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The Senate Trumpcare bill won't just throw 22 million people off of their health insurance, by the Congressional Budget Office's count. It would kill the hundreds of thousands of jobs that support those 22 million people's healthcare coverage. According to an estimate from George Washington University public health analysts, it would be about 912,000 healthcare jobs. Vox profiles a couple of the individuals whose jobs are on the line.
CHICAGO — From their offices in a crumbling former nursing school, Aimee Dinschel and Michelle Pihlaja-Olson were preparing to interview 25 applicants for public health jobs. It should have been a moment of optimism for their hospital system, which only recently began to turn a profit after more than a century of bleeding money, and which was expanding its services to the poorest residents of Cook County. Instead, the women were worried.
The health care bill moving through the Senate, and particularly its rollback of Medicaid, would threaten millions of dollars of funding for the county hospital system here. It could end mental health and behavioral services for low-income patients. And it has cast a pall of uncertainty over hospital staff: Dinschel and Pihlaja-Olson could not be sure that the jobs they were hiring for would still exist in a few years.
They weren’t sure their own positions would exist, either.
“What if we don’t have jobs in a year?” said Dinschel, a mother of two who is the main income earner in her family. It’s a question she’s considered several times since the election. “It’s hard to find a job, and this is a good position.” […]
“I think I could find another job,” said Pihlaja-Olson, who, like Dinschel, is her family’s main income earner. “But I worry a lot about the staff that I supervise and whether they will have jobs.”
The end of Medicaid as we know it? No exaggeration. The Senate version of Trumpcare has worse long-term cuts to Medicaid than the House version, to pay for tax breaks to the wealthy. Call your Republican senator at (202) 224-3121, and give them a piece of your mind. Tell us how it went.
By the way, if they lose their jobs, they could be among the 22 million losing health insurance. Dinschel and Pihlaja-Olson are managing patients in Illinois's expanded Medicaid program. They are great examples for telling this national story, because they work in Cook County, Illinois—where the most remarkable turn-around happened after the Affordable Care Act was passed and implemented. For the first time ever in 2014, after Medicaid expansion, the county hospital system broke even. Prior to Obamacare, more than half of the system's patients were uninsured, and in 2009 their care cost the county's taxpayers more than $500 million. Not only did Obamacare turn that around, it created jobs. The ripple effect went well beyond the public hospitals.
Cook County commissioners are panicking as well. They don’t have the money to subsidize uninsured patients if they are kicked off Medicaid. Larry Suffredin, a county commissioner for 15 years, said rolling back the Medicaid expansion could cost the county up to $400 million a year. Right now, he said, the savings from Medicaid have been funneled into the county courts, jails, and sheriff’s office. Suffredin said the commission will not raise taxes, but doesn’t know how else to keep people on Medicaid if Congress takes away the federal money.
If the time comes, Suffredin hopes the state will step in and help. But the chance of that happening doesn’t look good. The state of Illinois is in the midst of one of the worst financial crises in its history, and is struggling to balance its budget. Suffredin said it’s frustrating to see lawmakers in Washington, DC, be so irresponsible with their politics.
It's not just Illinois, but all of the 31 states that took the Medicaid expansion. Not having to foot the bill for the uninsured's emergency treatment freed up money for other things—including hiring people. Now governors and legislatures and county and city governments all over are facing the prospect of having to make some very difficult choices over what gets cut—law enforcement? Public safety? Nursing homes? Prenatal care? Children's health? With the way Majority Leader Mitch McConnell (R-KY) has written the long-term killing off of Medicaid, those decisions would keep coming for the next two decades and will get harder and harder.