Nearly 200 people attended a town hall on health care Sunday morning in Plymouth, hoping to receive answers on how their care would change under the Better Care Reconciliation Act, the GOP plan to repeal and replace the Obama administration's Affordable Care Act currently making its way through the Senate.
The town hall was hosted by the 11th Congressional District's chapter of Indivisible, a progressive activist group formed in response to the Trump administration. Fielding questions were Rep. Dan Kildee (D–Mich.), state Rep. Christine Greig (D–Farmington Hills) and Charles Gaba, an expert on health care who runs the website ACAsignups.net, which provides data on national health care.
The version of the GOP bill that passed the House of Representatives in May was projected by the nonpartisan Congressional Budget Office to kick 14 million people off health insurance by next year and 23 million by 2026, which Kildee called a tragedy at the beginning of the town hall.
"It's a tragedy of human dimensions that is almost impossible to contemplate," he said.
Throughout the town hall, Kildee stressed that the impact of the BCRA would not be limited to just the tens of millions who would become uninsured because of it. Like it or not, Kildee said "we all pay for one another's health care."
"The loss of access to preventive care simply means that as those individuals ultimately access the health care system, they will do it at a point in time when they are far more sick, when the cost will be a higher cost for a more serious disease and very likely will result in care that is not compensated," he said. "So what happens? All the costs that are not compensated are shifted. Shifted to people who have health insurance, or ultimately shifted to the biggest insurer, the United States government, through Medicare."
Under the BCRA, Medicare — the single-payer health insurance system managed by the federal government, benefitting U.S. citizens over the age of 65 — will become insolvent, Kildee said.
In addition to the problems it would cause for those on Medicare, the bill, which puts a prohibition on funding for Planned Parenthood, would also severely reduce care for women, Greig and Kildee pointed out.
"Whether we like it or not — and I don't — the Hyde Amendment is still in effect that prevents federal dollars from being used for abortion services," Kildee said. "But because Planned Parenthood provides a legal right to women to access those services and also provides other services, the 12 men in the senate who are making the decision about what this bill says have decided that women should not have that right. And that's pathetic."
And though the Hyde Amendment bans federal funding of abortion services, as Kildee pointed out, abortion should be treated and funded as health care, Greig said.
"Abortion is health care,” she said. “We can't shy away from it. We are at the lowest levels of unintended pregnancies right now, the lowest levels of STDs, teen pregnancies. And a lot of that has to do with the services provided by Planned Parenthood."
Kildee characterized the defunding of Planned Parenthood as governmental overreach by Republicans, calling them hypocrites.
"We have to make sure that we're clear on what this is," he said. "Remember that whole 'if you like your doctor, you can keep your doctor,' and what they said about Obama when there were problems with that? They're actually saying that you can only go to the health care provider that they approve of."
Gaba, whose website tracks data on the Affordable Care Act, explained some of the important changes that would take effect upon passage of the BCRA.
"Under the ACA, insurance companies for all plans guaranteed issue. 'Guaranteed issue' means they have to sell a policy to you," he said. "And that's really important, because before the ACA, if you had a pre-existing condition, like, say, being pregnant, or having cancer, pretty much whatever the insurance company defined as a pre-existing condition, they could say 'nah, we're not going to sign you up.' "
But according to Gaba, one of the most important aspects of the BCRA was not what it would do to Obamacare, but what it would do to Medicaid, the government-sponsored insurance program for low-resource individuals and families. According to the CBO report on the BCRA, Medicaid spending would decrease by $772 billion over the next ten years.
"The Medicaid impact is actually the larger story here," Gaba said. "Around 75 million Americans are on Medicaid. The Senate bill not only repeals the expansion of Medicaid, but it also decimates standard Medicaid that has nothing to do with the ACA. This was supposed to be about repealing Obamacare, it was not supposed to decimate Medicaid as well."
In response to an audience member's question about Democratic Party messaging, which the audience member said wasn't bold enough and focused only on opposing Republicans, Kildee and Greig both said their long-term vision for health care was to have universal coverage.
"I think we all have to acknowledge that in the last decade or so — even less than that — as a society, as a nation, we've made some progress on this question," Kildee said. "Clearly, the passage of the ACA is a massive step forward. That's not what I'm talking about. Just listen to the debate now as compared to the debate that took place under a decade ago. There's an acknowledgement across much of the political spectrum that we have to get to universal coverage and that the federal government has to guarantee this right."
And coverage should not be dependent on your employment status, Greig said.
"Back in the day, I used to put in payroll HR benefit systems for corporations, and I used to have to plug in the new charges every year for the plans so they could take the payroll deductions and all that, and I remember back then, just thinking 'that is just nuts that we tie employment and health benefits together,' " she said. "We've gotta rethink this, and make sure that we have universal coverage and it's not forced to be tied with employment."
Bob McCreevey, an audience member from Oakland County, said he had given his testimony on the pain he had been caused by privatization of health services at five different town halls, as well as before a committee in the state legislature. His son, who suffers from paranoid schizophrenia, had been in a support program for 12 years that kept him in a stable condition "beyond all belief," McCreevey said. After the government voted to privatize the program, he said the annual cost of caring for his son increased from about $1,800 to $180,000. Testifying before the House committee, he said, he lost his faith in government.
"It's different when you hear it on the news," he said. "When you sit in that room over there, on the third floor of the Capitol, and you watch 20 Republicans, and it's like pulling the strings on a Howdy-Doody: 'yes, yes, yes, yes, yes.' It's disgusting. This is no longer America that I know. When we don't take care of 'of, by, and for the people,' and the only thing we care about is the half of one percent that are running this country in a broken government."