Supervisors hold off on AHCA opposition letter

May 19--The Siskiyou County Board of Supervisors on Tuesday chose to at least temporarily forego sending a letter opposing the American Health Care Act -- until a new letter can be drafted that details concerns specific to Siskiyou County.

The board was tasked with deciding whether it would send a letter to Congressman Doug LaMalfa asking him to oppose the AHCA, drawing attention to the potential negative impacts to counties and the healthcare they provide.

The form letter -- which has been sent by a number of other counties -- opens with "Siskiyou County strongly opposes the [AHCA]. California is a state of nearly 40 million people and counties care for up to one third of Californians. If enacted, the bill would shift tens of billions of dollars in costs to counties and reverse the significant progress our state has made in providing health care coverage to millions of our residents."

The letter draws attention to the AHCA's proposed changes to Medicaid that are expected to make it more difficult to maintain health coverage, the elimination of matching funds that are used to support In-Home Supportive Services, and the loss of $90 million from the Prevention and Public Health Fund.

It also draws attention to the decrease in the number of uninsured residents in the state, which has dropped to 7.1 percent since the enactment of the Affordable Care Act, commonly referred to as "Obamacare."

The letter also references an analysis of the AHCA authored by the Congressional Budget Office, which estimated that, in the next 10 years, the AHCA would cut federal contributions to Medicaid by $880 billion and that 24 million more people would be uninsured. Finally, it also references a proposed amendment that would allow insurers to drop maternity care, substance abuse care and prescription drugs from plans they sell.

Siskiyou County Health and Human Services Director Stacey Cryer was present at Tuesday's meeting to inform the board on how the letter came to be.

Cryer is also a participating member of the Siskiyou County Healthcare Collaborative -- which is composed of healthcare professionals and agency personnel from around the county -- and she noted that it was the SCHC, along with the California State Association of Counties, that had first suggested sending a letter of opposition.

District 3 Supervisor Michael Kobseff opened the discussion at the board level by asking what the relevance of the letter would be, given that the AHCA had already passed out of the House and is currently before the Senate.

He added that, even if the bill comes back to the House due to changes made by the Senate, some of the concerns listed in the letter may have already been addressed.

Cryer stated that the prevailing thought is that making the concerns known to California representatives in both the House and Senate could reduce negative impacts.

District 4 Supervisor Lisa Nixon, who has attended a number of SCHC meetings, noted that, given an opportunity to vote on the letter, she would vote in favor of protecting the people of the county even if the vote would not be strictly along the lines of her personal beliefs.

Specifically, she called attention to the significant loss of revenue and jobs that could come about if the AHCA were to pass in its current form.

Both supervisors Ray Haupt and Brandon Criss also voiced concerns about the letter, with Haupt stressing that he did not like the first paragraph and its statement that the county opposes the entire AHCA. He said that his concern stemmed from the fact that he believes the bill makes some good changes to the healthcare system, and he would not be comfortable opposing everything -- good or bad.

Criss' concerns echoed Haupt, and he noted that he would be reticent to appear to take sides on what is an ongoing, highly partisan issue. He suggested departing from the form letter and making the letter more specific to impacts to Siskiyou County, although he stated that he also struggled with asking Cryer to take the time to draft an entirely new letter.

Jill Phillips, facilitator with the SCHC, noted that the concerns about the AHCA are not partisan, but actual predictions of what its provisions would mean.

Ultimately, the board asked Cryer to return with a different letter highlighting impacts specific to Siskiyou County, and possibly address some of the changes both to the AHCA and provisions of the ACA as well.

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