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Obamacare Replacement Could Hurt Rural States like MT

House Speaker Paul Ryan and other GOP leaders hope to replace Obamacare quickly, despite objections from hospitals, medical associations and AARP about the replacement bill. (Tony Alter/Flickr)
House Speaker Paul Ryan and other GOP leaders hope to replace Obamacare quickly, despite objections from hospitals, medical associations and AARP about the replacement bill. (Tony Alter/Flickr)
March 17, 2017

HELENA, Mont. - The main GOP replacement for Obamacare would have a negative impact on rural areas and especially on older residents, according to Congressional Budget Office figures.

The American Health Care Act would let insurance companies charge up to 40 percent more for health coverage for folks in their 50s and 60s. At the same time, said Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, cuts to Medicaid and especially the bill's reduced subsidies would land hard on rural states such as Montana.

"Capping and cutting federal funding, with those cuts getting larger each and every year over the long run, states are going to have to make increasingly severe cuts to their Medicaid programs," he said, "beyond what happens with the Medicaid expansion, but to their entire Medicaid program - children, seniors, people with disabilities."

When Montana expanded Medicaid in 2015, 70,000 Montanans became eligible. Republicans have pointed to other CBO projections that the replacement plan would reduce the budget deficit. However, Park said, most of the savings comes from shifting Medicaid costs onto states. He said the very wealthy and some big health-care and drug companies would see huge tax cuts.

Rural residents were more likely to vote for Donald Trump, Park noted, but they also are more likely to be negatively affected by the repeal proposal.

"Rural Americans are more likely to be uninsured, they have less access to job-based coverage, they're more likely to be low income, so they're disproportionately reliant on Medicaid for their health coverage."

Republicans note that under the Affordable Care Act, insurers have pulled out of some less-profitable rural markets. They have argued that this is one reason they want to replace Obamacare. Despite opposition from hospitals, nurses, the American Medical Association and AARP, GOP leaders in Congress hope to pass their ACA replacement quickly.

More information is online at cbpp.org. The CBO report is at cbo.gov and AARP's statement is at aarp.org.

Eric Tegethoff, Public News Service - MT