Republicans in the U.S. Senate have spent more than two months now trying to improve upon the abysmal health care bill passed by the House. I’m a Republican, so I am dismayed to learn that they don’t have much to show for the effort, at least according to the latest Congressional Budget Office assessment of their new legislation. The bottom line is that by 2026, the Senate’s Better Care Reconciliation Act (BCRA) still leaves an estimated 49 million people uninsured, compared with 28 million who would lack insurance under current law.
That just won’t do. As a veteran, I use the Veterans Administration (VA) health care system, which has certainly endured its own share of problems. But I am concerned for my fellow veterans on Medicaid; you may be surprised to hear that 1.75 million veterans — nearly 1 in 10 — get their health care through that program, including 3,700 here in Alaska. The BCRA would put a cap on federal Medicaid reimbursement for states, effectively cutting $772 billion over 10 years. We simply cannot make deep budget cuts like that in a program that is already woefully under-funded.
How might states compensate for these cuts? Possibly by covering even fewer people, including some veterans, or slashing benefits.
Another option would be to shortchange providers — but isn’t it unreasonable to expect them to care for much greater numbers of uninsured while also asking them to do so with fewer of the resources they need? The hospital and health system payment reductions that were used to fund coverage expansion under Obamacare must be restored in that case, not cut further. With Alaska’s large rural areas in mind, access issues are already a big enough challenge without undermining our community hospitals.
The Senate bill also permits waivers allowing insurers to avoid covering a list of services, such as maternity and mental health care. That may not seem like a big deal, but consider that more than half of the births in Alaska are financed by Medicaid. And the latter issue is a particularly sensitive one for veterans because so many suffer with PTSD and other mental health problems.
We must also protect those with pre-existing conditions and guarantee that they can afford meaningful coverage to get the care they need. We must provide for our most vulnerable populations such as seniors and low-income families. Any health care bill that fails to do so should be dead on arrival.
For her part, our own U.S. Sen. Lisa Murkowski, R-Alaska, has expressed misgivings to her GOP colleagues and is taking a careful “wait and see” approach to the Senate bill. She should be applauded for putting country ahead of party. I know she is getting a great deal of pressure from her party leaders right now.
I suppose I am most alarmed by the latest discussion of repealing the Affordable Care Act without simultaneously replacing it. Kicking the can down the road isn’t going to change the realities of the number of our citizens we need to care for and how much it will cost to do it.
Again, while I am concerned for all Alaskans who need coverage, I am particularly moved by our veterans’ needs, and I believe the Senate bill does not do right by them. While serving in the Army, I was deployed as a broadcast journalist and public affairs specialist to Kuwait and Honduras. I saw firsthand the devastating impact of war on our brave men and women in uniform. We fought for a country that takes care of its own, from the strongest and healthiest to those with the worst problems. As it is currently written, the BRCA does not honor the sacrifices we made. Fortunately, I believe Sen. Murkowski will keep fighting for Alaska.
• Stephanie Haydn is a U.S. Army veteran who lives in Interior Alaska. While serving in the Army, Stephanie deployed as a Broadcast Journalist and Public Affairs Specialist to Kuwait and Honduras, and finished her military service at Ft. Greely, Alaska, where she found her forever home. Stephanie has served on several nonprofit boards and advocated as a volunteer for more than 18 years.