Members of the local medical community Thursday said cuts to the federal Affordable Care Act would leave patients uninsured, increase emergency room use and harm innovative efforts to address the roots of health problems and control costs.
U.S. Sen. Ron Wyden, D-Ore., visited La Clinica in Medford to hear from a roundtable of providers as President Donald Trump and Republicans in Congress vow to repeal and replace the 2010 federal act that greatly expanded government-subsidized health insurance.
Providers said cuts would not only affect physical health care, but would roll back mental health services and addiction treatment.
Without health insurance, patients can be hit with financially devastating medical bills. Providers pointed to $750,000 hospital bills for open heart surgery and other major health problems. They said uninsured patients in their 50s who are too young for Medicare could lose everything, including their homes.
Pediatricians could be heavily impacted by Affordable Care Act cuts, because children are disproportionately on the Oregon Health Plan. Since the expansion of health care coverage, one in three Jackson County residents is on OHP.
Coordinated care organizations would be less able to use innovative, personalized and local tactics to improve people's health and reduce medical costs, said Josh Balloch, vice president of government relations and health policy for AllCare Health. AllCare coordinates physical, mental and dental benefits for Jackson County residents, along with the other local CCO, Jackson Care Connect.
Balloch pointed to the example of a patient who went to the emergency room a few days after abdominal surgery because he had popped out his stitches. No one was available to help him chop wood for his stove, so he tried to do it himself.
AllCare delivered wood to him and now asks patients who are being discharged how they heat their homes, Balloch said.
He said AllCare focuses on preventive care, which improves patient health and reduces costly emergency room visits and hospitalizations.
A local cardiologist said heart specialists are struggling to meet the increased patient load triggered by passage of the Affordable Care Act. People who had long been without insurance put off care, worsening their heart conditions.
With care, they are better able to manage their health and avoid heart attacks, he said.
Another local provider told how he struggled to find surgeons to take care of a man with lymphoma who didn't qualify for Medicaid, even with the Affordable Care Act expansion. He said some people continue to slip through the cracks.
Matthew Hough, medical director for Jackson Care Connect, said repealing the act would cost 49,000 jobs in Oregon.
"Health care is the biggest employer in Jackson County," he said, noting many of the jobs provide good pay and benefits.
Providers said there is still not enough local capacity to treat mental illness, and cutbacks would make the situation worse. Local emergency rooms and the psychiatric unit at Asante Rogue Regional Medical Center are overflowing with people in mental health crisis.
Meanwhile, Democratic Gov. Kate Brown has proposed closing an Oregon State Hospital psychiatric facility as part of proposed budget cuts and tax hikes. Providers said they have grave concerns about the proposal.
Efforts to combat addiction to methamphetamine, heroin and opioid prescription painkillers could take a hit. The Affordable Care Act expanded addiction treatment coverage, providers said.
Addiction not only impacts adults, but children of addicts and babies born to drug-addicted mothers. Newborn babies are regularly admitted to Asante's neonatal intensive care unit suffering from withdrawal after exposure to drugs while in the womb, providers said.
All the providers said skyrocketing medication costs are undermining their efforts to provide better preventive care and control overall costs. They noted hepatitis C pills that cure the disease cost $1,000 per pill.
Wyden said America is reaching a point where new cures and treatments are available, but no one can afford them.
A patient who had a stem cell transplant said he pays a a $30 monthly co-pay for ongoing medication, but learned the true cost of the drug to his insurance provider is $9,000 per month.
This year, his co-pay went up to $60 because the drug jumped in price to $11,000, he said.
The rising cost of medication is "gobbling every possible dollar of cost savings," said La Clinica Chief Executive Officer Brenda Johnson.