‘I don’t know how I would live’: How the Senate health care bill would impact the poor
R.W. Dellinger Jul 5, 2017
Cassandra Jones was having a hard time keeping her eyes wide open talking to me about her health problems. She had on a black watchman’s cap and black jacket over a T-shirt with the letters “LA” above a red heart. Her expression? A mix of fatigue, anxiety and pain.
We were in the back of St. Margaret’s Center, a Catholic Charities of Los Angeles multiservice site, in Lennox off busy Inglewood Boulevard. The 38-year-old soft-spoken woman said she left Virginia, where she was a chef, seven years ago. Out here she found a good job at a barbecue place. Then on Oct. 29, 2014, a shelf broke in the kitchen, sending down a restaurant-size pan of ribs on her back. The accident cracked her L3 lumbar disc.
Since then Cassandra hasn’t been able to work with the sciatic nerve pain down her left side plus her damaged disc. After scans and MRIs, along with three epidermals for the pain, doctors told her what she really needed was major surgery. Instead, she’s been using a walker to get around.
“Ever since getting hurt, I’ve been fighting workers comp,” she said. “I’ve lost a place to live. I’ve lost means to survive. I was on the street for about two years, but have a room right now right up Century [Boulevard]. But only for three months. And I’ve developed gastritis and pancreatitis from the medications I’m taking. I also need dental work and glasses.
“So I’ve been going downhill ever since the accident,” she pointed out. “‘Cause my temporary disability ran out after two years. And then you can’t do anything but get on public assistance and food stamps. I come to St. Margaret’s once a month for groceries. But I don’t have any real type of income. And I’ve been trying to get some counseling because I’m really depressed. I’ve gone through a lot.”
Cassandra’s one hope is Medi-Cal. She said she’s been seeing a doctor in Long Beach and other specialists at Cedars-Sinai Medical Center almost every month. They were still in the middle of all the “paperwork” needed for approval of the surgery. Surgery being her last chance.
“It’s just a matter of getting them to pay for it and then to get back to myself,” she said with a sigh. “So that’s why I hope [President Trump] doesn’t cut it off, ‘cause I’m gonna need it.” And she stopped. “Or I’m going to be living this way all my life.”
22 million cut by 2026
The U.S. Senate’s proposed “Better Care Reconciliation Act” would cut off 15 million men, women and children from the “Affordable Care Act” (Obamacare) next year. And by 2026, that number would rise to 22 million, according to a report just out by the nonpartisan Congressional Budget Office.
The biggest cuts in Obamacare would come from reducing federal spending on Medicaid. When it was created in 1965, the public insurance program offered health coverage to poor families and individuals — mostly children, parents, pregnant women, seniors and people with disabilities. And when it was expanded, the program also included near-poor nondisabled adults without children. Thirty-one states and the District of Columbia expanded Medicaid.
By 2026, the Senate bill would reduce federal spending on Medicaid by 26 percent by mostly removing taxes levied by Obamacare on wealthy Americans to help pay for the law. That would roll back the expansion to low-income adults and drastically cut the federal government’s support for the health care program, according to the Congressional Budget Office.
Bishop Frank Dewane, chairman of the U.S. Conference of Catholic Bishops’ Domestic Justice and Humane Development Committee, issued a terse statement within hours of learning that 22 million disadvantaged people will lose their public health care over the next 10 years if the Senate bill becomes law.
Part of it read: “This moment cannot pass without comment. As the USCCB has consistently said, the loss of affordable access for millions of people is simply unacceptable. These are real families who need and deserve health care. We pray that the Senate will work in an open and unified way to keep the good aspects of current health care proposals, to add missing elements where needed and to not place our sisters and brothers who struggle every day into so great a peril on so basic a right.”
The Catholic Health Association, which represents some 600 Catholic hospitals in the U.S., responded, “Just like the House passed the American Health Care Act, the Senate proposal will have a devastating impact on our nation’s most vulnerable populations.”
William J. Cox, president and CEO of the Alliance of Catholic Health Care, told Angeles News his organization was very much opposed to the Senate bill.
“Our primary concern is Medicaid,” he said. “And the Senate bill would cut $772 billion out of Medicaid [over the next 10 years] to direct those dollars then to tax cuts and balancing the budget. And this is the situation. Last year, just one of our health systems — Providence St. Joseph Health, which operates hospitals in California but also Alaska, Washington, Oregon and Montana — saw an increase of 1 million people who qualified for the first time for Medicaid benefits under the Medicaid expansion of the Affordable Care Act.”
He said these new patients had never been covered before, so many of them had pre-existing chronic conditions that needed to be treated immediately by their health care facilities. He called the increase of 1 million “mind boggling.”
Then Cox brought up some startling national numbers.
“Fifty percent of the children born today in the U.S. are born on Medicaid,” he said. “And 60 percent of seniors in nursing homes are covered by Medicaid. So you can say the Medicaid program is the nation’s safety net for children and elderly.
“And when we see, as Catholic health care providers who are committed to human dignity and who believe that health care is a right not a privilege,” he stressed, “we’re very much opposed to the Senate bill, as we are to the House bill.”
California will be hard hit
California will be particularly hard hit if the Senate bill, or something like it, becomes the law of the land. A state analysis recently released would leave California in the hole $115 billion for its Medi-Cal bill between 2020 and 2027. (Medicaid, a federal- and state-funded program, is called Medi-Cal in California.)
Currently, the program covers 1 of 3 state residents, about 13.5 million Californians. Medicaid expansion during the last three years added 3.9 million residents. Most or all of these newly covered individuals would go back to being uninsured if the bill passes Congress.
“California would see the nation’s biggest increase in the number of uninsured people next year,” Sen. Dianne Feinstein, D-Calif., said during a recent media call on the bill. “If this bill passes, we will see the three big children’s hospitals in the state have great difficulty surviving without Medi-Cal, because virtually all of the children that got there are on Medi-Cal.”
She was speaking about Children’s Hospital Los Angeles, UCLA Mattel Children’s Hospital and Valley Children’s Hospital in the Central Valley.
At a news conference in Los Angeles on June 27, L.A. County Supervisor Sheila Kuehl said the Senate bill becoming law “would be devastating to L.A. County. L.A. is ground zero.”
‘Already a struggle’
Cassandra Jones’ eyes were wide open now, but her expression was still a troubled mix.
What if you were completely cut off Medi-Cal?
“That would totally just crush me,” said the 38-year-old woman. “I wouldn’t know where to go. I wouldn’t know what to do. It’s already a struggle trying to get the help that you get. ‘Cause the information is not readily out there. You have to go searching for it. And you have to look hard and long just to get even minimal help.
“And for them to take it away — the minimal help — that would just devastate me,” she said. “‘Cause I don’t know how I would live. I don’t know how I would maintain life.”