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Divided House Republicans Put Obamacare Overhaul on the Ropes

Vancouver’s Republican Rep. Jaime Herrera Beutler has come out against the American Health Care Act, citing negative impacts on Medicaid services to disabled children. A vote on the bill was postponed on Thursday as Republicans lacked enough support for passage.
March 24, 2017

House Speaker Paul Ryan’s healthcare overhaul has hit a jam in Congress, as he appears unable to craft an Obamacare repeal that will please both conservative hardliners and more moderate Republicans whose House seats could be at risk in the 2018 midterm elections.

A key defector is Vancouver’s congresswoman, Rep. Jaime Herrera Beutler, who joined a group of more moderate Republicans opposed to the deep cuts to Medicaid along with tax breaks for the wealthy that have been made at the expense of working-class and middle-class people struggling to afford healthcare.

Herrera Beutler specifically called out Medicaid cuts to services that intellectually and developmentally disabled children depend upon:

“I’m disappointed that it appears my amendment to strengthen the Medicaid safety net for the kids who depend on it for their healthcare will not be considered,” she wrote in a press release. “Protecting vulnerable children is a core purpose of the Medicaid program and when the program fails to do so, it fails entirely. I will not vote to let those kids fall through the cracks.”

Washington, like Oregon and California, adopted components of the K Plan from the Affordable Care Act, which increased funding to home- and community-based services to elderly and disabled people, including children. States that expanded services may be punished more severely than other states, since they would be faced with putting in more money or rolling back services if the federal government stopped increasing funds as costs went up.

“We may have to go back to the days when only kids in crisis get help,” said Lilia Teninty, the director of the Developmental Disabilities Division at the Oregon Department of Human Services.

A proposal in the Republican health bill would cap growth at about 4.5 percent, but a tight labor market has been driving up costs to programs for intellectually and developmentally disabled children at a much higher rate than that. Oregon has already struggled to get costs under control, and would likely have to close the door to the program for all but the most critical cases, Teninty said.

Rep. Suzanne Bonamici, a Democrat representing west Portland and northwest Oregon, said in a conference call from Washington, D.C., on Thursday that other House Republican moderates had been concerned about a demand from conservative hardliners that the so-called “essential health benefits” of the Affordable Care Act be stripped from federal health insurance law. She said these lawmakers were especially concerned about the loss of coverage for mental health services and substance abuse treatments.

A Quinnipiac Poll indicates that the Republicans’ American Health Care Act may be downright toxic with the general public, with just a 17 percent approval rating  and 56 percent disapproving. Just 6 percent strongly approve while 43 percent strongly disapprove.

Portland Mayor Ted Wheeler became incensed at a press conference earlier this month when asked about cuts to behavioral health services, which are desperately needed to help his city’s burgeoning homeless population, many of whom Obamacare made eligible for Medicaid, which the Republican healthcare bill curtails.

A nonpartisan Congressional Budget Office report said that 24 million people would lose health coverage under the Republican law in the next 10 years, as the law shifts from income-based subsidies to much less generous age-based tax credits.

One estimate showed healthcare premiums for a 64-year-old adult with an income of $26,500 rising from $1,700 to $14,600.

Rep. Peter DeFazio, D-Springfield, mocked Republicans who argued that their plan would create a freer market and more choice. “The choices are pretty grim: You go uninsured and risk your health and bankruptcy. Or you spend all your money on healthcare premiums and end up homeless. Some choice.”

In addition to Herrera Beutler, House Democrats are united in their opposition to Ryancare. Meanwhile, Eastern Washington’s two representatives, Rep. Dan Newhouse of Yakima and Rep. Cathy McMorris Rodgers of Spokane, are supporting the bill, along with Oregon Republican Rep. Greg Walden of Hood River.

Washington’s other Republican, Rep. Dave Reichert of the Seattle suburbs, voted for the American Health Care Act in committee earlier this month, but changes to the bill have left him undecided, according to the Seattle Times.

Chris can be reached at [email protected].

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