Connelly: Cantwell -- Medicaid cuts would traumatize hospitals

U.S. Senator Maria Cantwell tells Seattle town meeting: "You won't want to do business in places where you can't get health care." U.S. Senator Maria Cantwell tells Seattle town meeting: "You won't want to do business in places where you can't get health care." Photo: GENNA MARTIN, SEATTLEPI.COM Photo: GENNA MARTIN, SEATTLEPI.COM Image 1 of / 5 Caption Close Connelly: Cantwell -- Medicaid cuts would traumatize hospitals 1 / 5 Back to Gallery

Rural areas of Washington, a bulwark of Trump support last November, face the prospect of hospital shutdowns if Republicans ram through their health care plans, with health care more difficult even for the insured, Sen. Maria Cantwell, D-Wash., and Dr. Paul Ramsey, told a Wednesday town meeting.

The town meeting, the first held by a Washington senator this year, packed the Roethke Auditorium at the University of Washington's Kane Hall. It drew rambling questions, but provided Cantwell an opportunity to "Geek out" -- her words -- on the intricacies of health care.

One key argument: The Senate Republican health plan, unveiled last week, will bring political trauma to hospitals big and small.

Tom Dickerson, a physical therapist, asked Cantwell about rural hospitals closing, at the height of the opioid epidemic, if Medicaid reimbursements get cut or taken away.

"Millions of rural people, insured or not, are going to lose their access to emergency care," said Cantwell. She cited additional economic impacts, adding: "You won't want to do business in places where you can't get health care."

At some places in Central Washington, Cantwell said, "up to 60 percent" of costs are covered by Medicaid. Thirty-one states, including Washington, have expanded Medicaid under the Affordable Care Act.

Ramsey, dean/CEO of the UW School of Medicine which includes Harborview Hospital, elaborated after the meeting, speaking of impacts both rural and in America's fastest growing city.

"The Medicaid cuts could be devastating at the urban level," he said. "They would be felt by Level 1 trauma centers, such as Harborview, but also to rural hospitals."

Harborview is one of America's major trauma centers. It provides emergency care to Washington residents, but also to injured persons from Alaska and Montana. Ramsey was asked specifically about the GOP plan unveiled last week by Senate Majority Leader Mitch McConnell.

"The magnitude of Medicaid cuts to University of Washington Medicine, over a 10-year period, would be over $1 billion," said Ramsey. "The majority of cuts would be to Harborview."

The town hall was, in part, a Seattle liberals venting session. Several listeners demanded of Cantwell why America can't have a single payer health system. She gently reminded listeners that Republicans control Congress, with priority now on defending the Affordable Care Act.

At the same time, Cantwell tabled a new option, for possible use if a draconian plan is rammed through Congress.

The West has a record of delivering better care at lower cost. "If we can bundle states, and form a larger market, and drive down costs, I am for it," said Cantwell, a member of the Senate Finance Committee, adding a moment later: "Washington, Alaska, Oregon, California -- I'm sure we can supply better health care."

States were given an option, under the Affordable Care Act (aka Obamacare), of adopting so-called basic health programs. They are a health plan that covers low-income residents through state-contracting plans outside the health insurance marketplace.

"New York has 650,000 people on a basic health plan getting more affordable rates," said Cantwell. "We should have a basic health plan back in Washington state." (plan was adopted under Gov. Mike Lowry, but later rescinded.)

Instead of secret meetings of "13 dudes" to draw up a plan, Canttwell believes the Senate should be arguing out in the open with its members trading ideas.

"How do we get to a bipartisan agreement on health care?" asked Jeff Johnson of the Christ Community Health Clinic.

"Quit beating up on Medicaid, fix the individual markets," Cantwell replied.

The senator then trotted out an idea that she put in the Affordable Care Act, to "re-balance" care of elderly patients away from nursing homes and into community care. It has been embraced by such conservative states as Texas, Arkansas, Kentucky and Mississippi.

"We could save $100 billion and stop beating up on Medicaid," Cantwell argued.

Cantwell drew one line. She decried repeated ideological attacks in Congress on Planned Parenthood, and money its clinics get from the federal government for non-abortion services (e.g. cancer screenings).

"We are not going to accept any poison pill riders or anything to de-fund Planned Parenthood," said Cantwell, to loud applause. "If you say they can't get Medicaid funding, you are taking that clinic away from that community."

The town meeting embodies a 50-state reality. People are scared of losing health care.

The session at UW was kind of an antidote to the scathing description of HMO's given a few years back in the Jack Nicholson-Helen Hunt movie "As Good as It Gets." Theater audiences erupted in applause at the "f****** HMO bastard pieces of s***" line from Best Actress Oscar winner Helen Hunt.

Instead, the town hall at UW heard affirmations of the quality of health care by those worried about accessing it. Cantwell heard stories of opioid treatment, addicted offspring, successful radiation therapy, "awesome" treatment for cancer by UW Medicine.

Go-it-alone partisanship, bribing senators with opioid appropriations, back door deal making, and attempts to drive through legislation without scrutiny -- all obscure progress and opportunities in American medicine.

"It is the most exciting time in health care and health research," said Ramsey. "What we can do in research is unbelievable."

Or , as questioner Kate McGann put it, "People are so bogged down on this debate that we aren't looking for solutions."