KC opposition rallies ahead of Senate vote on newly released health care bill

Kansas City Star (MO)

June 24--As U.S. Senate Republicans prepare for a possible vote on their newly released health care bill, medical professionals and others opposed to the plan joined Missouri Democratic Sen. Claire McCaskill to voice their concerns Saturday at one of the area's safety net clinics.

Nurses and administrators at the Samuel U. Rodgers Health Center on Euclid Avenue concerned about more uninsured patients joined Jackson County Sheriff Mike Sharp, who decried potential cuts to substance abuse treatment in the midst of an opioid crisis. Cathy Infield, an Independence resident with developmental disabilities who spoke with help from an electronic device, relies on in-home care provided through Medicaid and said the cuts could mean she'd need to live in an institution.

McCaskill said the speakers were representative of national health care, disability and anti-drug groups mobilizing against the Republican bill meant to replace the Affordable Care Act, commonly called Obamacare.

"I do think this is a crisis and I think it's all hands on deck," McCaskill said.

Senate Majority Leader Mitch McConnell released the bill Thursday and has said he plans a vote on it in the coming week. It's similar to a bill passed by Republicans in the U.S. House of Representatives last month. Both would wipe out most of the taxes and insurance mandates in Obamacare, then curtail rising Medicaid costs to pay for further tax cuts.

A Congressional Budget Office analysis found that the House bill would add about 23 million Americans to the ranks of the uninsured. A CBO score of the Senate bill is expected this week.

McConnell needs almost every Republican to support the bill. The Washington Post reported Friday that a political action committee tied to President Donald Trump was preparing an advertising campaign to pressure Republican senators to get on board.

But several Republicans, including Kansas Sen. Jerry Moran, have expressed reservations.

"We have concerns about what the changes in Medicaid may mean to those with disabilities," Moran said in a video posted to YouTube.

Kansas' other senator, Republican Pat Roberts, has said he supports the bill and the Medicaid changes will not harm vulnerable populations. Missouri Republican Sen. Roy Blunt is also on board, saying Obamacare is crumbling based on the number of insurers that have stopped participating.

Medicaid is jointly funded by the federal government and the states and the Republican bills would impose limits on the federal dollars for the first time. Those caps are projected to reduce Medicaid funding by 25 percent or more over 10 years.

The reductions would apply to states such as Kansas and Missouri that did not expand Medicaid under Obamacare and still use the program mainly to cover the elderly, pregnant women, children and people with disabilities. Depending on how states absorb them, the cuts could effect not only medical care, but other things Medicaid covers such as nursing home beds and in-home support services for people like Enfield.

Jawanda Mast, a disability advocate from Olathe whose daughter has Down syndrome, said she had been contacted by one of Moran's staff members to get her thoughts on the bill and had asked him to "be our champion now and vote 'no' to this bill that will be devastating for those with disabilities."

The Medicaid portion of the bill is also drawing opposition from the insurance industry, which has a growing stake in Medicaid as more states seek to privatize parts of their programs.

The heads of 10 Medicaid managed care companies sent a letter to McConnell and Senate Minority Leader Chuck Schumer asking them to rethink the proposed changes. Schumer, who leads Democrats in the chamber, opposes the bill.

Kevin Sparks is the CEO of UnitedHealthcare's Kansas Health Plan, one of three companies that administer Kansas Medicaid, or KanCare. His company was not one of the 10 that wrote to the Senate leaders, but he said Friday that he was also opposed to the bill.

"It really takes some big chunks out of Medicaid," Sparks said.

McCaskill conceded some problems with Obamacare, and pointed to the 25 "bare" counties in Missouri where no insurer is currently committed to selling subsidized individual plans on the exchange in 2018. She's introduced legislation to allow people in those counties to buy into the Congressional health plan if no insurers come in and she said that one feature of the Senate Republican bill she likes is that it continues to fund cost-sharing subsidies for insurance companies on the exchanges, at least temporarily.

That's something both parties can agree on if the health care talks open up beyond their current party-line positions, she said.

"If that (Republican bill) fails, then we can go back to the drawing board and work together to fix the problems with Obamacare," McCaskill said.

Andy Marso: 816-234-4055, @andymarso

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