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Prospect of Republican health care bill stirs worries among patients who benefited under Obamacare

FARGO - Ashley Seykora learned she had advanced melanoma two weeks after her second child was born. She was 31 years old and was told her life expectancy was 12 to 18 months."I remember being angry and thinking, 'No, no, no!'" Seykora said, recal...

Shila Stiefel of Bismarck was able to get treatment for her opioid addiction through Medicaid expansion. She's now in recovery and working, which she said wouldn't have been possible without health coverage through the Affordable Care Act. Photo by John Hageman.
Shila Stiefel of Bismarck was able to get treatment for her opioid addiction through Medicaid expansion. She's now in recovery and working, which she said wouldn't have been possible without health coverage through the Affordable Care Act. Photo by John Hageman.
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FARGO - Ashley Seykora learned she had advanced melanoma two weeks after her second child was born. She was 31 years old and was told her life expectancy was 12 to 18 months.

"I remember being angry and thinking, 'No, no, no!'" Seykora said, recalling the grim diagnosis she received more than two years ago.

After standard chemotherapy failed, she was able to get into a medical research trial at a hospital in Texas. Her employer-sponsored health care covered the research therapy, due to a provision of the Affordable Care Act.

The experimental treatment worked; doctors find no evidence of cancer in Seykora's body. But the Towner, N.D., woman's worries aren't over.

The Senate is expected to vote soon to repeal the Affordable Care Act and replace it with a Republican plan. Earlier, the House passed the American Health Care Act, which would eliminate health coverage for 30,100 North Dakotans, according to an analysis by the Center for American Progress, a nonpartisan nonprofit group

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As an advanced cancer survivor, Seykora worries she could lose her health coverage, or find herself faced with insurance too expensive to afford on her salary as an English teacher, if the ACA is repealed and replaced with something that provides less coverage.

"That's not right, and it's not right for North Dakota," Seykora said Tuesday, June 20.

The Senate bill is being drafted in secret, without public hearings or the opportunity to offer amendments. Senators reportedly will have 10 hours to review the bill before voting on it.

Sen. Heidi Heitkamp, D-N.D., is a critic of the secretive process, and will oppose any bill that resembles the House-passed American Health Care Act, which she said is "immoral."

Besides the thousands who would lose coverage, through elimination of Medicaid expansion and reduced financial support to make health insurance affordable, North Dakota health providers would lose more than $200 million from the loss of Medicaid expansion, under the House legislation, Heitkamp said.

"Those people who are suffering the most have chronic conditions," she said. "We've all agreed to share that risk with families."

If Medicaid expansion is eliminated, even if phased out over several years, those who lose coverage will face significant difficulty finding an affordable alternative, Heitkamp said. "That creates a level of uncertainty that is unspeakable in my opinion," she said.

Sen. John Hoeven, R-N.D., said he has not seen a draft of the Senate bill, but one might become available later this week. Senate leaders are hoping to vote on the bill before Congress takes its July 4 recess.

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"I put it in the we'll see category," Hoeven said of the timetable. "When a bill goes to the floor it's amendable."

Hoeven said he does not favor the secretive process the legislation has taken. "I'd rather see it go through the committee process," with public hearings, he said.

Although parts of the health legislation will be acted on under the budget reconciliation process, which allows passage with a simple majority, other pieces of legislation will require a 60-vote majority to pass, Hoeven said.

"This would be just one step," he added, referring to a possible Senate vote next week.

Hoeven said he wants to see coverage for pre-existing conditions and chronic conditions. To make coverage affordable, refundable tax credits would be available to those with low incomes. Those credits should be based on age as well as income, Hoeven said. The House bill does not base assistance on income.

Passage of a new health reform bill will require multiple bills, but Hoeven predicted Republicans will be able to accomplish the task.

"At some point, we're going to get health care reform," he said. "We have to, we need to. Look what's happening to Obamacare."
If the legislation closely resembles the House bill - which President Trump recently described as "mean" - polls suggest it would be unpopular in North Dakota. An average of eight polls compiled by the New York Times showed 47 percent of North Dakotans oppose the Republican bill, while 31 percent support it. Rep. Kevin Cramer, R-N.D., voted for the bill.

An analysis by the Center for American Progress estimated that 30,100 North Dakota residents would lose coverage under the House bill, while 1,190 households with incomes of $1 million or more would receive tax cuts averaging $32,271.

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Heitkamp said her office is receiving lots of calls and messages from constituents who are worried about losing coverage they have gained through the Affordable Care Act.

Shila Stiefel, a Bismarck woman, obtained health insurance through Medicaid expansion in 2013 that enabled her to receive counseling for her addiction to opioid painkillers. After being addicted for 20 years, she is in recovery and has a job that provides health coverage.

"I've been clean and sober for three years," she said. "None of that would have happened without Medicaid expansion. I wouldn't be where I am today. It saved my life."

Shila Stiefel of Bismarck was able to get treatment for her opioid addiction through Medicaid expansion. She's now in recovery and working, which she said wouldn't have been possible without health coverage through the Affordable Care Act. Photo by John Hageman.
Ashley Seykora, a Towner, N.D., woman shown with her husband and two children, had advanced melanoma, a form of skin cancer. An experimental treatment cleared her cancer. Her health insurance covered the treatments because of requirements in the Affordable Care Act. Photo special to The Forum.

Related Topics: HEIDI HEITKAMP
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