The U.S. Senate should tread carefully this week when it convenes to consider the Better Care Reconciliation Act.
Serious questions have been raised about how the act, or the House version, called the American Health Care Act, will affect Kansas and the rest of the country.
Both pieces of legislation are meant to replace the Affordable Care Act, also known as Obamacare.
Let us make this clear: The fact that we raise concerns about the House and Senate plans should not be considered an endorsement of the Affordable Care Act. We were never fans of the way that legislation was developed and rammed through Congress in partisan fashion. And there are other downsides, including increased costs for businesses.
But there are upsides to the Affordable Care Act, which should not be ignored or cast aside. The main benefit is that more people have health insurance and, therefore, have access to medical care. States that chose to expand Medicaid under provisions of the Affordable Care Act have seen an even greater benefit from this, as have their hospitals and other healthcare providers.
Without a doubt, there is room for improvement to the Affordable Care Act. But Congress should avoid doing harm to people and the healthcare industry with any changes it makes. And it should avoid a straight-up repeal of the Affordable Care Act without a better replacement. That would be irresponsible.
Kansas Sens. Jerry Moran and Pat Roberts were split on the last version of the Senate’s Better Care Reconciliation Act.
Roberts said the bill “protects the very sick, seniors and young people” and is “the best possible bill under very difficult circumstances.”
After a vote on the bill was delayed, Moran said he would have voted against it, saying it “missed the mark for Kansans.”
The Urban Institute has estimated that 120,000 Kansas residents would lose health coverage under the Senate bill and that the state would lose $1 billion in Medicaid funding under the House bill over 10 years, with higher losses over the long term under the Senate plan.
Kansas has already foregone as estimated $2 billion in money for Medicaid expansion, an option that would be eliminated under the House and Senate bills. Money that could be coming to Kansas would instead fund Medicaid in states that chose to expand the program.
The Kaiser Family Foundation has estimated monthly premiums for the silver plan would increase by 82 percent in Kansas, after financial assistance, under the Senate plan.
Medicaid cuts under the bills are expected to have a disproportionate effect on rural areas of Kansas, where studies have shown a higher percentage of children are covered by KanCare, the state’s version of Medicaid, and where small hospitals are in more precarious financial positions. The cuts would mean hospitals would see more uninsured patients, meaning they would provide more services for which they are not paid.
Economic factors should also be considered. The Commonwealth Fund estimated that the House bill would cause 5,300 job losses along with a $500 million loss to the gross state product over the next 10 years.
We commend Moran for raising concerns that could make him unpopular, if not a target, within his own Republican Party.
We encourage Moran, Roberts and all senators to make a decision based on what is good for the health of their constituents and our economy, not a decision based on politics.