SEBELIUS WARNS GOP REAL GOAL: HARM MEDICAID

May 9, 2017

Former HHS Secretary Warns Trump/Ryan Bill Cuts $890 Billion from Medicaid; ending 50 years of  health care and community supports for disabled, elderly and poor

Speaking to an overflow crowd at the 2017 ADDP LEAD Annual Conference, former U.S. Secretary of Health and Human Services Secretary Kathleen Sebelius warned the passage of the Trump/Ryan health care bill has the potential to destroy disability community living and employment as we currently know it.  Passed this afternoon by a two vote margin, the American Health Care Act (AHCA), will cut over $838 Billion from the Medicaid program by converting it into a capped block grant program to be reduced by 25% over the next ten years.

ADDP CEO Gary Blumenthal warned the 800 ADDP conference participants that, if the AHCA becomes law, community services for people with intellectual and developmental disabilities may be decimated, forcing the disabled to compete for budget crumbs with elders, people with psychiatric disabilities, children, the poor and the ill.  Blumenthal called Trump's bill mean spirited and the greatest danger in our lifetimes to health and human services.

In Worcester speech, Sebelius says Republican plan slashes Medicaid safety net

By Susan Spencer 
Telegram & Gazette Staff  

WORCESTER - As Republicans brought to the House floor on Thursday their latest attempt to repeal and replace the Affordable Care Act, also known as Obamacare, with their American Health Care Act, former U.S. Secretary of Health and Human Services Kathleen Sebelius told advocates for people with intellectual and developmental disabilities that the real harm of the Republicans' bill is that it would gut Medicaid.

But not only are many people unaware of the significance of the Medicaid program, the country's largest source of health insurance coverage, Ms. Sebelius said. "The problem is, nobody knows that's in this bill."

Ms. Sebelius, who served in the Obama administration and is a former governor of Kansas, was the keynote speaker at the annual Association of Developmental Disabilities Providers conference, held at the DCU Center. Some 800 service providers, family members and people with disabilities from throughout Massachusetts attended the event.

The House bill, which was released Wednesday, would cut $880 billion in federal Medicaid funds to the states over 10 years, a 25 percent cut.

Under the label of state flexibility, which the former governor said she often supported, "Governors will be able to further damage the program."

Medicaid, signed into law in 1965 alongside the Medicare program, which is primarily for people age 65 or older, is a federal-state partnership. Designed initially for low-income people who were receiving welfare benefits, eligibility has expanded, and Medicaid now represents the largest transfer of federal money to states.

Ms. Sebelius said Medicaid has played "a huge role in cradle-to-grave coverage," including protecting people from disease outbreaks and providing a health safety net during economic downturns.

In Massachusetts, Medicaid is known as MassHealth.

Medicaid now covers 72 million Americans, including 40 percent of all children, two out of three nursing home residents and 10 million adults and children with disabilities. Half of all births in the U.S. are paid for by Medicaid.

"Forget the Affordable Care Act," Ms. Sebelius said. "This is the target of this bill."

She said that even states that strongly supported their Medicaid programs wouldn't be able to make up the cost of the federal cuts, so services such as home care - anything that wasn't federally mandated - would likely be slashed.

Proposed block grant payments to the states would remove the safety net for the country's most vulnerable citizens, according to Ms. Sebelius. States would have to slice a smaller funding pie among low-income pregnant women and children, people with disabilities and people needing nursing home care.

And with 11,000 baby boomers a day turning 65, she said, "We're going to need more services and more supports for this population; not less."

On the private marketplace insurance side, she scoffed at the Republican proposal for states to re-establish high-risk pools to pull people with multiple medical needs and pre-existing conditions out of the general insurance market. While average premiums to healthy people would benefit, the high-risk pool would be unsustainable because of the expensive care these people require.

"High-risk pools are not insurance," said Ms. Sebelius, who ran such a pool in Kansas, in an interview beforehand. "Costs can only go up. They never go down."

Ms. Sebelius called on the audience to speak out to their representatives on Capitol Hill about what Medicaid means to them and what the impact of service cuts would be to people with disabilities and their families. She urged the audience to form broad alliances nationwide to get the message out.

"This isn't accidental that the Republicans are rushing this bill," she said. "This isn't accidental that nobody knows what's in this bill."

Ms. Sebelius said even the Affordable Care Act, which took 15 months with hundreds of hearings to pass, left some unsure of what it is.

She recapped that the Affordable Care Act, the first massive health reform since Medicare and Medicaid in the 1960s, set out to fill the gaps in health care coverage by providing affordable access; use the leverage of federal Medicare dollars to improve health care quality for all by shifting to value-based payments; and lower the rate of health care cost inflation.

On those measures, she pointed to progress. In 2016, more than nine out of 10 Americans had health insurance, the highest rate ever. Hospital safety and overall health measures were beginning to improve. And health care inflation was at its lowest rate in 50 years of tracking.

In an interview, Ms. Sebelius said the Affordable Care Act could still be improved with competition from more insurers in the marketplace. "But what insurers need is some stability and some sense of the rules," she said, calling for establishing set rules for a few years.

She praised the act's state stability fund, which gives states money where the market is less competitive to shore up a competitive insurance market.

"Now, all of that is at risk," she said.