Health care bill a death sentence for Eastern Kentucky

Change in life expectancy at birth by county, 1980-2014.
Change in life expectancy at birth by county, 1980-2014.

News reports this week have been confirming what many of us have always understood: The need for better access to quality health care in Kentucky is critical.

A study published in The Journal of the American Medical Association reveals that Eastern Kentucky is home to 8 of the 10 U.S. counties showing the greatest decline in life expectancy from 1980 to 2014. Improved access to quality, affordable health care is obviously needed badly and could be a real game changer for these struggling communities.

Unfortunately, the timing of the study doesn’t take into account the increase in health coverage brought about by the expansion of Medicaid in 2013. The Affordable Care Act and the creation of KyNect brought affordable health coverage to hundreds of thousands of Kentuckians, many for the first time in their lives.

Kentucky’s 5th Congressional District is home to 6 of the 8 Kentucky counties noted in the JAMA study. While we saw the third largest decrease in uninsured people in the entire country following the Medicaid expansion, the real effects of the adoption of the ACA are only now starting to become measurable.

Under the ACA, more than 82,000 people in the 5th District received health coverage, reducing our uninsured rate from 17.4 percent in 2012 to 5.7 percent in 2015. That’s a big deal. More widespread coverage means more preventive care; more services for expectant mothers and at-risk children; more effective treatment for chronic diseases like diabetes, heart disease and high blood pressure, and better access to substance abuse treatment and counseling.

Health benefits aside, our district saw the third largest increase in economic expansion in the U.S. resulting from the passage of the ACA. Our health-care providers received just short of $500 million between January 2014 and October 2015 attributable directly to Medicaid expansion. That’s big money going toward high-paying jobs in the health care sector, rippling through the region’s economy as a healthier workforce becomes more productive.

That’s why, as a proud Eastern Kentuckian, I was disappointed when the U.S. House voted on May 4 to repeal the ACA and replace it with the American Health Care Act of 2017. This move represents a giant step backward in fighting one of my region’s oldest and most stubborn demons: poor health. Additionally, the repeal will help fulfill the JAMA study’s prediction for those living in these eight Eastern Kentucky counties — people born there today can expect to live shorter lives than their parents.

The new AHCA omits ACA provisions designed to protect those with pre-existing conditions. The AHCA allows insurers to cherry-pick the youngest and the healthiest, again leaving those who need coverage the most left without any viable options.

The AHCA rips away coverage for substance abuse treatments that have been saving lives in a region losing its battle with an opioid addiction epidemic. These treatments, paid for by Medicaid, rose 500 percent during the first three years of the ACA.

It’s also important to note that in a region where some local governments are considering bankruptcy, the 5th Congressional District alone could lose up to 20,000 jobs —more than any other district nationwide — if the AHCA is passed in its present form. That’s nearly twice the number of coal jobs lost in Eastern Kentucky since 2011. The 5th District already has the sixth highest poverty rate out of all 435 congressional districts in America, so simply put, we can’t afford to lose any more jobs.

Certainly, Eastern Kentucky is at the epicenter of the American health-care debate, and while few of us could argue against improving the ACA, it’s foolish to dismiss the historic gains our region has made in terms of access to health-insurance coverage, or the positive economic impact the ACA has brought to a population struggling with the loss of its economy.

I hear regularly that we should “vote our values.” Assuming the values that move us to action are influenced by our Bible, shared morals, religion, compassion for others, or even simple economics, to me, repealing the ACA isn’t consistent with any of them. As a society, we should be lifting up those who are less fortunate and still struggling to realize their American dream. We should be taking care of those who can’t afford to protect themselves and need help to secure basic necessities like health care. No American should suffer because he or she can’t afford medical care, and the size of their wallet shouldn’t determine whether they live or die.

Replacing the ACA with the AHCA spins us around and marches us backwards in the fight to make health care available and affordable for everyone. Leaving Kentuckians trapped and vulnerable to the same old cycle of non-existent or inferior health-insurance coverage will only lead to more poor health outcomes and blighted economic opportunity. Those aren’t Kentucky values.

93rd District Rep. Chris Harris, D-Forest Hills, represents Pike and Martin counties in the Kentucky House of Representatives.