The U.S. Senate is set to begin its review of the health care overhaul bill that narrowly passed the House last week.
The American Health Care Act attempts to repeal and replace the Affordable Care Act, also known as Obamacare. The legislation is expected to undergo significant changes in the Senate, but there are concerns about what impact the bill as its written now would have on efforts in New Hampshire to combat the opioid epidemic.
New Hampshire Senator Jeanne Shaheen joined NHPR’s Morning Edition to talk about that issue.
When it comes to addressing the drug crisis here in the state, what do you see as the impact of this bill, as passed by the House last week?
I think it’s important to point out we’re still trying to figure out what the bill actually means because it was passed without any independent analysis and without any cost estimates for what the cost of the bill would be or what the impact on those who currently have health care under the Affordable Care Act, what the impact on those folks would be. So we’re still trying to figure some of those things out. But as I understand the bill, it would dramatically reduce the amount of money that goes to Medicaid. As most people in New Hampshire know, it was the expansion of Medicaid that has been so helpful in providing treatment for people who are dealing with substance use disorders. And so the fact that it would dramatically impact Medicaid and that treatment people are getting means here in New Hampshire, we will have tens of thousands of people who don’t have another option, and most of those people don’t, will lose their treatment for substance use disorder. So it will have a very significant impact on people dealing with substance use disorders.
Lawmakers on both sides of the aisle here in the state say they’re concerned about the future of New Hampshire’s Medicaid expansion program, which was part of Obamacare. The bill passed by the House makes significant cuts to that program. How key will that aspect of the law be as the Senate works on its own version of the bill?
It’s really too soon to tell. We know that Majority Leader Mitch McConnell has appointed some Senators to take the legislation and look at it and see what they might offer in the Senate. I was disappointed there are no women as part of that group because a significant impact of health care is on women. Women got substantial rights as part of the Affordable Care Act. We’re no longer able to be treated as a pre-existing condition as a woman. Under the Affordable Care Act, there is coverage for contraceptive, and all of that is at risk with this new proposed legislation that came out of the House.
And there’s of course been a lot of angst about pre-existing conditions as part of the debate over this bill.
It’s not clear how the pre-existing condition piece would work. As I understand it, it would be left up to the states and they would be able to set up high-risk pools for those with pre-existing conditions, but what we know from our experience in New Hampshire and in other states that those high-risk pools have not worked very well. They have very high deductibles and people are not able to stay in them because they can’t afford the cost. So the fact that we’ve got over 600,000 people in New Hampshire who have some kind of pre-existing condition, that they might not be able to keep their health care is just unconscionable. I’ve heard one person say, ‘Well, they haven’t led a healthy lifestyle, so they should have to pay for that unhealthy lifestyle.’ Well, the reality is most people with pre-existing conditions didn’t choose those pre-existing conditions. I was at an event Saturday night sponsored by the Juvenile Diabetes Research Foundation to support Type 1 diabetes. No one with Type 1 diabetes asks for that condition; they were all born with the predisposition that comes along sometime in their lifetime and has nothing to do with how much exercise, what they have to eat, just as most chronic conditions don’t. So to suggest that people with pre-existing conditions deserve to pay more for their health care…I just don’t understand it. I don’t understand how people can be so unfeeling towards those people who really need health care.
Over the weekend, Senate Leader Mitch McConnell said he doesn’t expect any help from Democrats in trying to pass this bill. What do you say to that? Are Democrats willing to work with Republicans on this?
What I’ve been saying for years now is we need to work together to address what needs to be fixed in the Affordable Care Act. We all understood when we passed it for any change that major, it would require addressing fixes along the way, just as when we passed Social Security, Medicare, and Medicaid. There were changes made to those programs over years. But what we’ve seen unfortunately from our colleagues on the other side of the aisle is that they have not been willing to try and fix it; all they’ve wanted to do is repeal it. What we know from the original plan – and this one the House is proposing now doesn’t seem much better – is that over the next 10 years, 24 million people would lose access to their health care. Wouldn’t it make so much more sense for us to work together on a plan we could all support? It’s disappointing to see that there is a deliberate effort on the part of this administration and Secretary of Health and Human Services Tom Price to undercut the Affordable Care Act. And Price is going to be in New Hampshire on Wednesday. I would urge people to go to that event, to let him know what the concerns are, to let the governor know, who seems to think this plan is fine despite the impact it would have on Medicaid and those with substance use disorders, as well as those with pre-existing conditions.
Republicans say they’re ready to pass this bill with a simple majority, so how do Democrats ensure they do get a voice in helping to craft whatever ends up being in the finished version?
I don’t think the procedural roadmap is clear yet. There are some requirements around what they have to do when they’re trying to do the process that they’re using because they’re not allowed to add to the deficit after 10 years. Because we don’t have the cost for this bill, we don’t know what it would mean for the deficit.