According to a new West Virginia Center on Budget and Policy (WVCBP) report, repealing the Affordable Care Act (Obamacare) would have far-reaching effects in the Mountain State.
"Repealing the ACA: Hurting Our Health and Our Economy," released Tuesday, says not only 184,000 West Virginians would lose health insurance, but the state's weak economy could falter with the loss of billions of dollars of federal funds.
An estimated 16,000 jobs would be lost by 2019 and nearly $350 million would be lost in tax revenue over five years. The Urban Institute estimates West Virginia would lose $14 billion in federal funds between 2019-2028, including $12 billion supporting Medicaid/CHIP.
Another study conducted by WalletHub shows West Virginia will be the state second most impacted in the nation by the repeal.
"The ACA is much more than a lifeline for hundreds of thousands of West Virginians who have gained health coverage and important patient protections," said WVCBP Executive Director Ted Boettner, who authored the report. "It has been a billion dollar investment in our people that has lead to thousands of new jobs during a time when our state's communities are struggling."
The release from WVCBP, a nonprofit, nonpartisan public policy research organization, said consumer protections for hundreds of West Virginians are at risk with the loss of the ACA, including pre-existing conditions, insurance plan lifetime limits or caps and free preventive care.
A replacement plan, Patient Freedom Act of 2017, proposed by four U.S. Senators, including Sen. Shelley Moore Capito, R-W.Va., has promised to keep intact the pre-existing conditions and lifetime limits protections; however, the plan specifics did not mention preventive care measures. Capito said in a release coverage would be preserved for mental health and substance use disorders.
Proponents of the ACA have also feared loss of coverage for young adults under 26 still on their parents' plans, but Capito said those individuals would remain protected under the replacement plan. Prescription drug costs for seniors were not addressed in the release about the replacement plan.
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Julie Vaughan-Meadors, of Charles Town, and her oldest son, Zachary, are hoping those senators make good on their promise to keep protections in place.
Zachary was 23 years old when he was diagnosed with thyroid cancer — a rare diagnosis for a young man. He's had multiple surgeries along with radioactive iodine ablation treatment, but each summer for the past three years, his cancer has returned.
Zachary, now 26 years old, fears he will not be able to utilize the final months of his health coverage under his parents' plan if the ACA is repealed.
"He's scared out of his mind," Vaughan-Meadors said. "He thinks he's going to get dropped tomorrow. We understand as adults it doesn't happen that quickly, but as a young person, you don't cope well with cancer to begin with."
She continued, "This is the first time a president can touch him. It's the first time he's truly been affected by a president."
Zachary will graduate from California State University in May with his degree in sociology. He has applied, and anticipates he will be hired, at a job in West Virginia.
His mom shared her pride in her son, who's worked so hard over the past several years toward his education despite multiple setbacks.
"He went back to school nine days after surgery," she said. "He could barely hold his head up, but he went back to school."
Zachary is hopeful to secure the West Virginia job and obtain private insurance through the company. His mom said the biggest concern right now is him having a gap in coverage, or getting denied for having a pre-existing condition.
"Our feeling is the insurance companies will be back in charge, as opposed to having regulation on them."
She said she hopes lawmakers, as they work to repeal and replace the ACA, will consider everyday, regular people.
"I wish they understood how it was affecting regular people, you know? People like my son. It breaks my heart that people like him have to be afraid."
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Since the ACA was enacted, West Virginia's uninsured population dropped from 14 percent in 2013 to 6 percent in 2016 — the lowest it has ever been.
Kat Stoll, an author of the WVCBP report, said, "Repealing the ACA would mean turning back the clock for many West Virginians, who, since 2010, have gained affordable, comprehensive health insurance, and protections from insurance companies."
Southern West Virginia saw decreases of 13 percent or greater in its uninsured population during that time: Mercer County (13 percent), Greenbrier County (14 percent), Monroe County (14 percent), Raleigh County (14 percent), Summers County (14 percent), Fayette County (15 percent), Wyoming County (15 percent), Nicholas County (15 percent) and McDowell County (16 percent).
The Washington Post cited a study by the New England Journal of Medicine, which found for every 455 people who gained coverage, one life was saved per year. If 20 million people lose coverage with the ACA repeal, an estimated 43,956 lives could be lost each year.
A recent report in the Journal of the American Medical Association showed from 1980 to 2014, the U.S. death rate per 100,000 people for all cancers combined dropped from about 240 to 192 — a 20 percent decline. More than 19 million Americans died from cancer during that time.
The study highlighted that cancer rates were rising in poor parts of the country, including West Virginia. Counties in West Virginia, the second poorest state in 2014 according to Forbes, experienced high or increasing rates of tracheal, bronchus and lung cancer, colon and rectum cancer, uterine cancer, kidney cancer and non-Hodgkin lymphoma, according to the report.
The ACA took effect in the study's final years, and because cancer takes years to develop, any resulting benefits wouldn't be evident in the latest report. The ACA, however, emphasized prevention services such as no-cost screenings for breast, colorectal and cervical cancers. The replacement plan recently announced has not shared specifics on such services.
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In the WVCBP report, authors argued the ACA should remain intact, but they acknowledged there are nearly 30 million Americans currently without health insurance coverage, including 108,000 West Virginians.
The authors called for Congress to address the following: high and rapidly escalating cost of prescription drugs; high out-of-pocket costs for people with health insurance; the availability of health insurance premium subsidies for families who have unaffordable employer-based coverage that bases affordability on the cost of coverage for the worker alone and not on the cost of coverage for the family unit; and improved competition in health insurance marketplaces through a regulated approach.
"While these four areas of opportunity present significant challenges both from the perspective of policy design and political will, they highlight some options to meet the challenge of moving West Virginia even further forward toward a better health care system," the report said.
The new administration's approach to health coverage will likely include federal money, in the form of block grants, distributed to each state to provide health care to Medicaid recipients.
Many questions remain about block grants, but Doris Selko, Southern Regional Coordinator for West Virginians for Affordable Health Care, told The Register-Herald such funding would not be enough to cover the health care needs of West Virginians.
Twenty counties in West Virginia had more than 30 percent of their residents enrolled in Medicaid 2015, including Raleigh (31 percent), Summers (31 percent), Fayette (33 percent), Nicholas (33 percent), Mercer (36 percent), Wyoming (36 percent) and McDowell (48 percent).
West Virginians for Affordable Health Care will host a rally Friday in Charleston as part of the national "Save Our Care" bus tour. The rally will begin at 11 a.m. on the north side of the State Capitol.
Anyone wishing to share their story about how the ACA has impacted them is invited to email Renate Pore at firstname.lastname@example.org.
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