Reaction to Republican health care legislation speeding toward a vote was mixed Wednesday among Pennsylvania's 18-member U.S. House delegation, as Gov. Tom Wolf made another attempt at urging them to defeat it, saying it would jeopardize people's lives.
In a letter Wolf's office released publicly, the Democratic governor said the GOP health care bill would blow a $2.5 billion to $3 billion hole in the state government's deficit-riddled finances.
Wednesday's letter comes a day before the Republican-controlled U.S. House is slated to vote on sweeping legislation to tear up major elements of former President Barack Obama's landmark 2010 health care law.
Wolf said the broad ripple effects of the bill would shift federal health care costs onto the state and hospitals, resulting in less coverage for the poor and potentially driving some hospitals to close. The state would face difficult decisions on who it could continue to help, Wolf said.
"We will be forced to either significantly scale back the health care programs we currently offer to vulnerable residents, such as seniors and individuals with disabilities, or will be forced to weigh decisions about who to cover against other critical state funding obligations, including education, infrastructure and the environment," Wolf wrote.
The bill would drive up rates for older insurance customers, strip treatment coverage from many mentally ill and drug addicts and dry up more than $22 million for state and county public health efforts, including vaccines and disease prevention screenings, Wolf wrote.
The disappearance of federal funding under the bill would "jeopardize health outcomes and frankly, people's lives, as our state immediately begins reeling from the implications of such a bill," Wolf wrote.
Even if it passes the House, the bill faces an uncertain future in the GOP-controlled U.S. Senate.
By Wednesday afternoon, five House Republicans from Pennsylvania had suggested they were inclined to vote for it: Lou Barletta, Mike Kelly, Tim Murphy, Bill Shuster and Lloyd Smucker. Three others — Brian Fitzpatrick, Scott Perry and Glenn Thompson — have said they opposed it. Five — Ryan Costello, Charlie Dent, Tom Marino, Patrick Meehan and Keith Rothfus — were not saying how they would vote.
"Obamacare has been a disaster. It must be repealed, and we are looking for solutions to bring relief to Pennsylvanians," Rothfus said in a statement. "The current Republican bill has some hurdles that need to be overcome, and we're working to overcome them."
All five Pennsylvania Democrats in the U.S. House oppose the bill.
The bill would bring big changes to Medicaid, which, in Pennsylvania, covers more than 2.8 million of the state's 12.8 million residents, or more than one in five. That includes children, nursing home patients and the disabled.
Some 700,000 of the 2.8 million are covered under the 2010 law's expansion of Medicaid income guidelines to include low-income working adults. Meanwhile, more than 340,000 Pennsylvanians qualified for a tax subsidy to help pay for a 2017 policy through the government's Healthcare.gov insurance marketplace.
The bill would gradually end the more generous slice of federal Medicaid funding for new enrollees covered under the expansion, while reducing federal help for Medicaid's other low-income recipients.
The expansion covers working adults who earn up to 138 percent of the federal poverty level, or about $16,640 a year.
Meanwhile, the bill would provide tax credits to help people pay for medical bills, although those tax credits would be generally skimpier than the tax subsidies provided in the marketplaces created by Obama's law.