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July 14, 20171:18 PM ET
Heard on All Things Considered

For Heather Gijanto, going to the doctor means taking a day off work and driving at least 60 miles round trip from her home in McNeal, Ariz., to the town of Bisbee. And that is assuming there is a primary care doctor available in Bisbee to get her in.

"You select one doctor and then you find out a few months later that that doctor is no longer going to be available," Gijanto says. "So then you have to start the whole process over again. And then you find that doctor and, for whatever reason, that doctor leaves as well."

Gijanto is frustrated and says she and her husband and their two young kids have had to change family doctors four times recently. Ideally, she says, the family would have one doctor who knew each member's medical history, so "I didn't have to explain my chart every single time or have to go over medications all the time with each new physician."

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TUCSON (KGUN9-TV) - Senate Republicans postponed the vote on the Better Care Reconciliation Act Tuesday.

"The good part of the discussion going on right now is the people are starting to ask a lot of questions about what will happen to me what will happen to my family," said Daniel Derksen, a University of Arizona College of Public Health professor.

Derksen says 70 million Americans are currently covered by Medicaid and two million of those are in Arizona.

"The estimate is either of these bills would cause about 400,000 Arizonans to lose their Medicaid coverage and be uninsured," he explained.

He says in rural communities, health infrastructure depends on small rural hospitals known as critical access hospitals and these would have a hard time providing services if funding was cut.

"In Arizona we have 14 critical access hospitals and they would be particularly hard hit by these drastic cuts," he said.

Derksen says over the next 10 years, $7.3 billion in Arizona's federal Medicaid funding would be cut and with the loss of funding, nearly 25,000 jobs will be cut from Arizona.

U.S. Senator John McCain says Arizona has been nationally recognized for running one of the most efficient and cost-effective Medicaid programs in the country.

He stated this type of legislation should reward the state, rather than penalize it.

Senator McCain stated he supports repealing and replacing Obamacare, but quote, "I will be working hard to include important measures that address the concerns raised by Governor Ducey and other leaders across our state about the bill's impact on Arizona's Medicaid system."

» See video at link below:

THE SUNDAY HERALD (Glasgow, Scotland) | Exclusive by Andrew Purcell
June 24, 2017

WITHIN five days, Trumpcare could well be on the US statute books. It hasn't taken long to get there. The journey began on May 4, when the Republican caucus in the House of Representatives gathered to vote on the American Health Care Act (AHCA). For seven years, they had promised to repeal Barack Obama’s signature legislative achievement, but now they had control of both houses of Congress and the White House, they couldn’t agree on a replacement. To conservative hardliners, the bill was too timid. Moderates worried that supporting it could cost them their seats.

Whips played Eye Of The Tiger on the stereo to harden their resolve, and projected an image of General George Patton urging them to "accept the challenge so that you can feel the exhilaration of victory.” Later, once the bill had scraped through 217-213, Republican Congresswoman Ann Wagner said: “The line of the day was out of Braveheart: ‘Freedom!’”

In their minds, these privileged few were Rocky entering the ring, William Wallace leading the charge at Stirling Bridge. Republican Congressman Jason Chaffetz rode in on a scooter, fresh from foot surgery covered by his subsidised government health insurance, to vote for a bill that will make the same operation unthinkably expensive for tens of millions of Americans. If it becomes law, thousands more will die each year because they cannot afford to see a doctor.

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The Christian Science Monitor| by Francine Kiefer | Staff writer
June 22, 2017

WASHINGTON—Republican senators unveiled their long-anticipated healthcare plan to replace Obamacare on Thursday, and it includes significant changes to Medicaid, the joint federal-state program for the poor, elderly, and disabled.

The bill, which does not yet have the support of enough senators to pass, reflects the ongoing tussle of costs vs. social benefits that sharply divides the two parties as well as Republicans themselves.

Like the Republican legislation that passed the House in May, the draft bill put forward by Senate Republican leaders aims to rein in federal spending on the burgeoning program – a move they say will strengthen it in the long term. But over time, that will mean substantial cuts to some of the country’s highest-need populations, say advocates – though the full scope of those cuts won’t be known until the independent Congressional Budget Office releases its report on the Senate bill early next week.

“Medicaid is fiscally unsustainable,” says Steve Kelly, spokesman for Sen. Pat Toomey (R) of Pennsylvania, the senator who represented the GOP conservative viewpoint on Medicaid as the bill took shape behind closed doors.

Thirty years ago, Medicaid accounted for less than 3 percent of federal spending. Today, it’s nearly 10 percent. About one fifth of the US population is enrolled in it, according to a Congressional Research Service 2015 report. It pays for almost half of all births. It’s the single biggest payer for substance abuse treatment. It helps rural hospitals stay afloat and supports jobs in the health sector. It covers nursing homes for the elderly and long-term care for the disabled.

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Jun 14, 2017 | Mohave Dalily News

PHOENIX (AP) — The only two insurance companies offering individual health plans on federal exchanges in Arizona have filed paperwork to continue selling coverage in 2018, raising hopes that the state can avoid a repeat of last year’s crisis when one county was briefly left without a health insurance provider.

Officials with Blue Cross Blue Shield Arizona and Centene Corp’s Ambetter by Health Net confirmed this week that they have filed with the state Department of Insurance to continue offering insurance.

The companies have until July 1 to notify current customers if they change their plans and decide to pull out of the market. But if they follow through, the situation that developed last August when Aetna pulled out of Pinal County, leaving it without a plan for 2017, will be avoided. Blue Cross stepped in and offered coverage in Pinal County, sparing an estimated 8,000 to 10,000 customers from being left without individual insurance.

Whether the two remaining Arizona providers would stick it out has been an open question, closely watched by health care insiders. Tara Plese, a spokeswoman for Arizona Alliance for Community Health Centers, said her group spoke regularly with the insurers and believed they would stay.

“We had some assurances that they would do so,” Plese said Tuesday.

Losing either of the companies would have been catastrophic for the insurance exchanges created under the Affordable Care Act. Iowa is scrambling to come up with a way to keep the only remaining provider selling in that state after three other insurers decided they would leave that market. Several counties in Missouri, Ohio and Washington state have no insurer for next year.

Pricing information hasn’t been released by the companies or the Department of Insurance, which will release proposed increases above 10 percent next month and all pricing by early-October. This year, the average premium in Arizona before subsidies nearly doubled, from $324 a month last year to $611 a month.

Those price boosts had varying effects, mainly because many people were shielded from them because of tax subsidies that increase with rates. But the number of people who signed up for insurance this year in Arizona who don't qualify for subsidies that can cover much of the cost of insurance plunged by 23 percent, according to an analysis of federal data released in March done by the University of Arizona health insurance expert Dr. Daniel Derksen. Meanwhile, signups by people who get subsidies went up by 3 percent.

The total number of Arizonans who received subsidies went up from 75 percent last year to 86 percent this year, according to data released by the federal Centers for Medicare and Medicaid Services on Monday.

The fate of those subsidies and of cost-sharing payments to insurers to help offset costs for lower-income customers is in doubt because of an effort to replace the Obama-era law with a new Republican-backed health plan. A proposal that passed the House is now being reworked in the Senate.

The agency said in a news release that affordability was effecting enrollment, pointing to the number of consumers who chose insurance plans during the most recent open enrollment period and then didn't pay the premiums. About 16 percent of the people who chose plans nationally didn't "effectuate" that coverage by paying the needed premiums.

In Arizona, the number was much higher. At the close of open enrollment, 196,000 people had chosen a plan in Arizona. But numbers released by the government show only about 140,000 paid the premium, a drop-off of 28 percent. State enrollment topped out at about 171,000 early last year.

The Georgetown University Center for Children and Families (CCF) Rural Health Policy Project released Medicaid in Small Towns and Rural America: A Lifeline for Children, Families, and Communities. This report resulted from analysis by researchers from Georgetown and the University of North Carolina Rural Health Research Program and examined "how the role of Medicaid has changed over time in 46 states with small-town and rural populations."

The CCF also developed an interactive map that displays the percent of children in these areas covered by Medicaid in 2014-15.
https://ccf.georgetown.edu/map/the-percent-of-children-in-small-towns-and-rural-areas-covered-by-medicaid-201415/