After announcing Tuesday she’s not happy with Republican senators’ current version of a replacement for the Affordable Care Act, Sen. Shelley Moore Capito, R-W.Va., said Wednesday she and other lawmakers will keep working on it ahead of an expected vote.
“The Senate bill was not the right fix for West Virginians,” Capito said during a conference call with reporters Wednesday morning. “But ... [Senate Majority Leader] Sen. [Mitch] McConnell delayed the vote, and so we’re back at it and I’m back at it with more time to try to improve it, to make it work, to get it right.”
Capito’s Tuesday announcement was issued jointly with Sen. Rob Portman, R-Ohio. It came after national news outlets reported that McConnell, R-Ky., said no vote would take place on the Better Care Reconciliation Act until after the July 4 recess, and after several other GOP senators said they wouldn’t vote for the current bill.
Capito said Wednesday the current version of the bill falls short in four areas: it doesn’t ensure access to affordable health care to West Virginians, doesn’t do enough to combat the opioid epidemic, cuts traditional Medicaid too steeply and would hurt rural hospitals and nursing homes.
Capito said for years she’s heard from West Virginians about the negative effects the Affordable Care Act have had on them, from higher deductibles to business owners who can’t afford to absorb the higher costs of health care. At the same time, West Virginia has the highest per-capita rate for expanded Medicaid, a provision of the Affordable Care Act, she said.
According to the state Department of Health and Human Resources, nearly 170,000 West Virginians have enrolled in Medicaid since it was expanded to those who make up to 138 percent above the federal poverty line.
“I know that many West Virginians rely on health care and access to substance abuse [treatment] through Medicaid, so I’m trying to balance these needs to find the best solution for West Virginia,” she said.
State officials have said about 50,000 people who have coverage through Medicaid expansion had substance abuse diagnoses in 2016. The bill would decrease the federal matching rate, which is currently about 90 percent, for the expansion population. It would decrease to 85 percent in 2021, 80 percent in 2022 and 75 percent in 2023. State Department of Health and Human Resources Secretary Bill Crouch already has said that any reduction in the federal matching rate would “create an unsustainable financial obligation” for the state. The bill also would cut Medicaid funding for those not covered by the expansion.
The Congressional Budget Office estimated that the current version of the bill would cut Medicaid by $772 billion over 10 years, based mainly on ending the extra funding for states that expanded Medicaid and setting per-capita based caps on Medicaid payments to states. The CBO estimated that 15 million fewer people would have Medicaid in 10 years, compared to 14 million fewer under the House version of the bill.
Capito said she would like for the Senate bill to include $45 billion in extra funding for substance abuse treatment and services in areas most deeply affected by the opioid epidemic.
“That is extremely important to me,” she said.
She also wants to make sure the bill would allow for affordable health care coverage particularly for older, rural people with lower incomes. Capito said she also thinks the funding the current bill allocates for Medicaid over a 10-year period isn’t enough to keep up with its growth.
Even if Medicaid is reformed, Capito said, “I still feel that the growth rate that is in this bill is not sufficient to carry what’s gonna be the expenses,” Capito said.
Capito said she made the decision to oppose the bill more than a week ago but waited to see if changes would be made to improve it.
“I was hoping that conversations I was having with the leadership to try to pull the bill in a direction that would be much more helpful for us,” she said. “I became very frustrated because in actuality the bill started going the other way.”
Reach Lori Kersey at email@example.com, 304-348-1240 or follow @LoriKerseyWV on Twitter.