Anxiety over AHCA grows in Missouri and Kansas as bill approaches Senate vote

June 20--Jawanda Mast is no novice when it comes to political advocacy. The Olathe mom has worked for years with lawmakers in the Kansas Legislature and in Congress on issues that affect people with disabilities like her daughter, Rachel, who has Down syndrome.

But even with those connections, she's had trouble getting information on the American Health Care Act, the bill Republicans in the U.S. Senate are considering as a replacement for the Affordable Care Act, which is commonly called Obamacare.

"They really are drafting this behind closed doors," said Mast, who has been in contact with the offices of Kansas Republican U.S. Sens. Jerry Moran and Pat Roberts. "They anticipate it being brought to the floor before the Fourth of July. That's what they're hearing and that's what they're telling. That it's going to come to the floor of the Senate before July 4th and that there will not be time for amendments."

Mast said she and other members of disability advocacy groups are scrambling for information ahead of that vote.

Moran and other senators from both parties have called for open hearings on the bill since it passed the U.S. House of Representatives along party lines in May.

But news reports from The Hill and other outlets have said that Senate Majority Leader Mitch McConnell, a Kentucky Republican, plans to move to a vote, without hearings, before the July 4th recess.

Conservative groups want a prompt Obamacare repeal, saying Republicans campaigned on it.

U.S. Sen. Roy Blunt, a Republican from Missouri, said the longer the process goes, the less likely it is to happen.

"I don't think this gets better over time," Blunt said earlier this month. "My personal view is we've got now until the Fourth of July to decide whether the votes are there or not."

Missouri's other senator, Democrat Claire McCaskill, blasted the secrecy surrounding the Senate Republicans' deliberations on the bill at a committee hearing earlier this month.

The voting timeline concerns people like Mast and disability advocacy groups that say they want to see major changes to the House bill the Congressional Budget Office estimated would reduce Medicaid funding by more than $800 billion over 10 years by capping payments to the states for the first time.

Mast said she has testified before Congress in the past and would like the opportunity to weigh in on the AHCA. She said she doesn't think the general public, or even some lawmakers, understand that Medicaid includes support services to help her daughter live independently after she graduates from high school next year.

"Those are optional services," Mast said. "So when you cut $830 billion from Medicaid and/or go to these per capita caps, there's not going to be enough money. So they're going to cut optional services."

Supporters of the Republican bill say that it will encourage states to find innovative ways to maintain coverage for those who need it most while curbing unsustainable cost increases.

Other groups are concerned about the bill allowing states to give health insurers the freedom to charge more based on pre-existing conditions and the end of the Medicaid expansion program that provided federal cash to extend health coverage to low-income people in states that opted in.

More than 50 health care and disability organizations from Kansas sent a letter last week to Roberts and Moran urging them not to vote for the AHCA unless there are major changes to the House version.

A group of 62 Kansas legislators signed on to a similar letter, organized by a group called the Alliance for a Healthy Kansas, that advocates for Medicaid expansion.

The Kansas Legislature voted to accept the expansion this year, but Gov. Sam Brownback vetoed it. All four members of the U.S. House of Representatives from Kansas voted for the AHCA, which would bar states from expansion.

That included U.S. Rep. Kevin Yoder, a Republican from Overland Park whom Mast and her daughter worked closely with on a bill called the ABLE Act that established savings accounts that can be used to cover disability-related expenses without jeopardizing Medicaid eligibility.

Mast, who described herself as a conservative Christian, said she wanted to make it clear that her opposition to the way the AHCA is being legislated is not partisan.

"We were in Yoder's campaign commercial," Mast said. "We are not liberal Democrats."

Andy Marso: 816-234-4055, @andymarso

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