Trumpcare vote creates backlash in Massachusetts

The U.S. House on Thursday voted 217-213 to pass legislation repealing the Affordable Care Act and replacing it with the Republican-sponsored American Health Care Act.

Republican Gov. Charlie Baker, who warned before the vote that the bill could lead to a "massive" loss of federal funds for Massachusetts, said he was disappointed by the vote.

"As the U.S. Senate takes up this bill, we will continue to advocate for the Commonwealth's priorities so that all residents have access to the health coverage they need," Baker said in a statement released after the vote. "Maintaining flexibility through the Medicaid program is critical to the Commonwealth's ability to provide coverage for the needy and I urge Congress to reject this bill in its current form."

U.S. House Majority Leader Kevin McCarthy, a California Republican, celebrated the vote.

"Today is the start of a new beginning. Yes, it's about providing better health care," McCarthy said after the vote. "But I happen to have been a small business owner and I listened to my district. Do you know how many families no longer have a 40-hour job and now have to take two part-time jobs? Or how many small business owners told me they couldn't expand anymore because they were afraid of what Obamacare would do to them. We are going to unshackle them and build an economy where people have greater choice in their health care, and protect pre-existing conditions."

The bill would cost Massachusetts at least $1 billion and "probably more," Baker told reporters.

"We're certainly not the only state for whom this is an issue and I remain deeply concerned that this particular bill -- and admittedly there are still facts to be learned about it, it's not completely clear what every element is -- would be a very difficult pill for the commonwealth to swallow," he said at an event in South Boston. "My hope is that folks will basically put it away and come up with something else, because I certainly think there are plenty of things we can do to fix the Affordable Care Act."

Baker noted the "fairly long, and some would say wonky and nerdy letters" that he's written to McCarthy and others about how he would prefer to see Congress go about changing the Affordable Care Act.

Though he spoke to reporters about 90 minutes before the House vote, the governor said that he expects to work with other state executives and the Massachusetts delegation as the bill advances to the U.S. Senate.

"Remember, this is a long process. This is the House of Representatives, it still needs to move through the Senate. There are many Republicans, as well as Democrats, in the Senate who spoke out against the previous proposal that was put forth before the House that they didn't vote on," Baker said. "And we would continue to work with other governors and with our congressional delegation and others to try to make sure that in the end whatever happens here, if something happens, it works for Massachusetts."

Health Care for All says the bill will "make massive cuts to Medicaid and rip up the insurance protections in the Affordable Care Act." The group plans a 4 p.m. "emergency rally" on the plaza outside the JFK Federal Building, 15 New Sudbury Street. Sens. Ed Markey and Elizabeth Warren have offices there.

Local reactions poured in after the vote:

-- Congresswoman Niki Tsongas said the bill passed with all Democrats and 20 Republicans in opposition and would move to the Senate for "possible consideration." Tsongas said, "The first version of Trumpcare, which was pulled from the Floor in March due to lack of support, was indefensible and incurably flawed. Under the bill, 24 million Americans would lose health care coverage, Medicare and Medicaid would be significantly cut and destabilized, premiums would soar and the wealthiest of Americans would get a tax break while increased burden was placed on seniors, the sick, low income families and millions more American families. The GOP plan undermined women's health care, gutted consumer protections, could cause major job loss, prevent millions from receiving life-saving substance abuse treatments and programs, and would have had negative ramifications for the many people who get coverage through their employer. None of that has changed. All of those irresponsible and harmful aspects of the original version of Trumpcare remain in the bill we voted on today. In fact, the version of the bill we voted on today is much, much worse. In an attempt to entice the most extreme members of their party, Speaker Ryan, President Trump, and GOP leaders made a deal that would allow states to cut the essential health benefits that insurers currently must cover, like maternity care, mental health, prescription drugs, and emergency room visits, just to name a few."

-- Congressman Stephen Lynch: "I remain strongly opposed to TrumpCare and I am disappointed that yet again House Republican leadership rushed their proposal to the Floor without hearings, time for public input, or an estimate of what this will cost average families. This is not a credible attempt to improve access to affordable healthcare. TrumpCare would weaken pre-existing condition protections, causing premium increases for millions. This proposal would hurt retirees' access to healthcare by weakening Medicare and by dramatically increasing costs for individuals over age 50. And TrumpCare does nothing to address the rising cost of prescription drugs."

-- Lora Pellegrini, president and CEO of Massachusetts Association of Health Plans: "As the model for the ACA, Massachusetts has made significant advances over the past decade in expanding coverage and on efforts to contain health care costs. We are concerned about the impact that today's vote will have on residents of the Commonwealth and will jeopardize the state's health reform efforts. We remain committed to working with Governor Baker and members of his Administration, the Attorney General, legislative leaders, the Congressional delegation, and our partners in the health care community on measures to ensure that today's vote does not disrupt access to health care for Massachusetts residents."

-- Tyrék Lee Sr., Executive VP of 1199SEIU United Healthcare Workers East: "With one reckless vote, Congressional Republicans have chosen to eliminate vital healthcare coverage for millions of hardworking Americans so that they can give a massive tax cut to the very wealthiest in our country. This bill will have catastrophic consequences for Massachusetts - threatening coverage for up to half a million of our most vulnerable residents, costing the state billions of dollars, and jeopardizing the Commonwealth's largest industry and one of its most important economic drivers. It will also weaken insurance protections, threaten mental health and addition recovery services and increase out-of-pocket expenses."

-- Lynn Nicholas, President & CEO, Massachusetts Health & Hospital Association: "Today's passage of an amended version of the American Health Care Act (AHCA) threatens to severely damage the progress our state and country have made in healthcare access, affordability and delivery. Most troubling, it will put health coverage in jeopardy for many Americans, particularly for older and sicker patients. The bill's replacement of today's equal state and federal partnership in the commonwealth's Medicaid program with a restrictive per capita financing scheme will result in significant funding implications for health coverage for thousands of Massachusetts low-income individuals and the providers that care for them. MassHealth, as it known in Massachusetts, covers nearly 1.9 million members and has been key to our collective effort to reduce the number of uninsured. Diminution of funding to MassHealth as result of the AHCA bill would directly imperil the program and its future goals. For those purchasing insurance in our insurance exchange, the bill's tax credit approach will offer far less to those with the most financial need, and lead to increased levels of uninsured and under-insured. Given the major implications on both Medicaid and subsidized insurance coverage, the AHCA threatens to turn back the clock on all of the work that has been accomplished since our state's 2006 health reform law and seriously disrupt efforts to improve the ways healthcare is delivered. The amended AHCA bill also permits states to obtain waivers from essential health benefits and rules governing how insurance is priced. Such an option would likely leave many around the country with inadequate coverage and make coverage for those with pre-existing conditions unaffordable. How can such a solution be good for anyone?"

-- Sen. Sal DiDomenico of Everett, who during the vote was speaking at an event promoting legislation that would lift a cap on benefits for children conceived while a family is receiving welfare, said afterwards he was sad to learn the bill passed. "It's a disgrace that the Republican party would play politics with the health of our country, especially kids," said the Senate Ways and Means Committee vice chairman.

-- Health Care Financing Committee Co-chair Rep. Jeff Sanchez: "The American Health Care Act hurts the most vulnerable among us - our elderly, sick and the disabled. Massachusetts' success in insuring 98% of the population and active participation from patients, providers, employers and insurers exemplifies what can work. TrumpCare is not good for Massachusetts and not good for America."

-- Dr. Jennifer Childs-Roshak, president and CEO, Planned Parenthood League of Massachusetts: "House Republicans just voted to kick millions of people off of their health insurance and told women across the country that their health does not matter. By passing this bill, House Republicans are eliminating critical protections for people with pre-existing conditions, undermining coverage standards for Essential Health Benefits, and blocking patients from receiving preventive care at Planned Parenthood health centers. This effort to 'defund' Planned Parenthood would have a devastating impact on the millions of people who rely on Planned Parenthood health centers for birth control, cancer screenings, and STD testing and treatment, and undermines the enormous progress we've made in improving women's health care and decreasing the rates of unintended pregnancy. This legislation would also allow insurers to consider pregnancy to be a pre-existing condition and refuse to cover maternity and newborn care, and force new moms with Medicaid coverage back to work shortly after giving birth. Simply put, this bill makes it harder to prevent unintended pregnancy, harder to have a healthy pregnancy, and harder to raise a family."

-- Henry L. Dorkin, MD, President of the Massachusetts Medical Society: "None of the modifications made to the original legislation have mitigated the grievous harm that this bill would inflict on our patients - including the most vulnerable. In fact, when it comes to affordable, reliable health care coverage, the current version of the AHCA is actually worse than the original. The AHCA would lead to millions of Americans losing the coverage on which they depend, and it would result in insurance coverage for millions of others that is costly and unreliable. Insurance coverage is not meaningful if patients cannot access the care they need. Affordable coverage of patients with pre-existing conditions is essential for their lives and well-being - and for the sustainability of America's health care system. The AHCA would skyrocket the costs of insurance for the millions of Americans who live with pre-existing conditions, and history has shown that high-risk pools are not an effective solution."