R.I.P. ACHA

For the last couple of weeks – since the ACHA was introduced in the House of Representatives – I've been working with an informal group whose goal is to try and identify and define the effects of the ACHA on Otsego county – its citizens, its healthcare systems, and the County budget itself.

It's been a moving target, as you probably know. The impacts, as the bill has gone through three major changes, have become more intense. The biggest impact would probably be the massive restructuring of Medicaid into a state block grant.

Otsego County – and most, if not all, counties in America – is statutorily required to provide a wide variety of services to its citizens. In return, the County is reimbursed – by an insanely complex, draconian set of shifting equations and timelines – with Medicaid dollars. This exchange is at the heart of a great deal of the work that is done at the County level, including and especially through the Department of Social Services, which the Committee I chair (Human Services) oversees.

I am extremely happy, for many reasons, that the ACHA was withdrawn today and, if we can believe the President, will not be re-introduced. It is a very big win – bigger than most of us understand – for Americans in all situations – pretty much anyone who pays taxes or interacts with the healthcare system in any way. It is also a win for me, because I will not have to try and summarize the impacts the AHCA will have on County functioning. The initial number – an $800,000 budget impact – was just the beginning.

The ACA - “Obamacare” - seems to work just fine. It needs some tweaks and adjustments, but the Congress did not see fit to address any of that. We will continue with a sound but not perfect health insurance system, and continue to muse over the reasons why we continue to be the world's only industrialized nation without a robust system that works for everyone.