ACHA poses a threat to Colorado’s rural communities
By Erin Egan
I am a rare thing: a physician working in a rural hospital in Colorado. Many are on Medicaid, and most will leave with a pre-existing condition if they did not have one already. Medicaid covers our most vulnerable: not just low-income people, but also seniors, children and the disabled.
My patients come to the hospital with heart attacks, strokes, pneumonia, overwhelming infections, and respiratory failure. Every patient I see will be touched by the effects of the GOP’s proposed American Health Care Act (AHCA), and overwhelmingly they will be worse off because of it.
To hide its ruthless impact on Americans, Congress quickly passed the bill without updated information on the damage it would do. From the initial analysis, we know the U.S. House of Representatives voted for a health care reform law that will leave at least 600,000 uninsured in Colorado alone, will raise costs and directly damage rural hospitals. The AHCA would cause 14 million people in this country to lose their insurance in the next year, and 24 million will lose insurance in the next 10 years.
Medical debt can be crushing, especially hospital bills. More than half of all bankruptcies are due to medical debt. People should not have to choose between their health and their house, their medications and their children’s future education, their present needs and their future hopes. Not having medical insurance does that to people. Yes, we do need to get a handle on the very high health insurance premiums we’re all too familiar with in Western Colorado, but the AHCA will only increase premiums for most of us.
The current Affordable Care Act (ACA) expanded Medicaid, helping 87,000 rural Coloradans gain coverage who could not otherwise afford it. Losing the expansion will mean millions lose health insurance. One out of five Coloradans who have gained coverage under the expansion live in rural communities. The Medicaid expansion has also expanded access to substance use disorder treatment at a time when many Colorado rural communities have been ravaged by the opioid crisis. The ACA stood to protect the people who need the help because it is the right thing to do.
The proposed AHCA stands to take that help away to save money — money that will go only to enrich a wealthy few through tax breaks.
Most Americans have some form of pre-existing condition, and currently, they cannot be denied coverage and can’t be charged more. The AHCA strips people with pre-existing conditions of the protections that ensure that they can afford the health care coverage they need. When health care coverage is so expensive that people can’t afford it, it is the same as not having access to coverage at all. Some will be literally crippled by not having access to the care and medications they need. People’s futures will be hamstrung by their health needs. Pre-existing conditions happen to everyone at some point in life, not people who somehow deserve it from the choices they made. Many people make the choices they do because of the limited choices they have — “lifestyle” related conditions occur much more often in the setting of economic and racial disparity. People develop poor health because of the disadvantages they started with.
Fairness in health care is an essential value in a compassionate society that shows care and concern for those who need it, because we will all need it at some point. We ask our legislators — honor your oath and our faith by demanding legislation that protects us. Demand justice for all of us.
The House Republican health bill would be particularly harmful to Colorado’s rural communities. However, with backroom-negotiations now underway in the Senate, Sens. Cory Gardner and Michael Bennet can prevent the bill’s harmful cuts and other changes from ultimately becoming law. They should reject any bill that takes coverage away from people, ends the Medicaid expansion, caps or cuts Medicaid, makes insurance coverage unaffordable, or takes away protections from people with health conditions.
Colorado’s rural communities already face a lot of challenges, and policymakers in Washington shouldn’t make life harder for the people who live there.
Erin Egan is a physician and an attorney practicing in multiple rural hospitals in Colorado. She teaches law and bioethics at the Sturm College of Law at the University of Denver. She is a Colorado native and did her training at Loyola University in Chicago.