Health system CEOs: Senate bill will not resolve healthcare challenges

When parents learn their daughter or son has diabetes, their first question generally is the same: Will my child be OK?

Then, as parents learn diabetes usually can be managed with a lifetime of blood monitoring, insulin shots and stringent diet management, their concerns shift to a longer-term question: Will we be able to afford the care needed to help our child remain healthy?

{mosads}The cost of care is an issue beyond diabetes, of course. Our five health systems provide care in communities serving 40 states and the District of Columbia, and we see many millions of families facing different health issues and the related concerns about costs.

Our healthcare system needs to be accessible and affordable for everyone in America, because illness can affect anyone. Most people will need healthcare at some point in their lifetime. In fact, half of all American adults suffer from at least one chronic health condition, such as diabetes. If care is not affordable, people will choose not to seek treatment and will suffer unnecessarily.

Fortunately, many families today have health insurance that covers the costs of their chronic illnesses — for now.

In the future, those families might be facing a drastically new reality. 

Last week and this week, Republican leaders in the Senate released a series of discussion drafts of the Better Care Reconciliation Act of 2017 (BCRA). BCRA would make major changes to the Medicaid program and to tax credits to purchase private insurance, significantly reducing the number of people who can access affordable coverage, particularly those who are most vulnerable. If a family receives Medicaid, it may no longer qualify in future years as the bill’s cap and cuts force states to reduce Medicaid coverage. If passed, BCRA will be catastrophic to working families across the United States.

BCRA may actually create new inequities and a new set of haves and have-nots in the United States. Millions of people will lose insurance through Medicaid if the bill becomes law, and even more will lose coverage in the private insurance market depending on income levels, insurance coverage, pre-existing conditions or even zip codes.

Under BCRA, coverage depends on where people live and how states choose to implement the law. If a family lives in a state that successfully implements one of the waivers allowed by BCRA, access to comprehensive benefits could be compromised or go away entirely.

How does the Senate bill compensate for this inequity? It provides $62 billion for states to help individuals pay premiums. That seems like a generous investment until it’s compared to the $138 billion that the House invested in a similar fund. It is clear that these numbers just don’t add up. The Congressional Budget Office has estimated that 22 million people in our nation will lose coverage over the next 10 years.

Many families covered by Medicaid today will lose coverage under BCRA. Medicaid today serves 74.6 million low-income and disabled Americans. It supports rural health clinics, preventive screenings for at-risk children, prenatal care for pregnant women and many other services. Medicaid also is the largest provider of long-term care and nursing home services for the frail and elderly in the United States. 

Capping and cutting Medicaid by over $700 billion will mean painful consequences for families confronting diabetes, opioid addiction, a mental health issue, an aging parent that needs nursing home care or special services for a child with a disability. 

Together, we can fix this. There is still plenty of room for improvement in our healthcare system. Healthcare is too expensive, coverage must be more affordable, Medicaid programs must become more innovative and efficient, the individual market must be stabilized and more payments for healthcare services must be made through value-based contracts. 

BCRA will reduce access to affordable coverage. In fact, in many places, premiums will increase for those that need coverage the most, and coverage will disappear for the most vulnerable. 

We are heartened that Majority Leader Mitch McConnell has delayed a vote on BCRA until after the July 4th recess, and we invite the Trump administration and members of Congress to work together with us to create a health system that always puts people first and never forgets that each of us is only one disease or one accident away from vulnerability. Let’s expand and strengthen coverage and access equally — for all. If there are not substantial changes in the right direction, we urge the senators from the 40 states in which we provide care to vote against BCRA.

Anthony R. Tersigni, EdD, is President and CEO of Ascension Kevin E. Lofton is CEO of Catholic Health Initiatives. Lloyd H. Dean is CEO of Dignity Health. Dr. Richard J. Gilfillan is CEO of Trinity Health. Rodney F. Hochman, MD, is CEO and President of Providence St. Joseph Health.

The views expressed by contributors are their own and are not the views of The Hill.