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Ahead of AHCA votes, Governor Wolf Urges Delegation to Consider Human, Economic Impact

March 22, 2017

Harrisburg, PA – As the U.S. House of Representatives prepares to advance the American Health Care Act (AHCA) towards final passage, Governor Tom Wolf is reiterating his concern about the impact of the bill on Pennsylvania, which will strip access to health care coverage for far too many Pennsylvanians and shift billions in costs to state taxpayers and hospitals.

“We must remove ourselves from the partisan politics that drive the health care debate today and consider how this proposal will impact people’s lives,” Governor Wolf wrote. “Our rough estimate is that the changes to Medicaid and the per capita proposal put forward in this act will cost Pennsylvania somewhere in the neighborhood of $2.5 to $3 billion each year. These costs, when considered in conjunction with our current $3 billion structural deficit, are far from inconsequential.

“We will be forced to either significantly scale back the health care programs we currently offer to vulnerable residents, such as seniors and individuals with disabilities, or will be forced to weigh decisions about who to cover against other critical state funding obligations, including education, infrastructure, and the environment.”

Governor Wolf has made protecting care for millions of Pennsylvanians, who could see their coverage eliminated or diminished by the AHCA, a top priority. The AHCA would also have wide-ranging negative impacts on Pennsylvania’s economy by increasing costs for older and vulnerable residents and sharply increasing the amount of uncompensated care provided by already struggling small and rural hospitals.

The governor’s top-line concerns, as outlined in the letter, include:

  • It strips coverage from more than 180,000 Pennsylvanians with mental illness and substance use disorders who have gained coverage due to Medicaid expansion and the Marketplace.
  • It charges older Pennsylvanians an “age tax” of up to five times what younger Pennsylvanians will pay. For low-income seniors currently receiving income-based tax credits, this will be especially devastating.
  • Pennsylvania’s uninsured rate, currently at its lowest ever at 6.4%, will skyrocket under this proposal.
  • Nationally, those newly uninsured individuals will seek $88 billion in additional uncompensated care in 2019 alone, $24.6 billion of that amount from hospitals. As federal funding for uncompensated care will increase only slightly, states and local governments will have to consider picking up the tab. In Pennsylvania, our current budget situation will make that impossible, which will shift the burden onto hospitals and other safety net providers. This unprecedented strain on the safety net system simply cannot be absorbed, meaning people’s health care needs will go entirely unmet and hospitals already surviving at the margins financially may have to close.
  • It dissolves the Prevention and Public Health Fund after October 2018, which will strip more than $22 million each year from our state and local health departments. These cuts mean children and adults will go without vaccines, underserved women will go without access to life-saving breast and cervical cancer screenings, and efforts to prevent chronic diseases like diabetes, heart disease, and obesity will be severely hampered.

You can read the full text of the letter below.

Dear Congressman:

As the House Rules Committee considers the American Health Care Act (AHCA) today ahead of the full House vote, I wanted to again voice my concern about the proposal and its potential for wide-ranging, devastating effects on the people of Pennsylvania and our economy.

I understand that we may have our political differences on various issues, but I truly believe this issue rises well above the tide of politics and is ultimately a humanitarian issue at its core. While the Affordable Care Act was far from perfect, particularly in the individual market, this bill stands to only make those problems worse.

I want to thank you for allowing me to engage with you on this vital issue, both in Washington last month and in phone calls over the past few weeks.

As elected officials, it is incumbent on us to fully understand the benefits and consequences of the legislative proposals that we consider every day. The AHCA is a glaring example of a proposal that needs further consideration and opportunity for public input. We must remove ourselves from the partisan politics that drive the health care debate today and consider how this proposal will impact people’s lives. With that said, below are my top-line concerns:

  • It strips coverage from more than 180,000 Pennsylvanians with mental illness and substance use disorders who have gained coverage due to Medicaid expansion and the Marketplaces.
  • It charges older Pennsylvanians an “age tax” of up to five times what younger Pennsylvanians will pay. For low-income seniors currently receiving income-based tax credits, this will be especially devastating.
  • Pennsylvania’s uninsured rate, currently at its lowest ever at 6.4%, will skyrocket under this proposal.
  • Nationally, those newly uninsured individuals will seek $88 billion in additional uncompensated care in 2019 alone, $24.6 billion of that amount from hospitals[ii]. As federal funding for uncompensated care will increase only slightly, states and local governments will have to consider picking up the tab. In Pennsylvania, our current budget situation will make that impossible, which will shift the burden onto hospitals and other safety net providers. This unprecedented strain on the safety net system simply cannot be absorbed, meaning people’s health care needs will go entirely unmet and hospitals already surviving at the margins financially may have to close.
  • It dissolves the Prevention and Public Health Fund after October 2018, which will strip more than $22 million each year from our state and local health departments. These cuts mean children and adults will go without vaccines, underserved women will go without access to life-saving breast and cervical cancer screenings, and efforts to prevent chronic diseases like diabetes, heart disease, and obesity will be severely hampered.

While our departments of Human Services and Insurance are working diligently to fully understand the financial impacts of this proposal, our rough estimate is that the changes to Medicaid and the per capita proposal put forward in this act will cost Pennsylvania somewhere in the neighborhood of $2.5 to $3 billion each year. These costs, when considered in conjunction with our current $3 billion structural deficit, are far from inconsequential. We will be forced to either significantly scale back the health care programs we currently offer to vulnerable residents, such as seniors and individuals with disabilities, or will be forced to weigh decisions about who to cover against other critical state funding obligations, including education, infrastructure, and the environment.

Regardless of who picks up the remaining tab from the lack of federal funds, this legislation will no doubt jeopardize health outcomes and frankly, people’s lives, as our state immediately begins reeling from the implications of such a bill.

I have shared projected district level impacts with each of your offices and will continue to provide any information you need to make informed decisions about the people that live in our communities. I ask again that you consider this an open invitation to work together on crafting a solution that works for the people of Pennsylvania.

Please vote no on the AHCA when it comes to the House Floor for a vote this week. Thank you for your consideration.

Sincerely,

TOM WOLF

Governor

Letter to Congressman Tim Murphy by Governor Tom Wolf on Scribd

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