Report: Health care bill could devastate rural Idahoans

June 29--The hotly debated Senate Republican health care bill that, based on a Congressional Budget Office estimate, would leave 22 million more Americans uninsured in 2026 than under former President Barack Obama's health care law would also devastate rural Idaho communities and the state's children, according to a study by Close the Gap Idaho, a group campaigning to close Idaho's health care gap and protect health care coverage.

According to Close the Gap, 42 percent of Latah County children relied on Medicaid or the Children's Health Insurance Program in 2014-15 and 73 percent of Idaho Medicaid enrollees are children.

"Congressional attempts to dismantle and cut Medicaid would disproportionately harm rural Idaho," the report said. "Recent proposals have included provisions that would radically restructure federal Medicaid financing by converting the program from a federal match rate to a per capita cap. Under this scenario, states would get less federal funding than under current law, with the cuts growing larger each year."

According to the report, states would be responsible for covering any costs in excess of the cap, and "to make up for these cuts, states would have to raise taxes, cut other budget priorities like education, or far likelier, cut Medicaid spending by reducing payments to providers or rolling back eligibility for the program."

And that would erase many of the gains made under the Affordable Care Act. According to the report, Georgetown University and University of North Carolina researchers found the rate of uninsured children in rural Idaho dropped from 13 percent to 8 percent from 2008-09 to 2014-15.

Idaho state Sen. Maryanne Jordan, D-Boise, opposes the GOP bill and said many Idahoans risk losing health care coverage, while the nation's wealthiest individuals will receive tax cuts.

"The thing that concerns me is the way that it's being touted as a repeal and replace," she said. "There is no replacement here. This bill is taking health care away from tens of millions of Americans and replacing it with nothing, and that's devastating."

Jordan said proponents of the bill say tax credits will make insurance available to Idahoans, but, she pointed out, a person making $20,000 a year cannot keep a roof over his or her head, pay for health insurance and wait for a tax credit.

"It just doesn't work that way and they're not going to be able to afford insurance," she said.

Jordan said the problem is exacerbated by the unprecedented cuts to Medicaid proposed in the bill.

According to the report, the bill "would make coverage unaffordable for thousands of Idahoans and would raise the number of uninsured in the state."

Last week, Idaho House and Senate Democratic leaders sent identical letters to U.S. Sens. Mike Crapo and James Risch, both of Idaho, urging them not to support changes to the ACA without public process.

"The idea that a bill impacting one-sixth of the nation's economy and millions of lives would be passed with absolutely no public input is unacceptable," the letters said. "When the ACA was passed it was done publicly and with amendments. Any changes should be done in the same manner."

Jordan said the ACA has been a great first step but there are improvements that can be made.

"I think it's important to keep people healthy and working and paying taxes rather than having people so sick that they are just incapable of being able to live their lives and contribute," Jordan said.

Garrett Cabeza can be reached at (208) 883-4631, or by email to gcabeza@dnews.com.

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