Senate Health Care Bill Would Mean Steeper Medicaid Cuts For Connecticut

June 23--Senate Republicans Thursday released health care legislation that contains deeper cuts to Medicaid than the House bill to repeal and replace the Affordable Care Act, further alarming Connecticut hospitals and policymakers.

"In some ways it's even more evil," said U.S. Sen. Chris Murphy. "In some ways it's even dumber than the House proposal."

More than one in five Connecticut residents rely on Medicaid, the federal insurance program for low-income and disabled individuals. Connecticut was the first state to expand Medicaid through the Affordable Care Act, and stands to lose as much as $1 billion a year in federal funds if the health care legislation is adopted.

"Medicaid will be eviscerated," said Gov. Dannel P. Malloy.

Though the Senate bill contains a more gradual phase-out of Medicaid expansion dollars, funding will be set at a lower level after the phase-out.

"They have gutted Medicaid even more ferociously." said U.S. Sen. Richard Blumenthal.

Hospitals were bracing for the potential cuts to Medicaid.

"The impact on Connecticut is particularly dangerous and harmful because of the cuts we've seen at the state level," said Rocco Orlando, senior vice president and chief medical officer for Hartford HealthCare. "It really adds insult to injury and really threatens our ability as providers to provide care for this vulnerable population."

Orlando said Connecticut could stand to lose additional Medicaid dollars because the state never fully reimbursed hospitals under the controversial state hospital tax.

"By returning the tax money to the hospitals, the state would have reaped additional federal dollars," he said. "By not receiving those Medicaid dollars that lowers the base rate for which future Medicaid calculations would be based."

Jennifer Jackson, CEO of the Connecticut Hospital Association, said she had "grave concerns" about the Senate proposal, "which makes deep cuts to Medicaid, removing crucial protections for our most vulnerable patients and allows states to eliminate benefits for pregnant women, emergency care, and mental health."

"It is also worth noting that the expansion of coverage through the Affordable Care Act was funded in part through cuts to Medicare payments to hospitals," she said. "The AHCA proposal would keep the cuts in place and shrink coverage too. This is unacceptable."

Blumenthal said tens of billions of dollars in funding for opioid addiction treatment in the House version of the bill were slashed in the Senate proposal. The legislation is expected to be voted on next week, and Blumenthal said he is helping to mobilize opposition.

"We're going to see days of actions at the grass-roots level," he said. "A call to be loud and be active. ... We've had an incredible response coming into my office. The emails and calls are off the charts."

State Sen. Ted Kennedy Jr., D-Branford, said cuts to Medicaid would hamper the fight against opioid addiction. His brother, former Rhode Island congressman Patrick Kennedy, has gone public about his battle with addiction and has been a chief advocate in that area.

"We have an epidemic, over 900 people overdosed [in Connecticut] last year," Kennedy said in an interview from Washington. "It's everywhere. Every family is touched by addiction. The pathway to treatment and to recovery is most often paid for by Medicaid."

Kennedy was in Washington Thursday for a board meeting of the American Association of People with Disabilities, where he is the chairman. He also appeared on MSNBC to talk about the impact of the Republican health care bill -- and the Medicaid cuts it includes -- on the disability community and state governments.

With billions of dollars in looming deficits, it's unlikely Connecticut would be able to make up for the loss of any federal funds.

"Everyone in Hartford is talking about ... how we're going to close a $2.5 billion budget deficit," he said. "If the health care plan goes through, Connecticut is going to have to come up with somewhere between $500 million and $1 billion in addition."

The Senate bill would also prohibit Medicaid funding from being used at Planned Parenthood for one year. The women's health clinic services about 60,000 patients a year in Connecticut, half of who rely on Medicaid to pay for treatment.

Federal law already prevents Medicaid funds from being used to pay for abortions, so the funding cut would affect other services like contraception and STD and HIV screenings.

"We see poll after poll that shows voters support Planned Parenthood and oppose efforts to block care," said Gretchen Raffa, director of public policy with Planned Parenthood of Southern New England. "If they were really listening to the American people senators would all be voting against this legislation."

Blumenthal and Murphy will be in New Haven Friday for an "emergency field hearing" on the Senate bill and plan to take the testimony they hear back to Washington. They have also scheduled events in New Britain, where they will meet with seniors at a nursing home, and Bridgeport, where they will visit a community health center, to highlight the impact of the Republican proposal on Connecticut.

The 142-page bill was negotiated privately by 13 Republican men, another key point of contention for Democrats. No public hearings were held, and the bill was not debated by any House or Senate committee.

"It should come as no surprise that Republicans preferred to hash out the details of this bill behind closed doors, rather than give the American people the opportunity to understand what is going to happen to their families," Malloy said.

Lt. Gov Nancy Wyman said: "Republicans drafted this bill in secret, and in nother reversal of hard-fought progress, not one woman sat at the table."

On Thursday afternoon, hours after the bill was released, four conservative Republican senators said they would not support it in its current form. Holding a 52-48 advantage in the Senate, the GOP can afford to lose just two votes.

Polls have shown that the House health care bill -- which includes many of the same provisions as the Senate legislation -- is wildly unpopular with voters. Respondents to a Quinnipiac Poll earlier this month rejected the bill by an almost 4:1 margin.

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