Kitsap health-care leaders share fears over Medicaid rollback

By:  Tad Sooter
Source: The Kitsap Sun

The economic recession threw Renee Kimball-Rouse's life into a tailspin.

She lost her job, lost her house and lost her health insurance. Her mental health deteriorated and she spent time in jail.

It wasn't until Kimball-Rouse qualified for coverage under the state's expanded Medicaid program that she was able to seek mental health care and begin to piece her life back together. She works for the Seattle Mariners now, serves as a patient advocate on the Peninsula Community Health Services board and advocates for affordable housing.

"I think taking away Medicaid ... a lot of us would regress," Kimball-Rouse said during a roundtable discussion with Sen. Maria Cantwell, D-Washington, and Kitsap health care leaders held Saturday at Harrison Medical Center. "Medicaid has helped us to be our most authentic self."

Cantwell swung through Bremerton to gather input on the value of the Medicaid program as Democrats in Congress rally opposition to a Republican bill that would repeal and replace key provisions of the Affordable Care Act, also called Obamacare.

Obamacare kicked in federal funding for states like Washington that chose to expand Medicaid eligibility. The GOP's American Health Care Act would freeze Medicaid expansion enrollment in 2020. It would also cap the amount of Medicaid matching funds distributed to states. Matches are currently allocated based on need.

Cantwell told the group she wants to make a case that Medicaid already saves taxpayers money by providing patients with access to preventive care and supporting innovative health initiatives. She said cutting Medicaid "is not the cost effective approach."

"I am interested in us moving forward as a country and continuing to innovate in health care as we do so well here in the Northwest," Cantwell said.

The Affordable Care Act had an immediate effect on health care access in Kitsap. About 24,000 residents obtained coverage following its rollout in 2013, including 19,000 covered under expanded Medicaid (called Apple Health in Washington). The county's uninsured rate dropped to below 5 percent — the lowest percentage in the state. More than 40,000 Kitsap residents are now enrolled in Medicaid programs.

While providing coverage for individuals like Kimball-Rouse, the sudden increase in insured residents resulted in more funding for organizations that provide services for low-income households, speakers at the roundtable said.

Peninsula Community Health Services saw its rate of uninsured patients fall from about 57 percent in 2012 to 8 percent in 2014. With more of its work reimbursed, the community health center was able to invest in dental clinics, behavioral health care and programs to help patients manage chronic disease. CEO Jennifer Kreidler-Moss said Peninsula Community Health would face a 40 percent reduction in revenue if the Affordable Care Act was fully repealed.

"We will have no choice but to start looking at cutting programs," she said.

Kitsap Mental Health Services CEO Joe Roszak said Medicaid expansion allowed the organization to offer care to more clients, reducing the likelihood of those people will wind up at emergency rooms or in jail. The GOP health care proposal could undue that progress, he said.

"It has the potential to push over 1,000 people back into the community that won't have available services, and we know the consequences of that," Roszak said.

Medicaid similarly aided tribal communities in expanding health and wellness programs, according to representatives of the Port Gamble S'Klallam and Suquamish tribes. Harrison Medical Center staff said the increase in insured patients makes it easier for hospital patients to find appropriate ongoing care with another provider instead of being sent home or kept at Harrison.

Other speakers noted Medicaid funding supports collaborative work to address regional health issues. Bremerton Mayor Patty Lent said health coverage for low-income residents is key to Kitsap Connect, an initiative that links chronically-homeless people to services. A three-county response to the opioid epidemic is being funded, in part, as a Medicaid demonstration project. Olympic Community of Health Director Elya Moore said Medicaid coverage also helps people with opioid use disorder afford the expensive medications needed to treat their condition.

Cuts to Medicaid "would be a major problem" for efforts to reduce opioid use, Moore said.

Kreidler-Moss told Cantwell that Medicaid expansion allowed health care providers to worry less about improving access for patients and more about improving the overall health of the community.

"Had you been here five years ago and sat in this room, we all would have told you about the access crisis in Kitsap," Kreidler-Moss said. "... Now what we talk about is a wellness crisis."