GUEST COLUMN by Tim Heberlein
Hurricane Irma may be over, but Florida’s families will face the storm’s aftermath for months to come. Those with the greatest barriers and least resources before the storm will face the greatest hardships in recovery, especially low-income women and families who have suffered injury, lost wages, and displacement.
At a time when politicians should be focused on helping vulnerable Florida and Texas who, in many cases, have lost everything because of the storm, Republicans have instead renewed efforts to dismantle healthcare by repealing the ACA and making radical changes to Medicaid that would hurt residents of these states and hurricane victims for many years to come.
The Graham-Cassidy repeal proposal that Republicans will try to jam through Congress by September 30th includes the same terrible cuts that the public and elected representatives have already repeatedly rejected. The bill would end tax credits under the Affordable Care Act (ACA) that help millions of Americans afford coverage including over 1.3 million Floridians and would cut Medicaid expansion funding with a block grant that ends Medicaid by 2026, virtually guaranteeing that the uninsured Floridians will never get coverage under Medicaid. The proposal would strip more than $2 million from Florida’s budget by 2026, shifting the cost of healthcare for increasing numbers of uninsured to the state.
Like previous versions, this legislation disproportionately hurts Florida women. It allows states to waive Essential Health Benefits like maternity, neo-natal care, pregnancy, and mental health services, among others. That means insurance companies could go back to imposing annual or lifetime caps on coverage and charging people with pre-existing conditions more for services, putting healthcare out of reach for millions. Moreover, the bill prohibits states from funding Planned Parenthood, a key source of healthcare for hundreds of thousands of women in Florida who depend on it for contraception, family planning, and preventive health services.
But the impact won’t stop there because the bill also converts the traditional Medicaid program into a per capita cap system, impacting many more families beyond those who receive ACA coverage including seniors, children, babies and people with disabilities. Over 4 million Floridians depend on Medicaid, over half a million seniors, a half million people with disabilities, and more than 1.7 million children. Medicaid is the largest payer of family planning services in Florida and also pays for nearly half the births in our state. Under a per capita cap system, federal funding for healthcare would shrink over time even as the state’s population ages and the need for services increases.
The Graham-Cassidy proposal’s restructuring of Medicaid would severely impede emergency response efforts during a crisis like the one we face now created by natural disaster. Medicaid plays an essential role in responding to emergencies, public health disasters, and similar crisis because of its current federal financing structure which is designed to respond to increased state spending on Medicaid. When states face an epidemic like Zika or opioid addiction, natural disasters like hurricanes or tornados or even national security crisis like the 9/11 attacks and expand Medicaid to address the crisis, the federal Medicaid program automatically increases funding to match the state spending based on its current open-ended formula. The proposed cap on funding would end this feature of Medicaid, preventing Medicaid from expanding at key moments when states struggling with a crisis need it most.
Health and Human Services Secretary Tom Price declared a public health emergency in Florida when Hurricane Irma hit the peninsula earlier this month. The Graham-Cassidy proposal signals a new health emergency for Floridians already struggling with recovery. If passed, this bill could create a permanent crisis for Florida, particularly women and families who are already facing tremendous barriers to healthcare and economic security in the state.
Senators Nelson and Rubio must reject this proposal to protect Floridians now and in the future from intense harm that will result from the loss of healthcare and economic security for every generation in our state. Florida has suffered enough: it’s time to move toward healing and recovery and leave repeal behind.
Tim Heberlein is the Tampa Bay Director for Organize Florida