Guest opinion: Gutting insurance for poor won’t improve health-care system
June 2, 2017
Access to affordable health care is a human right. Mountain Family Health Centers prescribes investing in Medicaid innovation that works, rather than cutting health insurance for low-income, working families as is proposed in the American Healthcare Act, now being revised by Republicans in the U.S. Senate.
Access to affordable health care is a human right: In 1948, the General Assembly of the United Nations released a document created by representatives from around the world — the first-ever Universal Declaration of Human Rights. Among the rights declared was Article 25, which states:
"Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care, and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."
More recently in 2016, The Elders, an independent group of global leaders founded by the late Nelson Mandela, reaffirmed access to affordable health care as a human right. The Elders called for: "All countries to commit to achieving universal health coverage, whereby everybody receives the health services they need without suffering financial hardship."
Nearly 70 years after the United Nation's landmark declaration of human rights, access to affordable health care as a human right is in serious jeopardy in our country, state and communities.
AHCA stands to reduce health coverage for 600,000-plus vulnerable Coloradans: On May 4, 2017, the U.S. House of Representatives passed the American Health Care Act. The non-partisan Congressional Budget Office released a revised analysis of the bill last week and found that the AHCA would increase the number of uninsured Americans by 23 million over the next decade.
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The majority of the increase in the uninsured comes from the reduction of Medicaid coverage for millions of low-income, vulnerable individuals and families.
In Colorado, more than 600,000 Coloradans currently covered by Medicaid are at risk of losing their health insurance under the AHCA. At Mountain Family Health Centers, where we serve as the medical, dental and behavioral health care home for more than 18,000 patients across Garfield, Eagle, Pitkin and Rio Blanco counties, more than 4,000 of our patients (whom we know as our family, friends and neighbors) are at risk of losing their Medicaid coverage.
To qualify for Medicaid, now called Health First Colorado, a single individual must have an annual income of less than $16,650 or a family of four must have an annual income under $34,000.
This is not a living wage in the Roaring Fork or Colorado River valleys. While our region is perceived as affluent due to the resort economies of Aspen and Vail, more than 36,000 of our residents live on less than twice the federal poverty level. (Source: udsmapper.org, 2017).
Public health insurance programs like Medicaid are critical for our families to be able to afford healthcare. And, according to the Colorado Department of Health Care Policy and Financing, 75 percent of adults enrolled in Medicaid work, contributing to our local economies.
Prescription for innovation: Instead of cutting health insurance coverage for low-income, working families, we would prescribe investing in Medicaid innovation that works. On the Western Slope, Mountain Family Health Centers partners with Rocky Mountain Health Plans and other medical and behavioral health providers to deliver Medicaid PRIME. Through PRIME, Medicaid patients receive coordinated, integrated, primary medical, behavioral and dental care to improve their health.
PRIME helps patients avoid unnecessary use of hospital emergency rooms, costly procedures and high-cost imaging.
It works. According to an April 15, 2017, publication by the State of Colorado, the average total cost of care for a Medicaid PRIME patient dropped from $532/month at the start of the program in September 2014 to $466/month in June 2016.
In addition, patients' overall health is improving, with Medicaid PRIME patients showing improved outcomes in diabetes management, weight assessment and counseling, and antidepressant medication management.
As the U.S. Senate debates the next version of the AHCA, the key to improving the quality and affordability of our health-care system is to invest in accountable local care innovations, not gutting health insurance for the poor.
Ross Brooks is chief executive officer of Mountain Family Health Centers, http://www.mountainfamily.org.
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