In an interview with STAT, Rep. Roger Marshall (R-KS) says he doesn’t support Obamacare’s Medicaid expansion because he believes some poor people just don’t want health care.
“Just like Jesus said, ‘The poor will always be with us,’” Marshall, a doctor and first-term congressman, said. “There is a group of people that just don’t want health care and aren’t going to take care of themselves.”
The author of the STAT piece, Lev Facher, writes that he “pressed” Marshall on that point. But the congressman “shrugged.”
“The Medicaid population, which is [on] a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging, I’m just saying socially that’s where they are,” Marshall said. “So there’s a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought [into] the ER.”
Marshall’s personal views aside, a Harvard School of Public Health study published last summer shows that Obamacare’s Medicaid expansion resulted in improved health for low-income adults — and fewer ER visits.
“Two years after Medicaid coverage was expanded under the Affordable Care Act (ACA) in their states, low-income adults in Kentucky and Arkansas received more primary and preventive care, made fewer emergency departments visits, and reported higher quality care and improved health compared with low-income adults in Texas, which did not expand Medicaid, according to a new study led by researchers at Harvard T.H. Chan School of Public Health,” a summary of the study says. “The findings provide new evidence for states that are debating whether to expand or how to expand coverage to low-income adults.”
But Marshall, citing the hospital he helped run in Kansas, suggested he’s primarily concerned with quality of care on the other end of the economic spectrum.
“Our vision was that we would look more like a hotel with customer service that delivered five-star health care,” he said. “So our cafeteria looks more like a coffee shop than it does a sterile hospital dining room. We have bright windows everywhere, and outside of every window there’s a garden. Thinking that healing is more than just a knife and a needle.”
The purpose of the STAT interview was to highlight Marshall’s role as part of the GOP Doctors Caucus, described in the piece as “a group of 16 lawmakers with health care backgrounds who have put themselves at the center of the effort to unwind the Affordable Care Act.”
Despite that fact that Republicans control both chambers of Congress and the White House, they have struggled to advance Obamacare repeal. President Trump has made a lot of promises about how he plans on making health care better and more affordable for all Americans, but offers few policy specifics about how those promises could become reality.
The GOP ideas about health care that have been floated so far would provide coverage to millions fewer Americans and offer less financial assistance for people to afford their plans. Perhaps that’s why Republican lawmakers have been secretive about what a replacement plan might entail. This week, Republican leaders prevented their Democratic colleagues from even laying eyes on a copy of the proposed legislation.
Nonetheless, the New York Times reports that “two powerful House committees” plan to vote on the GOP’s replacement plan as soon as next week. The latest draft of the repeal bill includes a provision that would phase out Obamacare’s Medicaid expansion altogether.