Senate Republicans' health care plan will inflict deeper cuts to Colorado's Medicaid program than previous proposals and reduce financial help for many people buying their insurance plans, Colorado health care experts said Thursday.
The bill, which Senate Republicans unveiled Thursday after months of closed-door talks, immediately came under fire by Colorado health care providers and Democrats. And it came amid protests led by people with disabilities, who say the bill places the interests of wealthy Americans ahead of those who are ill, disabled or poor.
"The cuts are really on the backs of individuals with disabilities," said Wilfred Romero, executive director of The Arc Pikes Peak Region, a nonprofit that operates thrift stores that employ people with disabilities.
Protesters rallied outside Republican Sen. Cory Gardner's downtown Colorado Springs office as the bill was unveiled on Capitol Hill, holding signs reading, "Trumpcare is only a tax break for the wealthy."
Their concerns stemmed from the Senate plan's deep cuts to Medicaid - a program best known for helping low-income Coloradans, despite also providing care and assistance for children, nursing home residents and people with disabilities.
The Senate's proposal would phase out extra money for Medicaid's expansion more gradually than the House-passed version - ending it in 2024.
But the proposal also places more stringent spending caps on the program - leaving states with far less money to cover Medicaid patients who have relied on that program for decades.
As a result, Colorado could find itself in a far deeper budget hole than it would be under the House-passed plan, said Joe Hanel, a Colorado Health Institute spokesman.
The House proposal would leave Colorado with a $14 billion budget shortfall, while leaving nearly 600,000 people without coverage from the program, a Colorado Health Institute analysis found.
The Senate proposal could raise that deficit to at least $15 billion, according to an initial analysis by the group, which does not take sides on legislative proposals.
The cuts could force Colorado to pare in-home help for people who can't feed, clothe and care for themselves - sending more people into nursing homes, said Patricia Yeager, CEO of The Independence Center, a Colorado Springs nonprofit.
"Public policy is taking a huge leap back," Yeager said. "And for people with disabilities, it means we're going back to the institutions."
Joan Labelle, who has an inflammatory disease that causes muscle weakness and skin rashes, said the proposal leaves her without a safety net.
"With these cuts, it could lead me into a having to go to a nursing home if there was placement (beds) available - and that's not even a guarantee," Labelle said.
Pam Bargoa leaned on a cane while criticizing the Republicans' proposal at the protest - lamenting the possible loss of her Medicaid benefits, which she uses to help treat conversion disorder.
"It's because of Medicaid that I'm healthy enough to walk down here," Bargoa said.
Medicaid also provides money to help disabled workers get transportation to their jobs. And its expansion under the Affordable Care Act helped end the yearslong wait that people with disabilities faced in signing up for the program.
Gardner - despite being one of the 13 Republicans tabbed to help craft the bill - said he hadn't seen the bill before Thursday's release.
"This is the first I've viewed the legislation so I am beginning to carefully review it as we continue to look at ways to rescue Colorado from the continued negative impacts of the Affordable Care Act on our healthcare system," Gardner said in a statement.
"It's frustrating that instead of actually reviewing the legislative text, some have decided to immediately oppose the bill before it was even introduced," Gardner added. "This deserves serious debate, not knee-jerk reaction."
Gardner was unavailable Thursday morning for questions, a spokesman told Colorado Politics.
Meanwhile, Colorado Democrats lambasted the proposal, calling it a "backward" step.
"It's no surprise that a bill drafted in secret, without public hearings and scrutiny, and planned for a rushed vote within days, will hurt Coloradans," said Gov. John Hickenlooper, in a statement.
For months, health care providers have voiced deep concerns with Republican proposals to slash Medicaid coverage, and the Colorado Hospital Association on Thursday again criticized Republicans' efforts at health care reform.
The Senate's bill also scrapped funding for Planned Parenthood - a "frustrating and disappointing" move for Planned Parenthood of the Rocky Mountains. It said the proposal imperils care for its 30,000 patients in Colorado, New Mexico, Wyoming and southern Nevada.
Senate Republicans also split with their House counterparts on how best to reform the nation's individual insurance market.
The proposal bases monthly premium tax credits on a policyholder's income, not age. And most financial assistance would shrink under a different funding formula.
It also shrinks the number of people eligible for that help.
"One of the big complaints that you hear about the Affordable Care Act is that people buy insurance but they can't use it, because the deductibles are so high and the co-insurance is so high - it's not very valuable insurance," Hanel said. "Well, this exacerbates that problem."
In Colorado, the state's uninsured rate dropped to a record low 6.7 percent, as of 2015. Still, the health law had flaws, Hanel said, including how tax credits and subsidies did not stretch far enough into the middle class, leaving coverage unaffordable for many.
"The Senate bill zeros in on those gaps and failings and makes them wider and worse," Hanel said.
Gazette reporter Seth Bodine and Colorado Politics reporter Ernest Luning contributed to this report.