In 2013, 20 percent of Montanans under age 65 had no health insurance — no private or government coverage. With marketplace subsidies from the Affordable Care Act, that uninsured number dropped to 15 percent in 2015. Last summer — just six months after Montana expanded Medicaid under the ACA to all very low income adults — the state’s uninsured rate dipped to 7 percent and has kept inching lower.

Montana has benefited greatly from the ACA, and thus has more to lose from the American Health Care Act that would:

  • Take Medicaid away from the 71,000 Montanans who got covered under the ACA.
  • Cut federal funding for the care of children, elders, disabled and pregnant women who were still covered by Medicaid.
  • Allow states to discard the ACA rule mandating coverage of pre-existing conditions.
  • Eliminate marketplace insurance subsidies based on income and replace them with much smaller subsidies based on age.
  • End ACA funding for community health centers, such as RiverStone Health, after Sept. 30, 2018.

Montana hospitals and clinics with slim or negative operating margins would have to increase local taxpayer subsidies or close their doors. Our rural and nonprofit community medical centers would be hardest hit.

Republicans in the U.S. House of Representatives rushed to pass that health care “reform” bill last week without crucial analysis of its costs and benefits. The nonpartisan Congressional Budget Office hasn’t had time to analyze the scheme that was narrowly approved to give GOP leaders and President Donald Trump a “win.”

The American Health Care Act passed without Montana representation. Our single House seat remains vacant after Ryan Zinke resigned to become U.S. Interior secretary. So it’s all the more important that our two senators understand how the hastily written AHCA will hurt Montanans.

The House GOP bill not only would tighten eligibility rules for adults, it would reduce the maximum family income limit for children ages 6-19, according to Kaiser Family Foundation. Only those kids living in families below poverty level would be covered after 2019.

Montana’ children’s Medicaid program, called Healthy Montana Kids, covers 81,000, making it the largest provider of children’s coverage in the state.

About 60 percent of elders in Montana nursing homes depend on Medicaid to pay for their care.

Rural states, including Montana, had high proportions on uninsured residents before the Affordable Care Act. Montana is a small business state where premiums on the old small group and individual health insurance markets were unaffordable for many who now receive premium subsidies.

Despite large double-digit increases in insurance premiums this year, 70 percent of Montanans who get federal premium subsidies were able to purchase coverage for less than $75 per month, according to a federal study completed late last year.

Instead of destroying the good that the Affordable Care Act has done, (as the House has voted to do) U.S. senators should demand and create a replacement to fix the problems of premiums rising for middle income Americans.

Tester needs to convince his colleagues not to destroy the good that the ACA has done.

Daines, who has long railed against the ACA, must look at the actual costs and benefits of the ACHA and work toward a much better replacement.

The ACHA as approved by House Republicans creates more problems than it solves. This ill-conceived scheme largely would take America — and Montana — back to where we were before the ACA when 20 percent of our state population had no health coverage.

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