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!