The last thing the people in the Caribbean, Florida and Southeast Texas needed this week was news of Maria, a hurricane headed up the same path as Irma, future path uncertain. The survivors are just beginning the rebuilding efforts that are going to take years, even with the amazing and inspiring ways in which thousands, if not millions, have joined them in acts of helping one another.
Most needed right now: a firm foundation on which they can begin to put their lives and communities back together, along with clarity about the help they can expect from insurers and government alike.
Then this past weekend along came news that the Republican Party was attempting to pass yet another repeal-and-replace bill for the perennially imperiled Affordable Care Act, this particular storm named the Graham-Cassidy Act after GOP Sens. Lindsey Graham and Bill Cassidy. It’s not even a repeal-and-replace. It’s mostly a “Blow the health-care house down” and “Good luck with reduced health-care options, higher premiums for any decent health-care plan and regrets about your pre-existing conditions” health-care bill, especially for people who live close to the margins and people on Medicaid. The difference is this storm is trying to slip in under the radar, even as it threatens our entire country.
What damage could Graham-Cassidy do?
- First, it removes the individual mandate and eliminates subsidies, throwing into chaos the individual market for people who are not insured through work or through Medicaid and other government programs. Insurers will not know how to plan.
- Second, it cuts back on the expansion of Medicaid to serve a growing population in this country. It does this by changing the system to a block-grant program to the states, supposedly in the name of “flexibility.” The truth is, states have had flexibility all along to design creative uses or “waivers” for the use of Medicaid funds in partnership with the federal government.
- Third, a per-capita cap in the future will lead to cuts in Medicaid services currently available. The mythology is that those reductions mean people who could be working will get back out there and get a job that pays health insurance. That is indeed fake news. Most of Medicaid helps pay for children and for long-term care, people with disabilities and seniors who need long-term support.
- Fourth, good luck searching for health insurance if you have pre-existing conditions and have to buy individual insurance in the future.
What does this mean for Texas, especially those impacted by Harvey and now trying to figure out how they’ll ever restore their lives amid all the rubble? In a state that already has the highest uninsured rate in the country, there are 750,000 people on Medicaid in the greater Houston area. Add an average of 300,000 non-elderly persons with pre-existing conditions per congressional district in all of Texas. Add uncertainty about how their individual and family health-insurance policies will be covered in the next five to 10 years, especially for the people rebuilding after Harvey. No amount of volunteer help will bring relief from that danger.
We will hear from the Weather Channel predictions for Maria. We might hear from the Congressional Budget Office some predictions for Graham-Cassidy. The sad irony is that a bipartisan group in Congress, along with a bipartisan group of governors and insurance commissioners, has been working on new plans to improve and strengthen what we now have — not to tear down and destroy.
Sens. Ted Cruz and John Cornyn of Texas frequently post dispatches about their efforts to help the survivors of Harvey — even, to their credit, getting down and dirty with actual cleanup. If they really want to help all of the victims of Harvey as well as citizens lacking health care across the rest of Texas, they should join that bipartisan effort. So should Congressman Bill Flores and other Texas members of the House. As should the whole country. It is inspiring to see people move beyond parties and work together to help people in need. If you agree, the way to volunteer now is to let them know. Otherwise, this particular storm’s devastation will endure for a long time.