Tester on Obamacare: 'I don't know what's going to happen'

Montana's senior U.S. senator was in Havre at Bullhook Community Health Center Tuesday collecting input on the Patient Protection and Affordable Care Act to be ready when Republicans bring the possibility of repealing Barack Obama's signature health care reform to a vote Jan. 4.

"The whole thing is, I don't know what's going to happen," Sen. Jon Tester, D-Mont., told a group including more than 20 people from the health care industry during Tester's health care round table in Havre.

Republicans have said they plan to have legislation repealing the act - commonly called Obamacare - on Donald Trump's desk the day he takes office.

Tester said he doubts the entire bill will be repealed, although he added that if that is what is needed, he would support that.

"If that's the right thing to do, we ought to do it," Tester said.

But, he said, with many people supporting provisions such as not excluding people with pre-existing conditions from health care and allowing people to keep their children on their policies until they are 26, he doubts that all of the act will be repealed.

"I think the right direction is to fix what's wrong with the bill," Tester said. "Don't throw the baby out with the bath water."

He said he is holding as many meetings as he can before the issue comes up for a vote in the Senate so he knows what to tell his fellow senators about what is good and bad in Obamacare.

Tester has put a site online for people to list how the Affordable Care Act has impacted them, available at http://bit.ly/2h3G77K.

Tester said that in the Havre meeting and at other roundtables he has held, he has heard success stories as well as hearing problems such as health care premiums making insurance unaffordable for many people.

"I met with some business people this morning, and they told me, quite frankly, that premiums are getting completely unaffordable, and I agree with them 100 percent," Tester said.

He said he thinks the solution is to keep the parts of the bill that are helping people - such as the success stories he heard at the meeting in Bullhook - while finding ways to make the plan affordable for the people who now can't afford it.

Northern Montana Health Care President and CEO Dave Henry said he doubts the Republican efforts, now that they control both houses of Congress and the White House, will lead to wholesale dismantling the act.

"They're the dog that caught the car," Henry said.

Because many Republican lawmakers come from areas where constituents like some part of Obamacare, they would have a hard time completely repealing the act.

Health reform giving health care to new people

Several health care providers said the Affordable Care Act, particularly Medicaid expansion, has allowed people to get medical treatment they couldn't have before, and that repealing the act would eliminate that care.

Dr. Dee Althouse said she sees people come into Bullhook who don't realize they are eligible for Medicaid or for insurance premium assistance under the Affordable Care Act, and it changes their entire perception once they have health insurance.

"They realize they can take care of themselves," she said.

That allows the medical community to work on preventative care and keep illnesses or injuries from happening, she added.

Using an overall approach, with a case manager, also allows them to treat many underlying problems, Althouse said - people might not be able to afford medications, might not have housing, might not have transportation. Until those underlying problems are addressed, she can't help people improve their eating habits or help them with other issues, she said.

She and others at the meeting said many of the people they see also have addiction problems, and people cited successes with addiction treatment made possible by Obamacare.

Nurse practitioner Suzanne Lockwood, a specialist in psychiatric and mental health treatment, said that in the six months she has worked at Bullhook her caseload has grown to 460 clients. Of those, 50 percent have chemical dependency issues, Lockwood said.

About 10 percent of her clients have private insurance, she said.

She said that many of the people who need help also have mental health issues. Often people who are using drugs are self-medicating, she said.

When Tester asked if many people would have to stop seeking treatment if the Affordable Care Act was repealed, Lockwood estimated that 75 percent would not be able to continue.

"There's no way," she said.

Kathy Shrauger, a certified application counselor who helps people enroll in Medicaid and Healthy Montana Kids and find insurance through the Health Insurance Marketplace, estimated that she has helped 3,000 people in Hill County obtain coverage through Affordable Care Act provisions since 2013.

"I could go on all day and tell you stories, heartbreaking stories," Shrauger said.

Tester asked the group what they would say if they had one chance to say something on the floor of the Senate when repealing health care reform is debated.

"Think about the patients' lives it affects, especially in rural states," Bullhook CEO Cindy Smith said.

Tester said he wants people to talk to their lawmakers so the lawmakers know what they want done - he believes citizen voices still are crucial in the process, he said, including on several bills already proposed for the next Montana legislative session to repeal Medicaid expansion in the state.

"I think people's voices are incredibly important in this process," Tester said.

He agreed with former state senator and public service commission chair Greg Jergeson when he said during the meeting that people saying Obamacare should be repealed have to show what the replacement would be, or it's just talk.

"I don't think anybody wants to step back to what we had," Tester said.