Mar 8, 2017 3 min read

Republicans’ plan to “repeal and replace” the Affordable Care Act is being met with anxiety over the future of health care for the tens of millions of Americans who receive care through Medicaid.

The GOP-crafted proposal, unveiled earlier this week, includes provisions that would fund the program – whose recipients include the low-income elderly, children and people with disabilities – through block grants and set a per-capita limit on money flowing to states for services, a measure that likely would reduce total funding for the program.

“For me, it’s almost a foregone conclusion, after doing this as long as I have, we can can expect all programs to be cut back somewhat, and it’s going to pit disadvantaged populations against each other,” said Brenda Dare of Tri-County Patriots for Independent Living in Washington, an advocacy group for people with disabilities. “It’ll disempower all of us.”

Of the 2.9 million Pennsylvanians receiving Medicaid, more than 39,000 are in Washington County, according to the Department of Human Services. In Greene, there are more than 10,000.

The proposal would freeze enrollment in the Medicaid expansion most states undertook as part of the ACA, commonly known as Obamacare.

In Pennsylvania, 716,700 people enrolled as a result of the expansion, according to DHS.

The Energy and Commerce Committee – which includes Rep. Tim Murphy, R-18th – was one of two House committees that began voting on and amending portions of the proposal Wednesday.

Murphy introduced an amendment that would prevent the legislation from affecting parity between coverage for mental-health and other services.

Republicans on Energy and Commerce described the prosed changes to Medicaid as giving states more flexibility, including the ability to use funds for preventive services.

“With today’s legislation, we return power back to the states – strengthening Medicaid and prioritizing our nation’s most vulnerable,” said committee Chairman Greg Walden, R-Ore. in a statement Tuesday. “Today is just the first step in helping families across this country obtain truly affordable health care, and we’re eager to get this rescue mission started.”

But some observers fear the Medicaid provisions could force state legislatures to make tough choices about how to prioritize medical care for their most vulnerable constituents if less money is available to pay for services – possibly resulting in cuts to services, coverage for fewer people or the costs of care shifting to patients.

“The concern I think we have is that’s going to be taken away, or that less kids will be eligible,” said Dr. Robert Cicco, a retired South Hills pediatrician and neonatologist who sits on the board of Pennsylvania Partnerships for Children.

Erika Fricke, health policy director at Pittsburgh-based nonprofit Allies for Children, said restructuring Medicaid would come with “major consequences,” and she wanted to see the proposal subject to public vetting.

“The thought of it moving that quickly makes me really uncomfortable,” she said.