GOP repeal and replace plan criticized by local health care providers and parents

May 31--In his Akron stop on a statewide listening tour, U.S. Sen. Sherrod Brown surrounded himself with skeptics of the Republican plan to repeal and replace the Affordable Care Act, or Obamacare.

The Cleveland Democrat has been kept in the dark as about a dozen conservatives in the U.S. Senate meet privately to consider a plan passed earlier in the month by the U.S. House. If accepted as is, the plan would result in 20 percent higher insurance premiums and 14 million Americans losing coverage by 2018, according to research published last week by the nonpartisan Congressional Budget Office (CBO).

That report has soured public opinion on the GOP plan. A poll of 1,205 adults conducted this month by the Kaiser Family Foundation found that 49 percent approve of the Affordable Care Act and 31 percent prefer the GOP repeal plan. Only one in 10 said the Senate should pass the GOP plan without making changes.

House Republicans passed the American Health Care Act, as their plan is called, before the CBO could score it.

Without knowing when Republican senators might bring a revised plan up for a swift vote, as was the case in the House, Brown is touring Ohio to unpack the complicated nuances wrapped up in a bill so significant that in 10 years the CBO figures it would reduce taxes on mostly wealthy Americans by $664 billion, threaten health insurance for 23 million now covered, cut Medicaid by $834 billion and, ultimately, reduce the federal deficit by $119 billion.

Missing costs, again

In an endorsement days before its passage, President Donald Trump said "the best thing that is happening with the [GOP plan for] health care is premiums will come down."

That doesn't appear to be the case. Premiums are expected to climb whether the Affordable Care Act stays or goes.

The Washington Post crunched the CBO's 10-year estimates to determine that health care premiums under the GOP plan would rise faster for 64-year-olds (about $5,700 faster over the next decade compared to the Affordable Care Act) while climbing more slowly (about $900 more slowly) for 21-year-olds and staying flat for 40-year-olds.

Asked by a reporter why Obamacare has not checked premiums, as liberals promised before passing it, Brown blamed a lack of young and healthy consumers in the government-run health markets to offset costs, soaring prescription drug prices pushed by Republican donors in the pharmaceutical industry and, more recently, insurers withdrawing from the exchanges because Trump sews instability by saying Obamacare "will explode."

Health pointers

Brown was in Cleveland on Friday to talk about how the GOP plan could cut $12 million a year in Medicaid reimbursements for special needs students in Ohio schools. In Toledo on Tuesday, he discussed how it would allow insurers to charge their oldest customers five times what their youngest pay; the ACA allows only three times more to be charged.

On Thursday, he'll travel to Dayton to talk about how Medicaid expansion has aided the fight against opioids, an epidemic health officials in Akron say does not seem to be subsiding. In Summit County, 300 children are born each year to drug dependent women who discover they are pregnant while being screened at detox centers.

Joining the roundtable discussion Wednesday at Akron Children's Hospital were CEO Bill Considine and his interim counterpart at Summa, Dr. Cliff Deveny. City and county agencies on employment, public health and addiction treatment, as well as community service providers, praised the uptick in preventative care under the ACA while warning of the negative health outcomes of its repeal on the poor, minorities and children on Medicaid.

The panel encouraged Brown to dispel notions that Medicaid traps people in poverty or that subsidized health insurance misses the middle class.

"The one thing Medicaid has done for my family is not let my son's condition bankrupt us," said Judy A. Doyle, a middle class mother of a chronically ill child and the coordinator for Akron Children's Parent Advisor Program.

Considine said children, though insured before Medicaid expansion, would be "slaughtered from the repeal," which includes steep cuts to a program that insures half the children in Ohio. "Medicaid to kids is what Medicare is to the adult population," he said.

Considine said a recent Yale University study shows children with Medicaid become more productive citizens who, eventually, pay more in taxes.

"Why we're not seeing that this is not an expense but an investment is beyond me," Considine said. He added that 300,000 Ohioans who gained coverage under Medicaid expansion have moved onto a private plan in the health care exchange. "So they weren't trapped, it became a stepping stone for them."

"[Conservatives] use the word trapped because they know, fundamentally, it's their only answer to the moral question of opportunity," Brown said.

Akron Public Schools Superintendent David James said 1,000 special needs students rely on Medicaid dollars for speech and physical therapy, or other services.

Summit County Public Health Commissioner Donna Skoda and Doug Smith, medical director at the Alcohol, Drug Addiction, and Mental Health Services Board, explained that Medicaid expansion dollars allowed Summit County to fund drug treatment beds and counseling for the opioid epidemic without decimating other programs.

Akron's Health Equity Ambassador Tamyka Rose said giving underserved populations, who suffer higher rates of chronic illness, the insurance needed to access preventive care cuts down on costly emergency room visits.

Doug Livingston can be reached at 330-996-3792 or [email protected]. Follow on Twitter: @ABJDoug .

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