As a physician of 30 years who has some experience in health care policy in rural areas, I feel obligated to weigh in on the stance of Idaho lawmakers toward recent health care legislation. As president of the AMA in Alaska before moving to Idaho, I have been very involved in the health care policy of rural states.
Before the ACA rural patients really struggled with access to insurance and to health care. Many rural hospitals were on the brink of closing for lack of funds due in large part to the care they offered to uninsured patients. The influx of federal dollars helped stabilize hospitals in underserved areas, though Idaho chose not to accept most of that funding.
Nationally the ACA was under fire from its inception by Republicans in Congress who chose to try to kill it or defund it at every turn. Some of the biggest enemies of the ACA were legislators from states who would benefit the most, Idaho included. The outright lies about the ACA, including that it contained “death panels,” was used to spread hysteria and misinformation among voters. Several House members, almost exclusively Democrats, were told by pollsters that they would lose their seats in Congress, and indeed in 2010, most did.
Fast-forward to today. The Republicans in Congress, after years of telling voters they would repeal the ACA if given the chance, are faced with an ethical dilemma. The ACA — once implemented and running properly — has insured more then 24 million Americans who were previously uninsured. It is the most conservative health care plan in the world, so trying to find a more conservative bill that will still cover most Americans and cover pre-existing conditions and eliminate lifetime caps is not possible. Enter the AHCA.
This hastily written bill with less than 17 percent approval rating among the American public was pushed through Congress without a period for public comment. They did not wait for a CBO (Congressional Budget Office) score so Americans would know the cost of the bill and what kind of insurance they would be getting. Indeed, it was rushed through so fast, the House members did not read it. It was published online just hours before the vote. A piece of legislation that affects 20 percent of our economy and affects every American life was passed without any input from the American people and against the advice of every medical and hospital association in existence.
We do know that more then 24 million Americans may lose their insurance, and there is no guarantee for anyone that they can be insured with pre-existing conditions. With no lifetime cap, insurance carriers can charge whatever they want. The days of the most common cause of bankruptcy will be back: medical bills.
Both Reps. Mike Simpson and Raul Labrador voted for this bill and then went to the White House for their photo op. When will they be held accountable for this lack of leadership?
Cynthia Brooke, M.D., has been a physician for over 30 years. She has practiced in Alaska, Idaho and Washington state. She’s currently semi-retired but works part time as an OB hospitalist and lives in Middleton.