KELLY MCEVERS, HOST:
The Republican Senate plan to replace Obamacare would dramatically change the country's largest public health insurance program, Medicaid. Medicaid covers 74 million people, including children, the disabled and older people living in nursing homes. Under the new Senate plan, which is broadly similar to the House Republican bill, fewer people will be eligible for Medicaid, and the expansion under Obamacare would eventually go away.
Pamela Morris is CEO of CareSource. That's a health insurance company in Ohio that provides coverage to thousands of Medicaid patients in the state. And I asked her how things at CareSource changed under Obamacare.
PAMELA MORRIS: Things changed for the better under Obamacare. We saw uninsured consumers get access to affordable coverage through the marketplace or through Medicaid expansion. So it was a very positive change.
MCEVERS: How many?
MORRIS: In terms of Medicaid expansion in Ohio, 700,000. Four-hundred-thousand of the 700 are CareSource.
MCEVERS: So what are your concerns with this new Senate health care bill?
MORRIS: Well, I think it takes us backwards. You know, it goes well beyond repeal and replace. So the deep cuts to Medicaid funding are our primary concern. So we are voicing our opposition to the deep funding cuts contained in both the House and Senate bills.
MCEVERS: In the Senate bill, the rollback of the Medicaid expansion is more gradual than what it is in the House bill. Does that relieve some of your concerns?
MORRIS: Not at all because it's still, at the end of the day, when the period ends of the rollback, that there are people who are going to lose their coverage. And if you're one of those people and you're in the middle of addiction treatment, serious illness and you're one of those, their voice counts. So we're very concerned about it. And the Senate version does very little to allay our concerns.
MCEVERS: And this is the first time lawmakers are proposing an actual cap on Medicaid.
MORRIS: Yes.
MCEVERS: How will that impact the people you serve?
MORRIS: You know, it's a fundamental change to the way the Medicaid program has operated since it was enacted in 1965. So we have very serious concerns about changing that open-ended nature of funding Medicaid in the federal state partnership to capping it. There will be loss of coverage. Provider reimbursement could be lowered. Jobs in the health care sector will be lost.
And with the loss of coverage, people are going to go back to using the emergency rooms for catastrophic coverage, and then we just start that spiral of cost-shifting all over again. And that was one of the benefits that we saw with Obamacare - that that cost-shifting really stopped as people got coverage.
MCEVERS: Ohio has one of the highest death tolls from opioid abuse in the United States. How will the new Republican plan affect coverage for substance abuse treatment and care?
MORRIS: Something we're very concerned about in Dayton in particular because we have an extremely high rate of opioid deaths in our county - it's not anything that we're proud of. When you have coverage under Medicaid today, you have access to treatment programs. You have access to primary care. So there's a whole support base and access to treatment that's available today that could be lost with these funding cuts. This is a crisis, as we all know, and this is not a step in the right direction.
MCEVERS: Pamela Morris, CEO and president of CareSource in Dayton, Ohio, thank you so much.
MORRIS: Thank you. Transcript provided by NPR, Copyright NPR.