The senate just unveiled their “health care bill.” This bill proposes cutting Medicaid by over $800 billion and giving that $800 billion in tax breaks for the wealthiest people, insurance companies and corporations. Why should we care? What is Medicaid anyway and how will it affect me?

Medicaid is the largest health insurance program in the country. Over 75 million people, 20 percent of our population, receive health insurance through Medicaid. Chances are you, or someone you know and care about, receives their health insurance through Medicaid.

Sixty-four percent of all nursing home residents have Medicaid. Forty-nine percent of mothers who give birth in our country are covered by Medicaid. Seventy-six percent of all poor children are on Medicaid. The majority of people with disabilities are on Medicaid.

So we are supposed to support taking $800 billion away from pregnant moms, poor children, the elderly and the disabled and give that money to the wealthiest people in our nation. This is one more example of just how much the Republicans want to destroy the social safety net in our country. I think they all sit in their gold-plated castles, make up their to-do lists and cross them off one by one. Medicaid — destroyed. Now let’s take care of Medicare, Social Security, food stamps Meals on Wheels, and anything else that helps the most vulnerable people in our nation. When you have Trump’s budget director saying that free lunches are bad for children because it makes them dependent on food there should be no doubt about where this party stands. Our own Senator Grassley is very concerned that Iowa farmers might lose some of their subsidies, but never mentioned the fact that poor Iowans might lose their food stamps. That’s because he doesn’t care. The Republicans don’t care. They have been trying to destroy these programs since they were put in place.

Barbara Paulding

Russell

Overhearing a conversation one said I wish not to be greedy all I want is my fair share. I asked what was his fair share. His explanation was more than clouded but I surmised it was about a government program. I have lived three-quarters of a century. Born during the Great Depression I learned how to survive. We survived by family caring for family. Neighbor helping neighbor. If you were lucky you ate once a day. Went to bed while your only pair of pants was washed and dried. If you were sick and could find a doctor he treated you for free or any produce you might have. Shirts were made from flour or feed sacks. Two buttons, no cuffs or color. Socks unheard of. Shoes only when school was in session. Maybe. From those times this nation built the highest standard of living ever. At what price? I would have gladly given that fellow his share of that. Our pot has run dry. The stupid politicians have failed to learn a large difference between influx and solid growth. Growth is allowing people with talent or something to contribute to society. Downfall is allowing people coming with hands outstretched. Our government has so convinced us we are wrong to question any choice they make or to say anything about anyone. If your party is either Republican or Democrat they both cannot do any wrong. Both are wrong and putting it to us so fast we do not feel the pain. We will topple with the next quake. This letter is not the rantings of an old man but one of truth who has lived both sides. The other side you will not like. If we have a chance of survival we must change our system of government.

Max Hulen

Ottumwa

We are opposed to the Senate draft, released Thursday, June 22 (the Better Care Reconciliation Act of 2017). It will cripple many organizations; such as Tenco, Inc. who is providing services to individuals in nine counties in Southeast Iowa and Southern Iowa Mental Health Center (SIMHC) providing services to clients in Southeast Iowa and Northeast Missouri. These two organizations provide support in community mental health and disability services to nearly 3,000 Iowans. Nearly 100 percent of these services are funded by Medicaid to help these vulnerable Iowans live, learn, and work in their community of choice. Medicaid fundamentally changes to a per capita cap program beginning Fiscal Year 2020. The base year calculation in the Senate version changes use of the FY16 fiscal year to an average of eight consecutive quarters between first quarter FY14 and third quarter FY17.

The Senate version decreases the amount to mental health and disability programs by downgrading the growth rate from the House version. The Senate is creating more federal "savings" with this change.

The 142-page bill would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment. This is not “better.”

The new bill shifts hundreds of billions of dollars in costs to states. At a time when Iowa faces over $100 million shortfall in its current budget year, this is clearly not sustainable.

The proposed cuts to Medicaid disproportionately harm those who rely on Medicaid for lifesaving opioid addiction treatment, at a time when mortality from the opioid epidemic is growing at a devastating rate. We are facing a national emergency on opioids. The ongoing opioid drug epidemic has killed more than 30,000 people in 2015. And opioid overdoses have quadrupled since 1999.

The proposed one-year grant fund for mental health and addiction treatment in 2018 doesn’t come close to meeting the real—and growing—need for care. Grants are not a substitute for health coverage. We don’t rely on grants for the treatment of heart disease or cancer. Addiction and mental health should be no different.

Congress has made incredible strides in advancing access to care for disability, mental illness, and addiction services in recent years.

On the anniversary of the Olmstead decision, the Senate is proposing a bill that would decimate community services to Iowans. Without funding and supports, community integration (as defined by the Americans with Disabilities Act and affirmed by the Olmstead Supreme Court decision) becomes a meaningless promise.

We urge everyone to contact their legislators to ensure that revisions are made to protect the 140,000 Iowans who will suffer if this draft moves forward in its current form.

Cheryl Plank

Tenco executive director

Christina Schark

Southern Iowa Mental Health Center executive director

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