A vote to repeal and replace the Affordable Care Act (“Obamacare”) had been expected to take place in the Senate this week but has been delayed by to give Sen. John McCain (R-Ariz.) time to recover from blood clot surgery.
“This proposal would affect not just the expansion of Medicaid in New Hampshire but also entitlements that concern kids, people with disabilities and those who receive nursing home care,” Shaheen told Memorial Hospital CEO and President Scott McKinnon at a roundtable discussion at the North Conway hospital.
They were joined by OB-GYN Dr. Marni Madnick; Kris Dascoulias, director of Memorial’s Family Birthing Center; Lawrence Carbonaro, Memorial’s practice director for women’s health; Abigail Kelly, Memorial case manager; Patricia McMurray, White Mountain Community Health Center executive director, and Laura Jawitz, president of the Memorial Hospital board of trustees.
During her visit to North Conway, Shaheen got an overview of Memorial Hospital’s “A New Life” program founded a year and a half ago to help pregnant women with substance abuse issues. The program provides weekly support during pregnancy and for a period after the baby is born.
Health-care professionals say the prenatal period offers a unique window to motivate opioid-dependent women to seek treatment. Fifteen women have gone through the program to date, with 11 currently enrolled, according to RN/Educator Leigh Copsey.
All were funded through Medicaid, the federal-state health insurance program for low-income people.
Proposed cuts in Medicaid would affect that care and other opioid and substance abuse programs, Shaheen said.
The government is proposing a $45 billion increase in substance abuse programs, Shaheen said, “but people should know they are also talking about $300 million cuts in Medicaid.
“It doesn’t help if they put it in one place but take it away from the programs, and it is important for us to remind people of that sleight of hand,” the senator said.
In a press release issued by her office, she noted that the Republican repeal bill would drive up premium costs, eliminate protections for pre-existing conditions, leave millions of working families without coverage and undermine efforts in New Hampshire to combat the opioid epidemic.
“This legislation still decimates Medicaid,” she said. “The additional funding in this bill for the opioid epidemic doesn’t come close to compensating for the treatment resources that this same bill eliminates.
McKinnon said hospital and insurer groups have spoken out against the bill, particularly the Medicaid cuts.
“I am aligned with the position that both our senators have taken (in opposing the bill),” said McKinnon. “In addition, I do work through the New Hampshire Hospital Association, which has done a significant amount of advocacy with legislators at the state and federal level. This is an extremely important time concerning health care. “
Shaheen also said Republican Gov. Chris Sununu also expressed concerns about the bill’s cuts to Medicaid.
“Gov. Sununu has been very helpful in coming out against the legislation,” said Shaheen, “but people need to continue their activism as this has been on a very fast course, and they (the Republican leaders) are trying to get this done very quickly.
“On the Senate floor (Thursday), I said if this is such a great proposal, why not have a hearing? Why has it all been behind closed doors? Why not let the American people have a say?”
She said Democrats knew when the Affordable Care Act was passed that it had problems.
“It wasn’t perfect, no,” she said. “We knew we would need to make changes because any time you pass a program that big, there always needs to be changes ... so, why not work together to improve it?”
She said she has introduced legislation to help take “some of the uncertainty out of the insurance marketplace” and its impact on insurance providers in New Hampshire and the rest of the country.
She said Medicaid cutbacks on nursing homes in the Granite State would be serious; in fact, “63 percent of nursing home residents in New Hampshire are covered by Medicaid. Some nursing homes would have to close, or people who won’t be covered will either have to have their families pay for them or they will have to go somewhere else,” said Shaheen.
McKinnon said the proposed Medicaid cuts under the Republican-backed Senate bill would have devastating impacts for small rural hospitals such as Memorial.
He said under the ACA, the percentage of uninsured patients receiving care in the hospital’s emergency room has dropped from 18 percent two or three years ago to 12 percent.
“Because of the legislation, people who didn’t have coverage now do,” McKinnon said, “so i(Medicaid expansion under the ACA) has been a really important piece of legislation.”
At the end of the meeting, Shaheen praised the health-care providers for their innovative approach to dealing with the opioid crisis. She said New Hampshire is proving to be a leader in dealing with the challenges of the crisis.