The changing landscape for health care & safety net programs

The Washington State Budget & Policy Center hosted a policy briefing on the changing health care landscape.

Misha Werschkul, executive director for the Budget & Policy Center, was joined by Dr. Bob Crittenden, Teresa Mosqueda , and Liz Schott.

Dr. Bob Crittenden, Governor Inslee’s senior health policy advisor, focused on what was happening in healthcare on the federal level. He believes one of the biggest challenges facing healthcare reform and the ACA is the narrative of the system being completely broken, that Republicans are going to save America from the ACA. Instead of allowing facts to drive reform, reform is now driven by political agendas.

An audience member aptly summed up the difficulty of bipartisan healthcare reform:

You don’t even believe the messenger if you don’t agree with what they’re saying.

But Republicans and the Trump administration have been unable to agree on a healthcare plan despite campaign talk which promised an immediate repeal of the ACA.

“I’m cautiously optimistic that we have time,” Dr. Crittenden said. “The more trouble they have [with repeal and replace] the better off we are.”

The Washington State Budget & Policy Center’s  article shows the possible consequences Washingtonians could face if the ACA is repealed without a replacement.

Teresa Mosqueda, political & strategic campaign director at the Washington State Labor Council, echoed Dr. Crittenden’s optimism.

“We’re building a West Coast wall,” Mosqueda said. “This is a good wall, not the bad wall, where we are saying Washington, Oregon, California, Nevada, we all have the ability to create what we’d like to see, a West Coast response, and wall ourselves off, if we can, from the attacks as it relates to healthcare.”

Mosqueda stressed the importance of state governments not over-reacting to potential changes on the federal level and the need for constituents to share personal stories so that politicians understand the full consequences of changing healthcare programs.

Since November, Mosqueda has seen an increase in involvement from advocacy groups and community members to keep the ACA, Medicare, and Medicaid intact. She agrees that while these programs are not perfect, they can serve as a foundation for future reform.

Liz Schott, senior fellow, family income support division at the Center on Budget and Policy Priorities, talked on the possible consequences of switching Medicaid to block grant funding. Schott has twenty years of experience working with Temporary Assistance for Needy Families (TANF), which is funded through block grants.

“It’s been pretty grim,” Schott said. “Every block grant of course is different and it depends on what the statute says and exactly how the law does it… but, it’s been a huge reduction in money available. The TANF block grant the way it was designed was a flat amount of money, no cut at the outset, and almost all of the Medicaid proposals involve cutting the amount of federal dollars even at the onset.”

Since 1972, the number of families receiving TANF benefits has steadily decreased as a result of inflation. In 1972, 82 percent of families living in poverty were receiving benefits; in 2014 that number had dropped to 23 percent.

Proponents of block grants argue that they give states more flexibility on how to use federal funding. Schott argues that states already have flexibility through waivers and block grants only allow states to choose what programs to cut.

“This is not about flexibility, the point is to pull the federal dollars out,” she said.

As the federal government continues to draft plans for the future of healthcare, Washington’s response seems clear: keep costs down and coverage up.