OPINION: National political fight on health care could land real punches on local lives

June 26--A lot of the national news last week focused on how best to deliver health care to the most people in the United States. That includes Hoosiers, of course, and Monroe Countians. Here are some thoughts.

Republican Congressman Charlie Dent from Pennsylvania was interviewed on NPR's "Morning Edition" on WFIU Friday morning about the Senate version of the bill that would repeal and replace the Affordable Care Act, aka Obamacare. He made more sense than usually comes out of Washington these days.

He said he wanted to hear an analysis from the Congressional Budget Office, which said the House version of a replacement for Obamacare, which he did not support, would mean 23 million people would likely lose insurance coverage. He wanted to hear from people in his district: patients, patient advocates and health care providers.

He's not an all-or-nothing guy. He said "we need to do something" to fix the problems of the Affordable Care Act, but realizes not all of it is a problem. He said he's been talking with Democratic members of the House "who have acknowledged they want to fix some things and we've started hashing out some ideas."

"We all know parts of this law will need to be repealed, parts of it replaced, parts of it repaired, reformed and overhauled and parts of it retained. We have to get our rhetoric right on this," he said.

It was a refreshing departure from choosing sides with no middle acknowledged or sought.

Dent is correct that the Affordable Care Act is not perfect, though it has put 20 million people on insurance plans, which allowed them to receive health care. Still, as the heavily stressed insurance marketplace shows, it does need attention.

But this plan the Senate put forward? Or the House plan before it?

Analysis by NPR, the New York Times and other media outlets that actually do care about truth and accuracy, despite claims to the contrary, show: Medicaid will be greatly weakened by the "repeal and replace" plans, which means millions of the most vulnerable people in this country will go without health care coverage. The Senate plan would cut $1 trillion in federal spending for health care programs over 10 years, including significant cuts to people with disabilities and those with mental health problems.

At the same time, both the House and Senate bills would cut taxes on wealthy taxpayers and repeal taxes on corporations to the tune of about $592 billion. The medical device tax, which has been opposed strongly by Cook Medical and other Indiana medical device manufacturers (and by our editorial board, though a little less vocally), is a small percentage of that -- $29 billion over a decade.

Our stories last week localizing this big story included knowledgeable local voices critical of the GOP plan.

Nancy Richman, executive director at Volunteers in Medicine of Monroe County, said the AHCA is likely to be "one of the most harmful pieces of legislation in American history."

"I think this bill is nothing short of disastrous," she said. "And not just for people in poverty. This is middle-class. This bill will affect everyone."

Kosali Simon, a health economist who generally looks at policy matters through the lens of a neutral academic, sized up the Senate bill as a slight improvement on the House version.

"Still, this is going to be a pretty big blow to Medicaid, and not just to the expansion coverage, but also to its bread and butter. That means children, disabled people, those who rely on this system," she said.

Indiana's Republican U.S. Sen. Todd Young happens to be from Bloomington. He said a couple things in his statement that his liberal hometown should not oppose.

First, he said: "One thing is clear: Doing nothing is not an option." And: "I am committed to improving our nation's health care system so everyone has the opportunity to access high quality and affordable care."

Between those statements, though, he devolved into the rhetoric of the right: "Obamacare has failed Hoosiers as prices have skyrocketed; insurers have left the marketplace, leaving severely limited choices; and deductibles have risen to a level where for some, insurance is useless."

That disregards thousands of Hoosiers -- and they are out there -- who received help and peace of mind from the Affordable Care Act, and especially HIP 2.0, made possible by Medicaid expansion dollars the GOP plan would gradually take away.

If he's really committed to "everyone," perhaps he'll join Congressman Dent in reaching across the aisle to look for ways to "fix some things" without crushing the parts of Obamacare that worked, simply in the name of politics.

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