Delaware delegation, healthcare officials: Fix healthcare

Date Published: 
Jan. 20, 2017

For 48-year-old Nick Serratore, the Affordable Care Act (ACA) provides stability. He gets the reassurance that, someday, his emergency costs will be manageable. He has a high risk of colon cancer but visits the doctor for preventative maintenance, trying to avoid hospital stays.

“I don’t want to be someone who gets something later on. I’m trying to prevent anything from happening. One of them is colon cancer. My father died from colon cancer in 2006,” Serratore said Jan. 13 at an ACA event at Nanticoke Health Services. “I need this healthcare to prevent this from happening. I don’t want to go through what my father did. It was very painful.”

Millions of Americans face uncertainty after Congress voted recently to begin dismantling the Affordable Care Act. Delaware’s delegation, all Democrats, are in the minority in trying to protect a system that has helped people gain proper health services, but has been faced criticism for increasing costs that haven’t quite stabilized for some people or insurers.

As a self-employed artist, Serratore’s income fluctuates every month.

“I’m the kind of person that benefits greatly from Affordable Care Act,” he said. “It’s a safety net guaranteeing me full care at a reasonable price. And preventive care is much cheaper than providing emergency care at the hospital.”

“What we face right now, with the repeal of the Affordable Care Act without actually knowing what we’re gong to replace it with, is like the firemen on ground telling people to jump,” U.S. Sen. Tom Carper (D-Del.) said Jan. 13. “They don’t have a safety net. ‘So, maybe, by the time you hit the ground, we’ll have it in place.’ … I think it’s very foolish.”

“Nearly 20 million more Americans — including 38,000 Delawareans — have gained access to high-quality, comprehensive healthcare coverage since 2010,” Carper, U.S. Sen. Chris Coons and U.S. Rep. Lisa Blunt Rochester (all D-Del.) wrote in a recent op-ed.

As part of the ACA, millions of people gained coverage under the Medicare expansion for low-income and poverty-level families. Delaware and 30 other states expanded Medicaid eligibility through the ACA but now risk losing that funding again.

“The state’s uninsured rate dropped has dropped to an historic low of 5.9 percent as a result of the ACA, which included Medicaid expansion,” according to Carper and Coons.

Under the ACA, young people could stay on their parents’ plans until age 26, and patients couldn’t be denied healthcare for pre-existing conditions.

In the realm of healthcare, the pendulum is swinging from sick-care toward wellness- and preventive-care, said Brian Olson, CEO of La Red.

“La Red health centers were formed to help vulnerable communities access care, and a large number of our patients at the poverty-level or slightly above the federal poverty level,” said Olson. “And these individuals who fall into the expansion area would not be able to afford [premiums].”

La Red is now seeing patients who had been uninsured for decades. Those patients have been able to start addressing chronic problems, such as diabetes and hypertension, that they may not have sought care for in the past. La Red has also helped some, including Serratore, shop around for insurance and find the most affordable plan.

But with the looming threat of an ACA repeal, some patients have already stopped paying their healthcare premiums, Olson said. The uncertainty over the program’s future could cause them to lose healthcare even sooner, as a result.

“I fear many of them will end up using the emergency room again, which is not the appropriate use for emergency-room centers,” Olson said. “The health and lives of our citizens are much more important than political debate.”

Congress’s budget resolution to begin the dismantling of ACA passed almost completely down party lines in both the Senate (51-48) and in the House (227-198), where Republicans hold a majority in both bodies and, soon, without the threat of a presidential veto.

During the actual Senate vote, Carper and Coons both spoke against the repeal, despite the presiding officer’s trying to maintain order, insisting that debate is not permitted during a vote.

“I voted against the repeal on behalf of ‘the least of these,’” Carper said during the event in Seaford, referencing a Bible quote about serving people in need. “I think that what Republicans, Democrats, persons of faith, Protestant, Catholic, Jewish, Muslim, whatever — I think we have a moral obligation to ‘the least of these’ in our society.”

Over the decades, healthcare plans have been proposed by Republicans and Democrats, Carper said.

“Is it perfect? No!” Carper acknowledged.

For instance, premium costs have increased. Carper said that’s because insurance companies originally charged less to stay competitive but now are getting a better idea of new program costs. He said taking subsidies away from companies that lost money is like removing the training wheels from a bike too soon.

“The ACA is possibly the best thing to happen to healthcare in my lifetime,” said Chuck Creswell of Bivalve, Md. “It expanded the availability to millions of people that never would have had that option.”

Now in his 80s and on Medicare, he was fortunate to always have healthcare from his job in the medical technology industry. Having gotten medical attention in Japan and Australia, he joked that those countries didn’t even have a facility to accept payments, since they had universal healthcare.

“We can’t let this [repeal] happen! I don’t know what we can do, except what’s going on here is at least a start,” he said of the event. “I couldn’t not come out.”

“Every advanced country on earth has a philosophy that medical care is a right, not part of business,” said Frank DeFranzo of Rehoboth Beach. “But in this country, everything has to have a profit. Medical care, in my view, should not be a profit-making organization. They’re raising all the rates because they’re not making enough money.”

The government doesn’t need to meddle in everything, DeFranzo said, but he believes life would be simpler if all Americans were on Medicare.

A veteran and retired social studies teacher, DeFranzo is covered by a mutual insurance company, where extra profits go to the members, not stockholders.

“Not everything has to be a business,” said DeFranzo, adding that he believes a full repeal is unnecessary to fix the ACA’s flaws.

“It was not a perfect bill … but certainly we have made significant strides in health in America,” said Steven Rose, president and CEO of Nanticoke Health Services. He described how hospitals are responsible for better patient experience and outcomes.

“We need the leadership in the White House. We need President-Elect [Donald] Trump to understand, if he’s going to make changes, that’s OK, but we need to think it through,” Rose said. “We need to be thoughtful about what we achieve.”

“It’s too good to repeal, and Congress should work together to fix the problems without hurting people like us,” Serratore said.

“Please reach out to your senators and representatives, and let them know your concerns,” Rose said.

Delaware’s Congressional delegation can be reached by phone, mail or online:

• U.S. Sen. Chris Coons at (202) 224-5042 or www.coons.senate.gov;

• U.S. Sen. Tom Carper at (202) 224-2441 or www.carper.senate.gov;

• U.S. Rep. Lisa Blunt Rochester at (202) 225-4165 or www.bluntrochester.house.gov.