Setting the record straight on ACA

Setting the record straight at the town hall hosted by WPSU on Aug. 10, Rep. Glenn Thompson made a number of statements about health care and, in particular justifying his vote for the Affordable Health Care Act. He repeatedly asserted that the Affordable Care Act is “failing, broken, a sinking ship, imploding.” Hyperbole and vague characterizations cannot easily be countered, but we can set the record straight with some facts about the ACA and Medicaid expansion.

Here is what Thompson said and the facts to counter his assertions. One of the points Rep. Thompson came back to over and over again are the number of uninsured. He did not focus on the number of people who are no longer uninsured because they gained coverage through the ACA and MA expansion. In Pennsylvania, almost two million individuals gained insurance coverage through the ACA and MA expansion. Instead, Thompson said the number of uninsured in Centre County alone had increased from 9,000 (7 percent) to 11,000 (9 percent). Contrary to the information cited by Rep. Thompson, health data for Centre County show that the number of uninsured dropped from 15,163 in 2013 to 11,322 in 2017, going from 13 percent to 9 percent.

In a response to a question about Thompson’s vote (as part of the AHCA) to defund women’s health care services provided by Planned Parenthood, he argued that (1) there were no Planned Parenthood clinics in his district and that (2) he was an advocate of federally qualified health care centers. So where are these centers in the 5th District and who do they serve? According to the National Association of Community Health Centers, these community health centers serve 142,000 underserved individuals in 15 centers, of which two are dental clinics and one is a youth clinic, so that leaves 12 general community health centers. Only one of the 12 clinics is a women’s health center, located in Huntingdon. While these options are good, they are woefully inadequate to serve the almost 700,000 mostly rural residents of the 5th District and especially the needs of low-income women in the district.

Low-income tends to be associated with lack of transportation, chronic health conditions, and early pregnancy. These circumstances make it extremely difficult for rural residents to access the widely dispersed clinics that Rep. Thompson advocates for providing access to women’s health care. Lack of access to contraception, family planning counseling, prenatal care, STI testing, and to cancer and general health screenings for diabetes and heart disease, mean that women will have more unintended pregnancies, have more problem pregnancies and poorer health outcomes for babies.

These women will be sicker and suffer higher rates of mortality than they would if they had access to the very specific women’s health care that Planned Parenthood provides. In response to a town hall attendee’s statement advocating for a single-payer health care system, Rep. Thompson cited the problems of the veterans health care system as an example of a single-payer system’s inherent problems. He continued in his response to object to the inherent rationing of health care that would be associated with a single-payer system. The example of rationing that he cited was Medicare patients in nursing homes who were denied physical therapy. It is my understanding that nursing home patients receive PT until they are judged to be “not making progress.”

Is Rep. Thompson suggesting that patients should be allowed to continue receiving PT even if it isn’t a benefit to them? Thompson’s rambling answer seemed unfocused and incoherent. Despite all the problems with the veterans health care system, the majority of veterans and the groups like the American Legion that advocate for them want to see it maintained and not privatized. The major problem with access to care for veterans seems to be a shortage of providers, both physicians and psychologists. Similarly, surveys of Medicare and Medicaid patients (single-payer type systems) show high levels of satisfaction with care. Anyone who has ever been denied a request for a test, a prescription, physical therapy or psychological treatment from their insurance provider has had care rationed. Rationing is not a new phenomenon. Managing health care costs means that there are limits on what any insured person, whether through private insurance, the VA, MA or Medicare can obtain. Worse yet are all the uninsured and underinsured whose care is rationed on a daily basis.

For these people, the cost of a doctor’s visit or a prescription for antibiotics or insulin strips makes health care inaccessible. Their health care is rationed because they cannot afford it. Responding to a question about voting to cut $800 billion from MA over the next 10 years (part of the AHCA), he claimed that MA would not have been cut drastically. Instead of responding to the concerns of the questioner, Thompson segued to the unrelated topic of coverage of pre-existing conditions. However, the cut in MA funding that he voted for is the ultimate form of rationing — establishing per capita caps or block grants — which would force states to reduce benefits and/or cut the number of recipients. Although the majority of MA recipients are poor children and adults, by far most MA spending in PA is for the elderly and disabled, either for nursing home or community-based services.

The ACA is not imploding, but Thompson’s portrayal of himself as a health care expert and caring human being is now a sinking ship. By voting for and continuing to defend his vote for the AHCA, Thompson demonstrates he is willing to bring the most vulnerable in his district — the elderly, disabled and economically needy — down with him.

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