I was so impressed with Rep. Joe Kennedy III for outing the republicans for their lack of compassion in their attempt to quickly push through their repeal and replacement plan for Obamacare or the Affordable Care Act (ACA), during the debates being held in the US House of Congress on 3/8/17.
This blog will show how Representative Kennedy who took time to read the republicans’ proposed bill, was able to uncover the absence of coverage for mental illness. Then this post questions how the lack of medicaid expansion in several southern states can possibly be consistent with the republicans claim to value the gift of life.
On 3/9/17, of Daily Kos penned the report, Rep. Joe Kennedy III slams Paul Ryan on ACA repeal–then forces GOP lawyer to admit major exclusion.
“Democratic U.S. House Representative Joe Kennedy III of Massachusetts added more good to the *Kennedy name and made many Americans proud on Wednesday, when he spoke out against the repeal and replacement of the Affordable Care Act proposed by Republican House Speaker Paul Ryan. The day before, Ryan had said Republicans are doing “an act of mercy” by repealing and replacing Obamacare. Joshua Miller with the Boston Globe reports Kennedy did not see it that way at all. Kennedy says:”
“I was struck last night by a comment that I heard made by Speaker Ryan, where he called this repeal bill ‘an act of mercy.’ With all due respect to our speaker, he and I must have read different Scripture,” Kennedy said as the House Energy and Commerce Committee dove into the details of the GOP effort … The one I read calls on us to feed the hungry, to clothe the naked, to shelter the homeless, and to comfort the sick.”
“Kennedy then refers to a powerful quote saying, “It reminds us that we are judged not by how we treat the powerful, but by how we care for the least among us.” The young Congressman adds:”
There is is no mercy in a system that makes health care a luxury.
There is no mercy in a country that turns their back on those most in need of protection: the elderly, the poor, the sick, and the suffering.
There is no mercy in a cold shoulder to the mentally ill.
This is not an ‘act of mercy.’ It is an act of malice.”
“Also on the topic of mental healthcare contained in the new proposal by Ryan, Kennedy basically unravels the fact that mental healthcare according to the new plan would not have federal coverage.”
“Here is the transcript of Kennedy forcing a GOP lawyer to admit that Republican repeal plan will cut off coverage to millions of Americans suffering from mental illness.”
Kennedy: “Question for the legislative council, just to make sure I fully understand it. Based off of what you were saying, sir, I understand the fact that this law does not impact mental health parity. But it was the combination of mental health parity and the ACA that included mental health benefits as part of the essential health benefits package. The parity just says if you offer mental health benefits, they have to be offered the same way that physical health benefits are — it does not mandate the offering of mental health benefits.”
“With the combination of the repeal language that we see on page 8, it means that mental health benefits are not required now, by federal law — that it would be up to the states to actually impose, so when we look at those essential health benefits, whether it’s mental healthcare or potentially for other health conditions, that is no longer essentially covered, or required to be covered by this version of this text, is that not correct?
Attorney: The text before us does remove the application of the central health benefits for the alternative plans in Medicaid.
Kennedy: It does remove them — including mental health. Yes, thank you.”
The value for life extends to raising the quality of life for its inhabitants. Several of the republican led southern states rate poorly when compared to other regions as to percentage of population living in poverty; public education results, and health outcomes. Health Needs in the South are exacerbated by these factors. Four states in the South (Kentucky, Louisiana, Mississippi, West Virginia), have at least one in five residents living in poverty. As noted below, The South includes the states with the highest infant mortality and cancer death rates.
On 2/16/16 Samantha Artiga and Anthony Damico of kff.org (Kaiser Foundation) published their report, “Health and Health Coverage in the South: A Data Update.”
“Southerners as a group are generally more likely than those in the rest of the nation to have certain chronic illnesses and to experience worse health outcomes. Overall, one in five (20%) adults living in the South reports fair or poor health status, compared to 16% of adults in the Midwest and Northeast and 17% of adults in the West (Figure 4).”
“Higher rates of diabetes and obesity for adults are concentrated among Southern states (Figures 5 and 6). The states with the nation’s highest adult diabetes rates are all in the South as are the states with the nation’s highest obesity rates.”
“The South also includes the states with the highest infant mortality and cancer death rates. Overall, the infant mortality rate in the South is higher compared to that in the other regions (Figure 7). The South also has a higher rate of cancer-related deaths compared to the Northeast and West (Figure 8).”
Health Coverage in the South
“Southerners are more likely to be uninsured compared to individuals living in the rest of the country.”
“Among the total nonelderly population, 15% of individuals in the South are uninsured compared to 10% of individuals in the rest of the country. Uninsured rates are lower for children compared to nonelderly adults, but children and nonelderly adults in the South are still more likely to be uninsured than those in the rest of the country (Figure 9).”
“Medicaid and CHIP eligibility levels are more limited in the South compared to other regions. The largest disparities in eligibility levels between the South and other regions are for parents and other adults (Figure 10). This finding reflects the fact that most states in the region have not adopted the ACA Medicaid expansion to adults. As of January 2016, 10 of the 17 states in the South are not moving forward with the Medicaid expansion (Figure 11). In these states, eligibility levels for parents remain low and other adults without dependent children remain ineligible, regardless of their income.”
“Among Southern states, those that have adopted the Medicaid expansion generally have lower uninsured rates as of 2014 compared to those that have not adopted the expansion. Moreover, those that adopted the expansion generally experienced a larger decline in the uninsured rate between 2013 and 2014, when the ACA was implemented, compared to those that have not adopted the Medicaid expansion (Figure 12). Louisiana has a relatively high uninsured rate compared to other Southern states that have adopted the Medicaid expansion because it has not yet been implemented in the state; the expansion is scheduled to become effective as of July 2016. Delaware and the District of Columbia show little change in the uninsured rate between 2013 and 2014 because they already had Medicaid coverage for adults as of 2013.”
“The ACA Medicaid and Marketplace coverage expansions have the potential to extend health coverage to many currently uninsured Southerners. Based on current Medicaid expansion decisions, 42% of uninsured Southerners are eligible for coverage (Figure 13). This includes 16% who are eligible for Medicaid and 25% who are eligible for tax credit subsidies for Marketplace coverage. However, 17% fall into a coverage gap in the Southern states that have not adopted the Medicaid expansion. These are poor adults who earn too much to qualify for Medicaid but not enough to qualify for premium tax credits, which begin at 100% FPL.”
“Because most states not implementing the Medicaid expansion are concentrated in the South, uninsured Southerners are more likely to fall into the coverage gap and less likely to be eligible for Medicaid compared to the uninsured in the rest of the country. If all states were to expand Medicaid, the coverage gap would be eliminated and 61% of uninsured Southerners would be eligible for coverage, with the share eligible for Medicaid increasing from 16% to 44% (Figure 14).”
“The South is a vital component of the nation, accounting for over a third of the total population. The region is racially and ethnically diverse and home to a large share of the nation’s people of color. There are significant health needs within the region. Southerners as a group are generally more likely than those in other regions to have a number of chronic illnesses and experience worse health outcomes.”
“While a broad array of factors contributes to the high rates of chronic disease and poor health outcomes in the South, ensuring individuals have health coverage that enables them to access preventive and primary care and ongoing treatment to meet their health needs can be an important step in addressing these disparities. Southerners are more likely to be uninsured compared to the rest of the country.”
“In states that do not implement the Medicaid expansion, many poor adults fall into a coverage gap. If all states were to expand Medicaid, the coverage gap would be eliminated and potential coverage gains in the region would be significantly larger.”