Repeal and replace must not leave vets behind

Floyd Trujillo
Floyd Trujillo

I’m proud to have served my country. But my country — or more precisely, its health care system — has fallen short in recent years. Veterans Affairs facilities have experienced well-known problems, and  1.75 million veterans who rely on Medicaid for health care face an uncertain future.

The Affordable Care Act (ACA) clearly needs to be repealed. However, a simultaneous replacement guaranteeing fair coverage must be enacted as well.

Given the Republicans have a golden opportunity to craft their own health care reform bill, members of Congress must remember it’s critical to ensure those with health coverage remain protected, especially those with pre-existing conditions. This is what President Donald Trump promised, and Congress must deliver.

Unfortunately, the Congressional Budget Office reports that the American Health Care Act (AHCA), the replacement bill that passed the House, doesn’t live up to this promise. The CBO found that under the AHCA, 51 million people would be uninsured in 2026, 23 million more than now. Many protections for those with pre-existing conditions would be taken away as well.

One major reason the bill falls short in my view is it’s detrimental to the Medicaid benefits upon which 41,000 vets in Colorado rely without offering any resources or other ways to take care of them. The CBO reports that Medicaid would be cut by $834 billion — which would be devastating to those who count on Medicaid for care, including veterans, if we can’t maintain expanded coverage. Block grants and per capita caps simply can’t be used to make cuts to an already underfunded program in any bill that passes the Senate. Otherwise, the hospital payment reductions used to fund coverage expansion under the ACA must be restored. We must make sure hospitals have the resources needed to offset the increased number of uninsured for whom they will care.

Meanwhile, Senate Republicans just unveiled their own bill, the Better Care Reconciliation Act. While the CBO will score this new bill in coming days and weeks, what we know is proposed cuts to Medicaid are even deeper, and many of the worst provisions in the House bill are retained.

The House plan eliminates the rule mandating Medicaid plans cover essential services. This includes mental health, substance use and behavioral health services — conditions from which, sadly, many of my fellow veterans suffer.
In fact, a 2015 survey from the nonprofit Iraq & Afghanistan Veterans of America concluded that 58 percent of respondents reported having a mental health injury related to service. For veterans who suffer from such mental health issues as post-traumatic stress disorder and are at much higher suicide risk than the general public, the AHCA could amount to a death sentence. The Senate bill offers little additional funding for opioid treatment even as it cuts more from Medicaid.

Both the House and Senate bills would leave hundreds of thousands of other Coloradans behind — especially the most vulnerable, like our children, the elderly and low-income families.

The AHCA would permit states to forgo certain insurance rules and consumer protections, especially those related to essential benefits and community rating. As a result, state waivers could allow premiums to be set according to individual risk for some consumers. Returning to that approach would mean millions more uninsured.

I find all this deeply troubling. I can’t support legislation that leaves millions vulnerable — especially those who’ve served our country in uniform — and I can’t imagine many Republicans will, either. I am glad to hear U.S. Sen. Cory Gardner, a Republican from Colorado, is scrutinizing the Senate bill. I hope he’s able to convince his fellow Republicans to pass legislation that fulfills the president’s campaign promises.

We need to urge lawmakers to return to the drawing board to find a solution that provides coverage to those who need it and ensures the most vulnerable, including those who’ve bravely fought for our country, aren’t left behind.

Floyd Trujillo is a Marine Corps veteran who’ s worked in the fossil fuels industry for more than 30 years. Trujillo has been active in Hispanics in Energy, Coloradans for Responsible Energy Development and during the 2016 presidential campaign served as chairman of Colorado Hispanics for Trump.