Friday March 10, 2017

Doctor in pro-Trump West Virginia says patients risk losing coverage under Republican health-care plan

U.S. House Speaker Paul Ryan and House Majority Leader Kevin McCarthy speak about the American Health Care Act, the Republican replacement to Obamacare, at the Republican National Committee in Washington on Wednesday.

U.S. House Speaker Paul Ryan and House Majority Leader Kevin McCarthy speak about the American Health Care Act, the Republican replacement to Obamacare, at the Republican National Committee in Washington on Wednesday. (Joshua Roberts/Reuters)

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If the U.S. Republican party was hoping for universal praise, it certainly did not get it this week when it unveiled its American Health Care Act.

The Democrats, predictably, loathe it, and conservatives within the Republican party complain the proposal is too much like the Affordable Care Act, a.k.a. Obamacare. While it has passed some major hurdles in the House of Representatives, its full passage in Congress is no guarantee just yet.

Dr. Mitch Jacques

Dr. Mitch Jacques is worried 20 per cent of his patients could lose coverage under the American Health Care Act. (Mitch Jacques/cabincreekhealth.com)

Some family doctors aren't so sure about the proposal, either.

Dr. Mitch Jacques, a family physician with Cabin Creek Health Centre in rural West Virginia — a place where U.S. President Donald Trump won by 67.9 per cent — spoke with with As It Happens host Carol Off about why he thinks many of his patients would lose their coverage under the proposed plan. Here is part of their conversation.

Carol Off: Dr. Jacques, Republicans are saying their health-care proposal is a better deal for Americans than Obamacare. Is it better for your patients?

Mitch Jacques: Well, I think for some of them it may be. We don't have all the details yet. But I think for the vast majority of them, it will jeopardize the health care they are currently receiving.

CO: And the health care they are currently receiving — how much better has it been for under the Affordable Care Act or under Obamacare?

'Donald Trump said several things. He also promised that everyone would have health care and health care would be better. I think people heard that.' - Mitch Jacques, family physician 

MJ: Well, you have to understand the population that I care for in southern West Virginia. We're in quite an economic decline.

The coal industry has declined in this part of the state. Most of the patients that I care for either work for minimum wage, or have lost their jobs, or are struggling. So for most of those individuals, they depend on either insurance they pay for themselves with premiums they can barely afford, or many are eligible under the Affordable Care Act for Medicaid.

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James Hughes of Louisville, Ky. holds a sign calling for the repeal of the Affordable Care Act during a rally for Senate Minority Leader Mitch McConnell on Oct. 31, 2014 in Louisville, Ky. (Luke Sharrett/Getty Images)

CO: So are there more people covered since the Affordable Care Act came into effect?

MJ: Oh yes.

We've not kept perfect statistics, but in our clinic, which is a rural clinic and community health centre, probably about 20 per cent of our population of the patients we see are getting care through the Affordable Care Act that were not getting before.

CO: West Virginia supported Donald Trump in the past election and considerably had support in your region. What do people understand about the Affordable Care Act? Did they understand when Donald Trump said that he was going to take that apart — that he was going to get rid of Obamacare? Did they understand what effect it would have on them?

MJ: Donald Trump said several things. He also promised that everyone would have health care and health care would be better. I think people heard that.

More importantly, I think for West Virginia, he said he was going to bring coal back, and bring jobs back, and bring the economy back. I think for most of the people in West Virginia, particularly those who have lost their job or threatening to lose their job, that's the most important thing to them.

They're hopeful that the future will be better under Donald Trump. I don't think many people had much of an understanding of exactly what the Affordable Care Act was or what it's commonly called, which is Obamacare.

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Supporters of the Affordable Care Act gather in front of the U.S Supreme Court during a rally March 4, 2015, in Washington, D.C. ( Alex Wong/Getty Images)

CO: And what have they said to you about it? What are their opinions of Obamacare or the Affordable Care Act?

MJ: Well, no one likes the word Obamacare. Obamacare has been stigmatized where every ill in health care is blamed on Obamacare. So I think if you asked the average patient of mine whether they liked Obamacare many would say no.

If you asked the same patient if they were thankful that they had health-care insurance that they didn't have, almost all would be very thankful.

I think people don't understand what the Affordable Care Act provides. Patients that I see, who have health care and didn't have it, are very appreciative that they have it now — and don't want to lose it.

CO: That's consistent with polls that show large numbers of American hate Obamacare, but they really like the Affordable Care Act, not realizing that it's the same thing.

MJ: Right, and that's politics. Politics is single sentences in today's world, not deep understanding of issues.

CO: But Obamacare or the Affordable Care Act was troubled. There were a lot of troubles with how it rolled out, as you know. So it did need some changes. Is there a chance you think Republicans will get this right?

MJ: I guess there's always a chance. What I've seen that they are proposing at this point in time doesn't seem to offer much hope that it's going to help those people on the fringe. [The Affordable Care Act] was not a perfect bill. It had many, many flaws. What it did do was provide more coverage. My fear is that under the proposals that are currently before Congress, it will take coverage away from many of the patients I take care of. As many as 20 to 25 per cent of our patients could lose their health coverage.

This interview has been edited for length and clarity. For more on this story listen to our full interview with Mitch Jacques.