Minnesotans with chronic conditions fret over GOP health bill

Adele Harris has plenty on her mind these days: An 11-year-old daughter with cerebral palsy that confines her to a wheelchair, makes her vulnerable to pneumonia and will soon force her to undergo oral surgery because her teeth are scarring her tongue.

But it's health insurance that's weighing heavily on Harris lately — as it has for many Minnesotans since the U.S. House passed a Republican health care overhaul, the American Health Care Act.

The bill would cut billions of dollars from federal health spending and give states the option to abandon many of the insurance regulations created by the Affordable Care Act under Barack Obama. The strategy is designed to lower health insurance costs and premiums — a huge burden lately for many consumers — by giving insurers and state officials more flexibility.

But it has ignited an emotional response among many of the 744,000 Minnesotans with common preexisting conditions such as asthma and diabetes — as well as those with crippling disabilities — who could find that insurance is priced beyond their reach.

Harris' daughter, Lily, has had millions of dollars worth of care covered by the public Medicaid program and by private insurance. So the White Bear Lake mother worries about a nightmare scenario of her daughter getting ousted from Medicaid due to federal budget cuts and then using up private insurance options if the legislation permits insurance companies to reinstate lifetime or annual benefit caps.

"Where do we go after that?" she asked while wheeling Lily into the Gillette pediatric hospital in St. Paul for a checkup Thursday. "There's nothing left after that!"

The House legislation still faces a skeptical U.S. Senate, and would ultimately need action by Minnesota's governor before provisions affecting preexisting conditions could take effect. Nonetheless, Minnesotans with cancer histories and diabetes say they are nervous, particularly about the bill's potential to allow insurers to raise premiums on people with conditions like theirs.

"It's not as if I'm unhappy with my work — I'm not," she said. "But if my health begins to deteriorate, what do I do?"

Lawmakers' recent town hall meetings have been packed by Americans with chronic health concerns, many of whom fear the legislation would take the country back a decade, when insurers could deny coverage on the individual market to anyone with preexisting conditions.

In fact, it would only permit insurers to penalize such individuals for one year, and only if they let their prior coverage lapse more than two months. And that could occur only in states that sought waivers from current federal health insurance standards and created high-risk insurance programs to help the sickest of the sick afford coverage.

Even so, the number of people affected could end up being substantial, considering the number of Americans who lose health coverage every year due to job changes, divorces, aging out of their parents' plans, and moves, said Karen Pollitz, an analyst with the Kaiser Family Foundation, a national, nonpartisan, nonprofit health research group.

Two months can pass quickly, she said, if people aren't diligent about renewing coverage — and then they'd still find coverage but at exorbitant prices.

Of course, high costs are one of the problems in the current system, and one that Republican lawmakers believe the AHCA can effectively address.

"Unless we address rising costs, the insurance market will continue to worsen for families, in terms of both access and affordability," U.S. Rep. Erik Paulsen, R-Minn., wrote recently.

Daniel Nowacki of Waseca, who has Type 1 diabetes, isn't as worried about losing health coverage some day as he is about the cost of coverage now. The 33-year-old works full time changing oil to support his family, including two daughters, and then part time as a night security officer to pay for his own insurance.

"If that goes up more, I don't know what I'm going to have to do," he said.

Kevin Knutson, 61, of Coon Rapids took early retirement from flooring construction work because of arthritis, and he has watched his individual monthly premiums climb from $500 to $800 to $1,100 over the past three years.

"Far from addressing health care costs, the Republican proposal aims to go after the very things that insurance protects," Andy Slavitt, a former Medicare administrator who lives in Edina, wrote recently. Among them are "the requirement to cover mental health benefits, the prohibition against lifetime caps and the federal protection against being charged more because of a prior illness," Slavitt wrote.

The AHCA would also cut $2.5 billion from federal funding for Minnesota's Medicaid program, used mainly by people who are poor or have disabilities, in its first 18 months, according to state Department of Human Services estimates.

Exactly how Minnesota would absorb those cuts — perhaps by trimming benefits or eligibility for the program — is unclear. Gov. Mark Dayton said it won't be worth whatever flexibility the state receives.

"Saying they are going to give us more flexibility and then half the money, I mean that is not a good bargain," he said following the bill's passage.

Parents such as Harris worry the cuts will fall hardest on them because their disabled children have so many needs. Her daughter was born without a pulse and received $1.5 million worth of health care just in her first three months of life.

"She'll always need continuous care," her mother said.

Jeremy Olson • 612-673-7744