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About Street roots. (Portland, OR) 1998-current | View Entire Issue (March 24, 2017)
Street Roots • March 24-30, 2017 SCHRADER, from page 4 trying to put a roof over your head, all the other stuff pales in comparison and just falls by the wayside. So it’s been a lifeline for a lot of folks. Joanne Zuhl: And people are telling you they’re worried about the GOP proposal if that goes through? K.S.: Oh yeah. I have people who are terrified. Just absolutely terrified. We’ve had some huge town halls, a thousand people in Salem, 600-plus in Milwaukie, a few hundred in Woodburn, and they’re all terrified of losing this access. The stories and the fear - the fear is palpable. Between that and the immigration issue, those two issues are striking fear and unrest, if you will, in a lot of Americans who shouldn’t have to feel that way. It’s sad this current administration is sowing that, and frankly, my "T b e president was Republican colleagues are p re tty cle a r in his sowing that type of fear and ca m paign: He d e e srft distrust. care about women. He's w r y m iso g yn istic, and u n fo rtu n a te ly, m y R ep u b lica n colleagues fro m these extreme r ig b i-w in g p ro -life states (a re j ju s t g o in g to prevent women fro m g e ttin g the preventive h e a lth services th a t they^ve enjoyed fo r the la st 2 0 o r 3 0 years. ThaCs sad/" J.Z.: Speaking of colleagues, your colleague from across the aisle, Congressman Greg Walden, is chairman of the House Energy and Commerce Committee and represents the district in Oregon that analysts say could be among the hardest hit by the repeal of the AC A. Walden’s district added more new Medicaid News Note: Medicaid DSH allotment reductions were put in place under the ACA to offset the reduced costs to safety net providers after more individuals gained insurance. The GOP’s plan to increase DSH funding in the AHCA reverts back to offsetting the cost to safety net providers’ serving more people who are uninsured. I think it’s important to remind people that we had a serious problem with runaway premium inflation and deductible increases before the Affordable Care Act. That was the reason we did this. It was a bipartisan, universal agreement - we needed to do something about the runaway prices in health care, given the advances in medicine and the costs therein and the fact that baby boomers were retiring. I think people forget in a short period of time what the system was like, just eight years ago, when the system was inflating through the roof. Unfortunately, the Republican budget puts us back in that same area. J. Z.: You could also argue that it takes us further back. The proposal defunds Planned Parenthood by cutting off Medicaid reimbursements. For many low-income women, Planned Parenthood is their primary caregiver. This means birth control, diabetes and cancer screenings, and reproductive health care will become less accessible to many women in poverty, particularly in rural areas. What are women to make of that attitude toward their wellbeing? K. S.: Well, I think the president was pretty clear in his campaign: He doesn’t care about women. He’s very misogynistic, and unfortunately, my Republican colleagues from these extreme right-wing pro-life states have decided that the Hyde Amendment - which rec ip ie n ts u n d e r th e A C A w a s a g o o d b a la n c e , I th o u g h t, a fa ir b a la n c e , than any of the other congressional districts in recognizing the diversity of views in our country - is not good enough, and they’re just going to prevent women from getting the preventive health services that they’ve enjoyed for the last 20 or 30 years. That’s sad. This is truly pushing the clock to the dark ages, where we’re burying our heads in the sand about what’s going on. And frankly, for my Republican colleagues, they don’t want to legislate all this stuff back home: states’ rights and all that. But they’re fine about legislating in the bedroom, which I think is just disgusting and reprehensible, taking advantage of this thing and turning that clock back. It’s very, very sad. GOP control. What do you say to him, and what do you talk about? K.S.: Well, I try not to poke my good friend and colleague in the eye. I’m sure Greg’s very aware that 45 percent of his folks are on Medicaid. Poor, low-income folks are not an attribute of urban areas only. Rural America has a huge poverty issue, and frankly it’s been tough to earn a living in rural America these days. So they end up falling into the safety net system - it’s a lifeline for those folks. I’d like to think that Greg is probably one of the reasons the Medicaid proposal is not just a flat block grant. There is some nod toward caseload and some toward inflation. It penalizes our own state, ironically, but at least there’s a nod in that direction. I worry - hopefully, it won’t be as bad as people say it is, but the CBO report was pretty devastating. My read on it is we go all the way back to the way it was pre-Affordable Care Act, where instead of 24 million that have coverage, 24 million don’t have coverage. There’s no money to do anything but acute care treatment. We go back to big uncompensated care budgets. You see where the Republication put a huge DSH (Medicaid’s Disproportionate Share Hospital) payments back in. Yeah, if you’re not going to cover people and you want to help the providers out a little, but it’s the exact wrong way to go. It’s going back, unfortunately, over what we’ve done over these last eight years. Note: The Hyde Amendment, named for Rep. Henry Hyde (R-Ill.) prevents the federal funding of abortions through Medicaid except to save the life of the woman or if the pregnancy is the result of incest or rape. It was originally passed in 1976 and is required to be voted upon for renewal with each budget. This year, a proposal to make it permanent, and also ban federal funds for insurance coverage for abortions, passed the House. J. Z.: Another proposal that’s gotten a lot of attention is the anticipated cuts to addiction treatment and the effect that could have on efforts to stem the nationwide opioid epidemic. There have been considerable efforts made to address it, certainly in Oregon, as both a health care and addiction problem. It sounds like with this plan, that’s all in jeopardy. K. S.: I think very definitely, the opioid Page 5 epidemic, mental health treatment in general is in jeopardy as a result of this misguided Republican repeal agenda. It goes exactly against what we tried to accomplish just last year in our rewrite of the mental health laws. We addressed the opioid epidemic last year. We tried to put more money into the treatment and prevention that a lot of the advocates have asked us for. That was a nice bipartisan bill. By taking out the requirement that mental health be included in the essential benefits package for low-income people in particular, is going to mean that a lot of states that can’t afford to pick up the tab as the federal government cuts the reimbursement are going to say we can’t afford to do mental health, we can’t afford to do dental health, or behavioral health. And all of that stuff will go by the wayside and undermine the exact work we tried to accomplish last year. It’s penny-wise and pound foolish, and I don’t think they understand - well, I guess they do. Let’s be honest, what I heard all through the hearings was we’re worried about flexibility, we’re worried about market forces; there was not a single comment about making sure our most vulnerable people got health care. And that’s what i t ’s s u p p o s e d to b e about, health care, rig h t? J.Z.: I want to ask you about the 27-hour meeting. „ , K.S.: It was a long, bloody 27 hours. g e la g b a c k to tfee d a r k a g e s /" U.S. REP. KURT SCHRADER J.Z.: Did anything move? Was there any progress? K.S.: None of the amendments were accepted. I think some of the points were made. I was surprised at the relative cogency of the discussion. Even at hours 24, 25, 26, members were still making good points. I was actually a little impressed that at 4:30 in the morning, I got a little play on an idea I had on how to deal with the Medicaid reimbursement going forward. People were paying attention. But it’s unfortunate they wouldn’t take any of our actual fixes. Because that’s what’s really needed. The individual market is in real trouble. Everyone acknowledges that’s 5 percent of health care delivery in the country, and a small part of the ACA gets some outsized recognition for what it is. And in that individual market, half the people in there just feel lucky as hell they got health care at any price because they could never get health care before. There are some problems for people who aren’t on subsidies, in terms of premiums and deductibles - so let’s fix that. Let’s not throw the whole thing out. That’s dumb, and we’re going back to the dark ages. D on’t miss a single issue. Follow Street Roots on Twitter and Facebook!
