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Trump told to use care in adjusting Obamacare

CHARLESTON — Federal Health and Human Services Secretary Sylvia Burwell on Tuesday urged the incoming Trump administration to weigh patient access, health care quality and affordability in reconsidering the law that extended Medicaid and private insurance coverage to millions of Americans.

Burwell, visiting her native West Virginia, and others at a forum called the federally supported coverage critically important. Six state residents recounted illnesses that would have gone untreated or driven them into dire financial straits without required coverage and patient payment limits.

“It would have probably bankrupted my family,” said Mina Schultz. Shortly after graduating from college, the Fairmont woman was diagnosed with bone cancer that required expensive surgery, chemotherapy and other treatment.

The Affordable Care Act is a signature Obama administration initiative that President-elect Donald Trump has vowed to at least partly roll back. Trump has praised its guaranteed insurance coverage of people with pre-existing conditions and letting young adults remain on parents’ policies until age 26.

That 2010 law established exchanges where almost 13 million U.S. residents have enrolled for commercial insurance, with about 7 million more joining expanded Medicaid, the government program for the poor.

In West Virginia, 37,000 people got commercial coverage through the exchange, most qualifying for federal subsidies that reduced their premiums. Nearly 180,000 more enrolled through Medicaid, which the state expanded by raising income eligibility to 138 percent of the federal poverty level paid by the federal government.

Burwell’s effort launched Tuesday is called “#CoverageMatters.” Open enrollment for coverage next year is underway. She acknowledged the federal program needs to be improved.

“Today is about shifting the conversation to real substance,” she said, adding that it’s meant to move the debate past slogans. “This is about people’s lives and what happens every day in their lives.”

It’s also about money.

Rocco Massey, community chief executive for Beckley Appalachian Regional Hospital, said expanded health coverage has saved the state’s hospitals about $300 million from fewer unpaid emergency room visits and hospitalizations. His own organization has seen unpaid care drop from 10 percent to 2 percent, he said.

According to Burwell, the rise in health care costs has slowed significantly since under the Affordable Care Act, also affecting commercial insurance covering about 150 million employees of private companies, coverage she said is also tax-subsidized. Meanwhile, incidents of patients harmed at hospitals through falls or other incidents have declined. All those effects have saved hundreds of billions of dollars, she said.

The Congressional Budget Office has estimated total federal health care subsidies at $600 billion this year. The office also estimated that repealing the Affordable Care Act would increase the total of uninsured by about 22 million next year and actually increase the federal budget deficit because of various economic factors.

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