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AHCA must not gut Michigan Medicaid

• Jun 26, 2017 at 3:00 PM

The following editorial was published in the Traverse City Record-Eagle on June 18:

Lawmakers must take a cue from their counterparts in the medical world and "do no harm" as they tinker with health insurance reform.

There's no denying the Affordable Care Act has begun to show some substantial flaws — since its inception the well-meaning system of health insurance exchanges has spiraled in some areas from a marketplace to a monopoly. And the landmark law fell victim to special interest pressures, failing to install common-sense market reforms like cross-state competition and standardized forms.

But the ACA did accomplish several needed changes like requiring insurers to cover people with pre-existing conditions, expanding Medicaid coverage to many low-income working Americans and allowing children to continue on their parents' health insurance until age 26.

So, it's a bit dismaying to hear rhetoric from Washington built on absolutes when it comes to the ACA: One side seems dead-set on dismantling the law, throwing the baby out with the bathwater while some on the other side seem to believe what we have now is infallible.

Both sides need a bit of a reality check, maybe step away from the swirl of political chest thumping in Washington, D.C., and take stock in what position might best serve their constituents, not special interests.

They must commit to "do no harm" as they monkey with the second reworking of our health insurance system in a decade.

And they won't have to look far to find potential harm in the Grand Traverse region.

Thousands of northern Michiganders — working people who don't earn enough to afford private health insurance — received coverage under a Medicaid expansion ushered in by the ACA. Health policy experts, Gov. Rick Snyder and officials from Munson Medical Center all have railed against the slash to Medicaid funding included in the version of the American Health Care Act recently passed by the House. They all contend the shift — a move to a fixed payout to states to provide Medicaid to their low-income residents — would gut the expanded coverage in states like Michigan and toss many working-class citizens off of insurance coverage.

It's a change that could impact 140,000 people in Munson's 24-county coverage area in northern Michigan. That includes the 50 percent of children in the region who receive Medicaid coverage.

That expanded coverage wasn't just a handout, either. The program drastically reduced the number of people who racked up steep emergency room bills without a way to pay for care, piling bad debt on hospitals that are required to provide emergency treatment. It wasn't a complete remedy, but the move certainly allowed many to receive non-emergency treatment and sent at least partial payment to providers who otherwise would often receive no reimbursement for care.

It's an impact rendered from the ACA that is widely accepted by lawmakers on both sides of the aisle in Michigan as positive.

That's why it was so dismaying to see northern Michigan's Rep. Jack Bergman join his colleagues in the House in supporting the AHCA in the form it passed to the Senate. Now, Republican senators work behind closed doors to hammer out the version of the AHCA they hope to pass in the near future.

It's a version we all should hope sets aside the soap box rhetoric and commits to "do no harm."

TRAVERSE CITY RECORD-EAGLE (AP)

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