In the increasingly murky national debate on health care, it can be hard to see exactly what effect the Senate health care bill (which may or may not make it to the Senate floor next week) would have in Ohio. But both the Senate’s health care bill and the previously-passed House proposal would make dramatic funding cuts to Medicaid, greatly impacting residents of Preble County.
Medicaid pays 1 out of every 4 dollars spent on health care in Ohio, but it plays an even bigger role in rural communities like Preble, where almost one in five adults get their coverage through Medicaid. Under the Affordable Care Act (or Obamacare), the rate of uninsured Ohioans dropped dramatically, from 11 to 6.5 percent between 2013-2015. Most of this new coverage came through Medicaid expansion.
In Preble, 9.4 percent of adults enrolled in Medicaid through expansion, which helped many previously un- or under-insured Ohioans get preventative health care and better care for chronic conditions. Ongoing access to health services can be the difference between life and death for people with conditions like diabetes, heart disease and high blood pressure.
But under both the House and Senate health care bills, federal funding for Medicaid expansion would be cut dramatically, effectively ending Medicaid expansion. Medicaid as a whole will also be sharply cut: Preble County stands to lose $50 million in Medicaid funding by 2025.
And the proposed legislation would not just threaten Preble residents covered by Medicaid. Older residents buying insurance through the Marketplace would see significant premium increases, dubbed an “age tax” by the AARP. A typical 60-year-old in Preble County who makes $30,000 a year would pay an extra $1,880 in annual premiums (after accounting for tax credits) under the Senate bill.
Rural hospitals and health care providers are also under threat by proposed health care legislation. The Chartis Center for Rural Health estimates that more than one in five rural hospitals in Ohio would be vulnerable to closure under any loss of revenue. Medicaid dollars in Ohio make up a full 12 percent of revenue for rural hospitals, so the cuts proposed in the House and Senate bills would be incredibly damaging. If these health providers go under, rural Ohioans will have to travel farther and farther to get care.
This matters in Preble, where 10 percent of private sector employees worked in healthcare in 2015. According to the Economic Policy Institute, the 8th Congressional District can expect to lose 4,669 of these jobs by 2022 under the House’s health care bill, and Ohio as a whole could lose 81,385. These are not losses anyone can afford.
Health care cuts are especially pressing in light of Ohio’s growing opioid epidemic. Last year, 2/3 of the one billion dollars that Ohio spent battling the crisis came from Medicaid. Its expansion has played a huge role in helping 500,000 Ohioans get access to the substance abuse treatment and mental health services they need. Just one southern Ohio substance abuse treatment agency, Counseling Center, Inc., has used expansion funds to treat over 1,100 men and to hire 67 full-time employees. How will such agencies continue to do this critical work under cuts to Medicaid and Medicaid expansion?
Alan Morgan, CEO of the National Rural Health Association, said of the Senate’s most recent bill, “In its current form, this bill is anti-rural.” Medicaid, affordable private insurance, and healthcare jobs are too important in Preble to allow this hastily-assembled Obamacare repeal act to go through. Things are changing fast in Washington. Let your Senators know what matters to you in health care legislation.