Lawmakers at odds on American Health Care Act

May 09--With the future of the Affordable Care Act and American Health Care Act now up to the U.S. Senate, the commonwealth's two members of the upper chamber -- Sens. Bob Casey Jr. and Pat Toomey -- are already expressing their opinions and preparing for what is expected to be a challenging and possibly contentious legislative process.

Last week, the Republican-controlled U.S. House of Representatives passed its version of the AHCA, which is designed to replace the ACA, also called Obamacare, named after its main supporter, former President Barack Obama.

House members and Republican President Donald Trump celebrated with a ceremony at the White House.

But the bill is not yet the law of the land.

The Senate is now attempting to create its version.

"The House bill is merely the first legislative step and I look forward to being a part of this process as the Senate writes its own version to repeal and replace Obamacare so that Pennsylvanians can have access to quality health care at a price they can afford," Toomey, a Republican, said.

He feels the administration has already "begun a series of important regulatory reforms and actions to stabilize the health care market" because there have been "massive spikes in premiums and deductibles so many Pennsylvania families are enduring, the loss of choices, and the collapse of individual markets."

In comparison, Casey, a Democrat, called the Trump-backed plan "an economic punch to the gut of middle class families in Pennsylvania."

He, instead, referred to it as "a scheme to cut taxes for millionaires and big corporations, a giveaway for special interests, and forces middle class families in Pennsylvania to pay more for their health care."

Casey, joined by 12 other Democratic senators, sent a letter to the U.S. Department of Health and Human Services and Office of Management and Budget, expressing concern that the administration is reportedly considering stopping cost-sharing reduction payments to insurers that are used to defray the cost of health care insurance for eligible enrollees.

"Despite health insurers, medical providers, and business leaders stating that continuing cost-sharing reduction payments is key to the success of the health insurance Marketplaces and is the 'most critical action' the Administration could take regarding the ACA, the Administration appears to be considering terminating these payments," according to the letter.

The area's two congressmen -- U.S. Rep. Keith Rothfus, R-Sewickley, from the 12th Congressional District, and U.S. Rep. Bill Shuster, R-Everett, from the 9th Congressional District -- voted in favor of the House version.

"Obviously, the Senate's going to have a different take on things," Rothfus said during a recent visit to Johnstown. "This is a collaborative effort. And we've got to continue to work for a better health care system."

The final version of the bill was not scored by the Congressional Budget Office.

But, the analysis on a similar previous proposal estimated the AHCA will cause an estimated 24 million people to lose or forgo insurance and reduce the deficit by $150 billion over 10 years.

About 37,000 citizens in the 12th District and 41,000 in the 9th District could lose health care coverage, under the AHCA, according to projections.

A 2010 CBO report estimated 10 million citizens would be added to the Medicaid rolls by 2016 because of Obamacare. That number ended up being more than 14 million, according to factcheck.org. A projected increase of 23 million individuals getting policies through newly created health care exchanges by last year ended up being only between 10 and 11 million.

"I take all the CBO reports with a grain of salt," Rothfus said. "If you take a look at the CBO report from 2010, it said that by this time there would be 22 million people who were paying insurance through the exchanges. Only about 10.5 million, 11 million have actually done so. There are a lot of dynamics that go into these numbers."

The House version of the American Health Care Act allows insurance companies to charge customers with pre-existing conditions more for coverage, which is prohibited under Obamacare, in certain situations. It would still prevent companies from denying coverage due to pre-existing conditions, but premiums could be increased to the point where many sick citizens could not afford coverage.

"The essential part of the health care reform package we have is to maintain protection for people with pre-existing conditions," said Rothfus, a cancer survivor.

"That's a huge issue for me. It's a huge issue in my family. I am confident with the triple layer of protection that we have in this legislation that it offers a better way forward on health care because we've seen skyrocketing premiums. We have to get a handle on that."

But, in Casey's opinion, the House version of the AHCA "will throw Pennsylvanians with pre-existing conditions into a high-risk pool, forcing them to pay thousands of dollars more for coverage.

Dave Sutor is a reporter for The Tribune-Democrat. He can be reached at (814) 532-5056. Follow him on Twitter @Dave_Sutor.

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