U.S. Sen. Jon Tester

U.S. Sen. Jon Tester, D-Mont., holds a press conference at Riverstone Health to talk about the Senate's healthcare bill Friday.

CASEY PAGE, Billings Gazette

BILLINGS — U.S. Sen. Jon Tester encouraged Republican lawmakers who backed away from the Senate GOP healthcare bill this week to follow through by voting against it after the July 4 break.

Tester, a Democrat, said during a stop at Riverstone Health in Billings that the GOP opposition that resulted in Senate Majority Leader Mitch McConnell dropping plans for a vote this week wasn’t enough.

The Senate GOP’s Better Care Reconciliation Act, written to repeal much of the President Barack Obama’s 2010 Affordable Care Act, should be scrapped Tester said.

U.S. Sen. Jon Tester

U.S. Sen. Jon Tester, D-Mont., at a press conference in early 2017 in Billings.

Since the ACA’s 2010 creation without GOP support, Republicans have vowed to replace it, objecting to the ACA mandate that all Americans buy health insurance and that states be empowered to extend Medicaid to the working poor. In Montana, 79,000 workers earning $16,400 a year, equal to 138 percent federal poverty level, now have Medicaid under ACA provisions.

Tester counted himself among Democrats willing to work with Republicans to fix the ACA if the GOP health care bill fails.

“Only 17 percent of Americans are in favor of this bill. It’s hardly a profile in courage for these senators to voice opposition now, but it will be important for them to follow through with a no vote,” Tester said. “Opposition should not be based on popularity and party. Folks should oppose this bill because it’s irresponsible. It doesn’t address the real problem of higher premiums and deductibles for the folks that aren’t getting subsidies.”

U.S. Sen. Jon Tester

Vicky Byrn of the Montana Nurses Association speaks during a press conference called by U.S. Sen. Jon Tester, D-Mont., at Riverstone Health to talk about the Senate's healthcare bill Friday.

Tester emphasized that if the Senate GOP’s health care bill passes, thousands of Montanans will lose coverage, primarily through cuts to Medicaid. The number of people nationwide to lose health coverage under the Senate majority plan is estimated to be 22 million by the Congressional Budget Office.

Montanans older than 50 will face higher rates adjusted to reflect the costs of their health care needs. Tester called the higher rates for Montanans age 50-plus an “age tax".

Medicaid provided to low-income veterans, who in some cases choose the option when Veteran’s health care benefits aren’t offered close to home, would also face cuts, Tester said.

“All of this will happen so some D.C. politicians can fulfill a bumper sticker campaign promise,” Tester said, “and cut taxes for the wealthiest of the wealthy in our country.”

U.S. Sen. Jon Tester

Barb Schneeman of Riverstone Health talks about her breast cancer diagnosis as U.S. Sen. Jon Tester, D-Mont., looks on during a press conference to talk about the Senate's healthcare bill Friday.

The senator was flanked by members of Riverstone Health, Yellowstone County’s community health center, the largest of its kind in Montana with roughly 20,000 patients. Half of Riverstone’s patients rely on Medicaid. The cuts to Medicaid spelled out in the Senate GOP bill would result in tough decisions for Riverstone, said John Felton, the health center’s president and CEO.

Medicaid cuts, spread over seven years, equate to a $5.3 billion cut in federal funding for Montana, according to a study commissioned by the Montana Healthcare Foundation.

The Montana Healthcare Foundation was created in 2013, and came into existence as a result of the sale of Blue Cross and Blue Shield of Montana to a private corporation. In accordance with state law, the assets were transferred to a charitable trust to be managed for public benefit. 

“There are only three ways to deal with less Medicaid money,” Felton said. “You can reduce eligibility, you can reduce benefits, or you can reduce payments to providers, all of which have the ultimate effect of decreasing access to health care services for our most at risk and vulnerable neighbors.”

In the undercurrent of the GOP Senate bill debate, is the elimination of the Prevention and Public Health Trust Fund. The $900 million portion of the Centers for Disease Control budget is key to prevention programs in Montana, where the trust fund has provided $23 million on prevention activities like diabetes prevention and immunizations.

“We all understand the need to reduce the overall cost of health care. Prevention is unquestionably the best way to do so in the long term,” Felton said.

Nurses are concerned that the removal of health care mandates baked into the Affordable Care Act will result in state’s dropping important care requirements, said Vicky Byrd, Montana Nurses Association executive director. Byrd said essential services are at risk.

“Who’s ever needed prescription drugs, hospitalization, pediatric services, laboratory services, rehabilitative services preventive wellness, ER visits, pregnancy and maternity?” Byrd said. “And probably the most important essential health care benefit needed as we battle the opioid and other addiction crisis, is the mental health and substance abuse services, which includes behavioral health treatment.”

Montana’s Republican senator, Steve Daines, has said he’s undecided on how he will vote on his party’s health care bill. Daines wanted to wait until after hearing from Montanans before making a decision. He set those terms June 22, the day the BCRA was released to the Senate. The contents of the bill, crafted by 13 Republican lawmakers behind closed doors, had not been fully known until last week.

Daines, much like Tester in the year leading up to the passage of the Democrat’s health care reform bill, has limited the opportunities for opponents of BCRA to confront him face to face. However, he has conducted call-in town hall meetings with 30,000 to 40,000 people dialed in to participate.

Tester, has advocated for the Affordable Care Act through in-person town hall meetings more in the last six months than he did in the year before the bill became law. Conservative opponents to the ACA, who were sure to protest at public meetings in 2009, have been nonexistent as the senators defends the ACA this year.

Tester said the Affordable Care Act, better known as Obamacare, has earned support as people learn what it does.

“It’s about the benefits. People can see the benefits now, where before it was air,” Tester said.

Tester said he is willing to work with Republicans on a health care reform bill.

“What we ought to focus on is what isn’t working and I don’t think it’s any big mystery,” Tester said. “I’ve had listening sessions all over the state and we’ve heard concerns from docs and hospital administrators, patients, citizens, about the cost of premiums and the high deductible that goes with them, both in the individual exchange, particularly in the small business component and I think there’s an opportunity to get folks together in a bipartisan way and discuss that without throwing 77,000 Montanans, or 22 million Americans, off of policies.”