As residents ponder what Congress’ new health care bill will mean for them, St. John’s Medical Center’s CEO said the hospital will continue to provide care to all Teton County residents even if some lose their health insurance.

The nonpartisan Congressional Budget Office estimates the health care bill unveiled last week by the U.S. Senate would reduce the federal budget deficit by $321 billion over the next 10 years but also that 22 million more Americans would be uninsured by 2026.

St. John’s CEO Dr. Paul Beaupre said there is no need to panic. In Teton County 1 out of every 9 people, nearly 3,000, are currently covered by former President Barack Obama’s health care law. The national average is closer to 1 in 33 people.

“The news for everybody in Jackson right now is that the hospital will remain open and capable of providing services,” Beaupre said. “We never turn anyone away on their ability to pay. We just don’t do that.”

Beaupre also said that while caring for uninsured patients might cost St. John’s more money, the hospital wouldn’t try to make up the difference by raising prices.

The Senate’s new bill, known as the Better Care Reconciliation Act of 2017, is the Republican Party’s bill intended to repeal and replace the Affordable Care Act, sometimes known as Obamacare. The vote on the bill has been pushed to after the Fourth of July recess because Republicans do not yet have enough votes to pass it.

Although Beaupre isn’t convinced that this is the final version of health care legislation, he worries about where the conversation is headed.

“What’s unfortunate in my opinion about modifying or repealing the ACA is that there is a significant amount of scientific data that says and has shown that countries that provide affordable or subsidized health care to the entire population have better outcomes,” he said. “We are moving, in my opinion right now, in the wrong direction.”

Patients speak out

Some valley residents are worried about being priced out of health care under the new bill.

The Congressional Budget Office reported that subsidies to help people buy health insurance would be “substantially smaller than under the current law.” In many cases, deductibles for low-income people could be higher. Premiums for older people would also be higher than under the current law, according to the report.

Predictions like those have some patients saying they’d rather die.

Jackson resident Richard Ray, 70, has Parkinson’s disease. He’s doing all right but knows the symptoms won’t be manageable in the next 10 years without full-time assistance in a nursing home.

“I expect to be pretty much out of luck,” he said. “I doubt I’ll die on the street, but I’m not at all able to see a way that my weakened, tremor-racked, slowly degenerating body will get the care I’ll require once I can’t feed myself or wipe my own ass. I figure my best choice will be a friendly doc, a vial of the right pills and a quiet corner before it goes that far.”

Others have said they would consider traveling to Colorado, where assisted suicide is legal, if their medical bills became insurmountable.

Resident Julie Scharnhorst lived in Denmark on and off for five years, where there is universal health care — and high taxes.

“It is truly amazing to have everyone taken care of and not ever having to worry if they can get treated or not,” she said. “No system is perfect, but I can tell you first hand that living in a country with those benefits was truly a gift and something we as Americans should have.”

Both Wyoming senators, John Barrasso and Mike Enzi, were part of the group of 13 Republican senators that created the bill. They say that Obamacare is failing and that the Senate’s health bill will help Wyoming residents who only have access to one insurance provider.

“As a doctor for more than 25 years in Wyoming, I know how important it is to give patients access to quality and affordable health care,” Barrasso said. “That’s why our draft bill focuses on lowering the cost of care for people in Wyoming and across the country. Also, as a doctor and the husband of a breast cancer survivor, I know how important it is that patients with serious illnesses are covered.”

He also said that “there are no actual cuts to Medicaid” but that funding “will not be as fast of a growth rate as before.”

Enzi said the bill fixes challenges facing Medicaid while also providing health care to “our most vulnerable populations.” A highlight of the bill, he said, is repealing the individual and employer mandates.

Enzi’s press secretary, Max D’Onofrio, said that “we have some people who are supportive of our efforts and some who aren’t,” but that overall he thinks slowing the growth of Medicaid is a good thing because it should be a fallback, not a starting point.

“Health care is personal,” D’Onofrio said. “Yet it’s difficult and some might say impossible to legislate health care for 321 million people and satisfy everyone. ... We have to make changes. Change is hard, but we know that and have taken steps to protect the most vulnerable among us.”

Other highlights of the bill include capping federal funding for Medicaid, temporarily freezing federal funding for Planned Parenthood and keeping protections that make sure insurance companies don’t charge people with pre-existing conditions more. A last-minute add would make people wait six months to sign up if their previous coverage has lapsed for more than 63 days. That’s designed to keep people from buying insurance only when they are sick.

Teton County Republicans chairman Paul Vogelheim said “we need to be mindful and involved” in creating a health care system that has affordable access with choices and personalized control.

“The current draft needs some more work,” he said.

He also believes there is plenty of work to be done with more local issues, like infrastructure challenges.

Teton County Democrats firmly oppose the new bill.

“Since the Republican AHCA is going to once again leave millions uninsured or underinsured,” Chairwoman Marylee White said, “and Democrats believe that access to health care is a right, Teton County Democrats support adoption of a single-payer health insurance system.”

The upside

There are residents from around the county, and the country, who would benefit from the Senate health care bill in its current form.

St. John’s Medical Center trustee Joe Albright, an Affordable Care Act navigator, estimates that 2,400 Teton County residents “stand to benefit directly if the Senate Republican health bill becomes law.”

Roughly 400 low-income residents currently don’t qualify for Obamacare subsidies or Medicaid because even though their incomes are below the poverty line they are able-bodied and childless.

“The Senate Republican bill would for the first time ever make them eligible to buy health insurance — if they can afford it — with government-subsidized premiums, deductibles and co-pays,” Albright said.

The subsidies would end after 2019.

A larger group of beneficiaries is an estimated 2,000 residents whose tax returns show an income above $250,000 per couple or $200,000 per individual. Those high-income residents would get tax cuts of 3.8 percent on their capital gains and dividends, effectively “cutting their income tax bills by thousands of dollars a year,” Albright said.

Economist Barbara Herz, vice chair of the St. John’s Medical Center board of trustees, said she doesn’t need a tax break and is worried about health care for her kids and grandkids.

“The bottom line is more Americans will pay more for less insurance while we get a tax break,” she said. “Seems so wrong to me.”

Contact Kylie Mohr at 732-7079, or @JHNGhealth.

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