
The Republican majorities in Congress are working to repeal and replace the Patient Protection and Affordable Care Act, and both pending bills would phase out extra funding for the Medicaid expansion, likely making the program too expensive to maintain at regular federal funding rates. In addition, later changes in how traditional Medicaid is funded would significantly decrease the amount of money available to the program as well.
Claude Lucas, 51, who was a coal miner for 27 years and has black-lung disease, told Bicker that he is worried, adding that Medicaid had saved his life because it pays for his medication and treatments. Lucas is unable to work and lost his health insurance when the mine closed.
Lucas is a patient of Dr. Van Breeding, a primary-care physician and clinical director at Mountain Comprehensive Health Corp.
Breeding, a Letcher County native, told Bicker that he is afraid Washington is so busy with the politics of the bills that they have forgotten about the health issues that he deals with daily.
Kentucky has some of the highest rates of cancer, heart disease, diabetes and obesity in the nation, and the rates are often highest in Eastern Kentucky, to say nothing of the opioid epidemic.
"There shouldn't be any sides. There are no sides to this. The only side is great health care for every American," said Breeding, who was named Staff Care's 2017 Country Doctor of the Year. He added that he believes lawmakers should be looking at the healthcare models used in the United Kingdom and France.
"Other countries have done it. They've set the groundwork for us. We can take what they've done and use it and build on it to make it the best program in the world," he said. "That's why the United States is as strong as it is. We've always taken things and made them better. Why can't we take a healthcare product and make it better instead of fighting over it."
Eighty percent of Letcher County voters chose Trump, who not only promised to bring coal jobs back to the county, but promised not to cut Medicaid.
Caherine Collins, who is paralyzed and has been in a wheelchair since her car accident 12 years ago, and depends on Medicaid for her care, told Bicker that she is angry about these broken promises.
"I think Donald Trump is just taking into consideration his concerns and he's not thinking about the little people," Collins said. "I don't know what he's thinking. He promised a lot to get in the office. And he's went back on a lot. Big words were spoken. A lot of lies were told by him."
But Matthew Caudill told Bicker that Obamacare has "been a real mess for him and his family" because of the increase in his premiums --up to $400 a month for himself and two children from $43 a month -- and high deductibles.
"It has devastated my family's coverage. I find myself unable to feel sorry for anybody else when my children's coverage is so poor. I must worry about my family first. If nothing changes then this will get much worse in the coming years," he said.
Obamacare requires plans to cover 10 essential benefits and no longer allows insurance companies to not cover pre-existing conditions, provisions that have caused many premiums to rise. Both provisions are at risk of being removed in Congress. In addition, uncertainties about the subsidies that make health insurance more affordable and the individual and employee mandates have caused premiums to soar recently.
Another Breeding patient is Cortney Akeman, who is four months pregnant and part of a program that helps pregnant mothers who are addicted to drugs wean off of them so that their babies aren't born addicted. The program is covered by Medicaid, "but that is being reconsidered in the latest draft of the health bill," Bicker notes.
Breeding, who said almost half of his patients are on Medicaid, believes this type of preventive medicine will save money in the long run and should help break the cycle of abuse.
He added, "I think we all should have the same insurance. If we said that from President Trump down to me and any of my patients that we all had the same insurance I think we would all be bought into making sure that it worked right for everyone."
Bicker writes, "The cry I heard over and over from Letcher County was the same. Don't take away our health care."
The Republican majorities in Congress are working to repeal and replace the Patient Protection and Affordable Care Act, and both pending bills would phase out extra funding for the Medicaid expansion, likely making the program too expensive to maintain at regular federal funding rates. In addition, later changes in how traditional Medicaid is funded would significantly decrease the amount of money available to the program as well.
Claude Lucas, 51, who was a coal miner for 27 years and has black-lung disease, told Bicker that he is worried, adding that Medicaid had saved his life because it pays for his medication and treatments. Lucas is unable to work and lost his health insurance when the mine closed.
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| Dr. Breeding works 16-hour days. Photo: BBC News |
Breeding, a Letcher County native, told Bicker that he is afraid Washington is so busy with the politics of the bills that they have forgotten about the health issues that he deals with daily.
Kentucky has some of the highest rates of cancer, heart disease, diabetes and obesity in the nation, and the rates are often highest in Eastern Kentucky, to say nothing of the opioid epidemic.
"There shouldn't be any sides. There are no sides to this. The only side is great health care for every American," said Breeding, who was named Staff Care's 2017 Country Doctor of the Year. He added that he believes lawmakers should be looking at the healthcare models used in the United Kingdom and France.
"Other countries have done it. They've set the groundwork for us. We can take what they've done and use it and build on it to make it the best program in the world," he said. "That's why the United States is as strong as it is. We've always taken things and made them better. Why can't we take a healthcare product and make it better instead of fighting over it."
Eighty percent of Letcher County voters chose Trump, who not only promised to bring coal jobs back to the county, but promised not to cut Medicaid.
Caherine Collins, who is paralyzed and has been in a wheelchair since her car accident 12 years ago, and depends on Medicaid for her care, told Bicker that she is angry about these broken promises.
"I think Donald Trump is just taking into consideration his concerns and he's not thinking about the little people," Collins said. "I don't know what he's thinking. He promised a lot to get in the office. And he's went back on a lot. Big words were spoken. A lot of lies were told by him."
But Matthew Caudill told Bicker that Obamacare has "been a real mess for him and his family" because of the increase in his premiums --up to $400 a month for himself and two children from $43 a month -- and high deductibles.
"It has devastated my family's coverage. I find myself unable to feel sorry for anybody else when my children's coverage is so poor. I must worry about my family first. If nothing changes then this will get much worse in the coming years," he said.
Obamacare requires plans to cover 10 essential benefits and no longer allows insurance companies to not cover pre-existing conditions, provisions that have caused many premiums to rise. Both provisions are at risk of being removed in Congress. In addition, uncertainties about the subsidies that make health insurance more affordable and the individual and employee mandates have caused premiums to soar recently.
Another Breeding patient is Cortney Akeman, who is four months pregnant and part of a program that helps pregnant mothers who are addicted to drugs wean off of them so that their babies aren't born addicted. The program is covered by Medicaid, "but that is being reconsidered in the latest draft of the health bill," Bicker notes.
Breeding, who said almost half of his patients are on Medicaid, believes this type of preventive medicine will save money in the long run and should help break the cycle of abuse.
He added, "I think we all should have the same insurance. If we said that from President Trump down to me and any of my patients that we all had the same insurance I think we would all be bought into making sure that it worked right for everyone."
Bicker writes, "The cry I heard over and over from Letcher County was the same. Don't take away our health care."
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