A new Republican president-elect and an allied GOP-led Congress is eager to take the nation from a predictable health market during the last two years of the Obama administration to a new era of uncertainty. This inauspicious forecast comes from Open Minds, which touts itself as having “monitored everything happening in the sectors of the health and human service field serving complex consumers” since 1987.

Health and human service organizations should be alert and stay focused, now that expenditures coming from the federal government could change dramatically as a new White House led by soon-to-be President Donald Trump works on its top priority, the repeal and replace of the Patient Protection and Affordability Act [ACA], better known as Obamacare.

With 29 percent of health care expenditures, and an even-larger proportion of social service funding soon to come under fire, health care management professionals at Open Minds warn the new administration will likely have a big impact on the health and human service field, although the exact repercussions won’t be known for a while.

In a separate finding, the Kaiser Family Foundation finds that nearly eight-in-10 Americans believe prescription drug costs are too high and Congress should work to lower the costs of drugs. The new breed of Washington Republicans running the 115th Congress are moving quickly to repeal the ACA, passed without their help in 2010, that enabled 30 million Americans over the last six year to gain access to health care insurance previously too expensive or out of reach due to pre-existing health conditions.

Brown To Fight ACA Repeal

In his first conference call with Ohio print reporters following yesterday’s swearing-in ceremonies, Sen. Sherrod Brown vowed to fight efforts by Republicans to return the nation’s healthcare landscape to where it was before the ACA  [a.k.a Obamacare] became law. “They should be ashamed of themselves,” Brown said of what Republicans say they’ll do. Rural hospitals in Ohio, and across the nation, will be hit hard without financial help delivered through the ACA, he said, noting that in most communities, large and small, hospitals are always among the largest employers, so both jobs and patient services will be at stake. “It’s irresponsible, it’s immoral what they’re doing, and its all about their political talking points,” he told reporters Wednesday.

Sen. Brown declined to comment on the Democrats’ new, national resistance to Trumpism slogan: “Make America Sick Again.” Preferring not to engage in verbal political polemics, he didn’t hold back about his willingness to fight to keep out-going President Barack Obama’s ACA in place given the promise President-elect Trump and Majority Caucus Congressional Republicans made to their base that their first priority is to repeal and replace it.

Controlling Drug Costs

Joining Sen. Brown on the call was Akron resident Kathy Giller, who told the sad story of her husband’s diagnosis of stage 4 cancer, that has now spread to his brain, and their problems finding health insurance coverage. Health insurance companies considered her husband’s cancer a pre-existing condition and denied them coverage. “Our story is not unique,” Mrs. Giller said, sobbing as she said her husband’s disease, while treatable is not curable and will one day leave their children without a father. She said insurance they were able to secure had high deductibles and co-pays for oral chemotherapy treatments that hit $3,000 per month. But for a nonprofit that partners with the pharmaceutical company that manufacturers her husband’s cancer drug, they could not afford the treatment costs.

Estimates are that America’s yearly drug costs are about $430 billion, but some argue that by reducing drug company patent protections that figure could be lowered by more than 80 percent to about $60 billion . Sen. Brown responded by talking about a bill he and Arizona John McCain co-sponsored last year, that they intend to introduce again this session. It will address price gouging, give the Secretary of Health and Human Services the authority to better negotiate drug prices for seniors, increase drug transparency and boost competition and innovation in the market place.

“Our job is to delivery results,” he said about the approximately 30 million Americans plus many Ohioans who could lose health coverage under the ACA if Trump and GOP congressional leaders are successful in repealing the nation’s healthcare law. Because of the ACA, Sen. Brown said Ohioans are each benefiting with health insurance price reductions of $1,100.

The senator was asked about prohibiting the direct advertising to consumers by drug companies, a practice virtually no other country permits. Wiping out patent protections, he said, would kill innovation. He did advocate for the development of so-called “biologic equivalents” to reign in drug costs. In spite of the heavy influence drug company lobbyists wield with this new congress, Sen. Brown said “biosimilars” should be pursued. For clarity, a biosimilar is a biologic medical product which is almost an identical copy of an original product that is manufactured by a different company.

The two-term senator running for a third term in 2018 said it does make sense to ban advertising since it drives demand and adds to the cost of drugs. One way to do that, without triggering free speech issues, he said would be to eliminate the deductibility of those costs as a part of tax reform, an major issue both major parties are prepared to address.

Kathy Giller said that generic forms for some drugs are just not an option. One suggestion she did offer that Sen. Brown thought interesting, was to consider chemotherapy drugs delivered through IVs or orally as medical treatments instead of pharmaceutical treatments. “I don’t know if that would have a benefit to keep costs down,” she said, noting she’s not an expert. “If viewed differently, would that help with costs?”

Kasichc’s OHT Makes Solid Case For ACA-Medicaid Expansion

The immediate fear for Sen. Brown is taking insurance away from more than 800,000 Ohioans who have it now solely because of the ACA and Ohio’s acceptance of Medicaid expansion.

Ohio’s Office of Health Transformation [OHT] provided an update today on the many benefits of expanded Medicaid coverage, that could have been written by the Obama White House or Sen. Brown himself. Keep in mind that Gov. Kasich, a Republican, said Obamacare should be repealed and that he’d do so if elected president. Mr. Kasich didn’t get elected president, but he did an administrative end-run around his Republican legislature that voted to not accept it. OHT findings include the following:

A large decline in the uninsured rate for low-income adults to the lowest rate ever recorded;
Most enrollees (89 percent) were uninsured prior to obtaining Medicaid coverage;
Improved access to care was associated with a reduction in unmet medical needs;
High-cost emergency department use decreased;
Many detected previously unknown or unaddressed chronic health conditions;
Health status improved for most (48 percent) and worsened for very few (4 percent);
Many enrollees (32 percent) screened positive for depression or anxiety disorders;
Many enrollees reported it was now easier to buy food and pay rent; and
The percentage of enrollees with medical debt fell by nearly half.

Brown Still Waiting For GOP ACA Fix

Before today’s call with Sen. Brown, House Speaker Ryan said called Obamacare is a “failed program that’s hurting families,” but added that people using it shouldn’t “be caught with nothing” when its repealed. Vice President-elect Mike Pence reiterated the top priority of the Trump Administration, to repeal the ACA and replace it with an as-yet undisclosed plan that “lowers costs without growing the size of government.” Meanwhile, it’s likely that a majority of people using Obamacare likely voted for Donald Trump. Their fear now is that Donald Trump and allied Republicans will actually deliver on their worst nightmare and his top priority, taking their affordable health care insurance away, leaving them again in the lurch.

Sen. Brown’s response was to again remind reporters that for all their bluster, Republicans “have never come up with anything close to an answer or a solution.” They can continue to explain it as a failure,” he said, “but they will have to explain to Ohioans who will lose insurance coverage why they are losing it.” he said people are fearful, noting that Speaker Ryan and VP-elect Pence don’t share the same fear because they “have good taxpayer funded insurance.”

Sen. Brown said he’ll be sitting behind outgoing President Obama and former President Bill Clinton and wife Hillary Clinton, who lost the Electoral College to Donald Trump but won the popular vote by nearly three million, on Inaugural Day on Jan. 20th in Washington D.C.

His committee assignments will remain the same: Finance, Ranking Member on Banking, Veterans Affairs and Agriculture. Fighting any wholesale repeal of the Dodd-Frank Bill, that put the brakes on irresponsible Wall Street activities and created the Consumer Financial Protection Bureau led by Ohioan Richard Cordray in the process, will be a priority for him. He joked that he anticipates Republicans to exercise their “collective amnesia that we had a crisis a decade ago that wasn’t caused by Wall Street.”