GOP “Plows Forward” with Health Care Lawsuit Amid Public Health Crisis, Continues Blocking Life-Saving Medicaid Expansion

New reports over the past week have detailed how GOP health care policies are already undermining the nation’s public health response to the coronavirus crisis: moving forward with their toxic lawsuit to overturn the entire Affordable Care Act and end protections for people with pre-existing conditions, and refusing to expand Medicaid in 14 states. 

Washington Republicans have continued to double down on their legal strategy, with President Trump confirming this month that the GOP still wants to “terminate” the health care law as they plow ahead with their Supreme Court lawsuit even in the midst of a public health crisis. At the same time, Republican opposition in Alabama, Georgia, Kansas, North Carolina, South Carolina, and Texas has prevented full Medicaid expansion under the ACA and rejected billions of dollars in federal money to expand coverage — denying health care to millions and now putting coronavirus treatment out of reach for people who need it.

Senate Republicans share responsibility for this agenda after voting repeatedly in Washington to gut Medicaid expansion funding and pre-existing conditions protections, and setting the GOP health care lawsuit in motion with their support for the 2017 corporate tax giveaway. Not one Republican senator has taken meaningful steps to stop their party’s anti-ACA lawsuit.

IN CASE YOU MISSED IT

The Daily Beast: GOP Plows Forward on Plans to Kill Obamacare, Pandemic Be Damned

By Sam Brodey

March 30, 2020

Key Points:

• The worsening coronavirus outbreak may be stretching the limits of the U.S. health care system and overwhelming state governments, but that isn’t deterring a group of 18 state attorneys general from plowing ahead with a lawsuit that could overturn the Affordable Care Act within a year—a move that could disrupt the health care system at a time of deep crisis. 

• Their determination to kill the law, no matter the circumstances, mirrors President Trump’s. Asked at a press conference last week whether the virus had changed his plans to press ahead in court, Trump affirmed that “what we want to do is terminate it.” 

• If the Trump administration and these states succeed in repealing the ACA, the impact on the country’s public health system would be immense, pandemic or not. That the decision could come early next year—at the tail end or recovery stage of a devastating outbreak—gives it a seismic significance for the 20 million Americans covered by the law, the 84 million who are uninsured or under-insured, and the insurers, hospitals, and governments that have adapted to Obamacare over the course of a decade.

• While Congress has passed legislation to provide free coronavirus testing to everyone, health insurance to cover related treatments and other ailments is another matter. Last week, an uninsured Boston woman who contracted COVID-19 and went to the hospital was sent a bill for $35,000. On Wednesday, the mayor of Lancaster, California, confirmed that a 17-year old boy died from COVID-19 after a local hospital turned him away for treatment because he didn’t have insurance. 

• Unless legislators step in with a ready-made replacement for Obamacare—which is unlikely—at least 20 million Americans would lose their coverage if the Supreme Court strikes it down.

• “The only thing worse than a public health pandemic is a public health pandemic without health care,” said Jesse Ferguson, a Democratic strategist. “It’s hard to imagine their sales pitch for a lawsuit that takes away health care for 20 million Americans as we face a pandemic. It’s like watching the Chernobyl disaster and deciding to bulldoze the fallout shelters.”

• After hearing arguments this fall, the Supreme Court could render a ruling in the case as early as spring of 2021. It’s unclear how long the coronavirus public health emergency will last, but it’s widely accepted that the U.S. will be dealing with its fallout for months, if not years, after it tapers off. 

• Tara Straw, a health care analyst at the left-leaning Center for Budget and Policy Priorities who has studied the Texas case, said that pressing ahead with efforts to overturn the ACA right now is “unconscionable.” She predicted the decision could have far-reaching consequences: if the coronavirus outbreak spurs a long period of high unemployment, for example, far more than 20 million people could lose coverage if the ACA is struck down. 

• That could also shift heavy cost burdens to state governments that are facing long-term financial stress because of the crisis, and hurt broader recovery if people are directing more of their income to medical care. “Talk about compounding a crisis,” said Straw.

NBC News: Coronavirus challenges states that rejected Medicaid expansion, leaves uninsured with few options

“This outbreak is going to bring to light and highlight really strongly the types of disparities and the gaps in our health care system that leave people vulnerable,” one expert said.

By Phil McCausland

March 26, 2020

• Now doctors and clinics who treat these patients are sounding the alarm that the nation’s working poor may be forced to make a difficult calculus if they test positive for the disease that is sweeping across the United States.

• Advocates argue that expanding Medicaid, or loosening enrollment rules, amid the outbreak would encourage the working poor to receive necessary care, help reimburse medical centers and alleviate medical debt that patients would accumulate.

• The debate over the coverage gap in the United States is particularly stark in the 14 states — including North Carolina — that didn’t expand Medicaid under the Affordable Care Act.

• The decision to forgo an increase in state Medicaid programs… has left nearly 5 million people across the country without access to health care coverage and meant states turned down billions of federal dollars that would have come with the expansion.

• In North Carolina, expansion would have allowed the state to provide coverage to more than 194,000 members of the working poor who earn too much money to qualify for Medicaid but too little to purchase their own insurance plans. The state legislature balked at having to foot 10 percent of the fund by 2020, which means North Carolina also could not receive an estimated $40 billion worth of federal funds since 2014.

• “This outbreak is going to bring to light and highlight really strongly the types of disparities and the gaps in our health care system that leave people vulnerable,” said Jennifer Tolbert, the director of state health reform at the Kaiser Family Foundation, a nonprofit that researches health care issues.

• Having patients with medical coverage through a program like Medicaid would expand their ability to treat patients by receiving reimbursement for care, [Dr. Meredith Niess, the medical director of Charlotte Community Health Clinic in North Carolina] said, and it wouldn’t cause the spread of the coronavirus to seem quite as existential for them.

• That’s not only the case for clinics. For the uninsured individuals like Wingard, if the American health care system doesn’t change, it could also mean the end — financially or otherwise — of their own futures. “If we do not come together some kind of way, there are going to be more fatalities,” Wingard said. “A lot more people are going to get infected, and this country is just going to fall apart.”

Kansas City Star: Kansas and Missouri didn’t expand Medicaid. Could that worsen the COVID-19 pandemic?

By Bryan Lowry, Jason Hancock & Jonathan Shorman

March 29, 2020

Key Points:

• As the single mother of a daughter with a congenital heart defect and compromised immune system, Melissa Dodge is taking every precaution she can to limit her exposure to COVID-19.

• She’s cut her hours at the grocery store where she works in Derby, Kansas. When she comes home, she doesn’t touch any of her four children before changing her clothes.

• Worries about illness aren’t new for Dodge, 35. She doesn’t have health insurance, and getting sick means having to calculate the risk of skipping a doctor’s visit versus paying out of pocket. The coronavirus pandemic has amplified those concerns.
• Dodge’s children, including her 9-year-old daughter with the heart condition and 11-year-old son with autism, are covered by Medicaid, the federal-state program which provides health care for disabled and low-income families.

• But Dodge is caught in the triple bind that ensnares thousands of working poor in Kansas and Missouri. She makes too much from her part-time customer service job at the grocery store to qualify for Medicaid herself. She makes too little to buy insurance through the federal health care exchange, and she works too few hours to receive benefits from her employer.

• Dodge is one of roughly 130,000 Kansans and 200,000 Missourians who would be covered by Medicaid if their states had expanded eligibility under the Affordable Care Act. The change would cover adults who make up to 138% of the federal poverty line — an income of a little more than $17,600 for a single adult, or $42,300 for a family of five like Dodge’s.

• The decision to pass up billions in federal aid since 2014 will make coping with the novel coronavirus even more costly than anticipated, advocates contend. It could also put the insured at greater risk, as those without health coverage remain untreated and accelerate the spread of the virus.

• One of Kelly’s closest allies in the Legislature, state Sen. Barbara Bollier, a retired Mission Hills physician, said one of her biggest concerns is that people who develop symptoms may wait longer to consult a doctor, exposing others to the virus if they don’t self-quarantine. “A virus doesn’t check to see if you have insurance first,” said Bollier, a Johnson County Democrat running for U.S. Senate.

• David Larson, a 56-year-old Wichita resident… who has clinical depression, said he’s secluding himself to avoid catching the virus. But if he does contract it, he’s unsure of how he’ll pay for treatment. “A lot of us are just going to suffer,” he said.

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