While House Republicans, including Rep. Martha McSally, celebrated their first major legislative victory with President Trump after their chamber voted to repeal the Affordable Care Act, my thoughts turned immediately to patients I see as a hospital physician at Tucson Medical Center.
Will the woman with metastatic colon cancer I recently admitted for blood and urinary tract infections be able to get coverage and care in a post-ACA world? How will her family afford her hospital bills if we return to the bad old days of pre-existing conditions? How will my female patients cope when they’re denied access to birth control?
These discriminatory practices were the health insurance industry standard before the Patient Protection and Affordable Care Act became law in March 2010. And if the bill McSally voted for last week becomes law, Arizonans will face health-care discrimination once again.
Our state budget would suffer, too. How will our state support the Arizona Health Care Cost Containment System (AHCCCS) program once massive Medicaid cuts go into effect? Thousands of families would be impacted as they lose their coverage throughout Southern Arizona — threatening the very existence of our rural hospitals due to the increase in uncompensated care expenses.
In 2013, then Gov. Jan Brewer wisely used ACA funds to expand AHCCCS/Medicaid by working with both parties in the Arizona Legislature. She secured billions of federal dollars for Arizona and extended coverage to more than 300,000 low-income families and individuals. To her credit, Brewer recently criticized the Republican ACA repeal plan for the negative impact it would have on our state. Our U.S. senators should heed her warning as deliberation on repeal moves to the Senate.
Then there’s the “age tax.” Will my patients age 50 to 64 be able to afford the drastic increases in premiums that they could soon face because of this hastily constructed bill? The ACA ensured that coverage for all people would remain within reach, but this repeal bill would allow their premiums to be five times more expensive than a younger person’s.
The ACA’s crucial protections prevent seniors, women, disabled people, the chronically ill and others from being extorted by health insurers for profit. Rolling back these protections puts insurers right back in the driver’s seat, but we’ve already been on that ride.
So why would our congresswoman lead the charge for this plan, when hundreds of her colleagues, including 20 Republicans, took a stand for patients? Make no mistake, McSally was not dragged along unwillingly by Speaker Ryan or President Trump. Far from it. Moments before the vote, she fired up the GOP conference with an impassioned, expletive-laden battle cry to send her colleagues off to the House floor. To me, unbridled zeal for a politically expedient victory lap at the expense of thousands of Southern Arizona families is appalling.
The discussion we should be having is how to work together to strengthen competition among health insurers and allow Medicare to offer plans in areas where private health plans are not available. The ACA helped seniors with the prescription drug doughnut hole, and we can go further by authorizing Medicare to negotiate drug prices — just as the VA currently does for American’s veterans. Most importantly, we have to be smart and weigh the cost of covering people against the exponentially greater cost of not covering people. Preventive care is almost always the cheapest option.
Basic medical care is a right and a necessity, not a luxury or a privilege. As I return to the hospital later this evening, I will work alongside all my physician and nurse colleagues, who must care for all patients, regardless of their condition or circumstance. It’s our oath. Unfortunately, in Washington, McSally and her House GOP allies chose a different course this week: one that would once again leave Arizonans to face discrimination and high costs as they seek coverage and care.