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tik Orrice or The Govennon Hanmieeuns March 22, 2017 “The Honorable Tim Murphy United States House of Representatives 2332 Raybum House Office Building Washington, DC 20515 Dear Congressman Murphy: [As the House Rules Committe considers the American Health Care Act (AHCA) today ahead ‘of the full House voto, I wanted to again voice my concern about the proposal and its potential for ‘wide-ranging, devastating effects on the people of Pennsylvania and our economy. {understand that we may have our political differences on various issues, but I truly believe this issue rises wel above the tide of politics and is ultimately a humanitarian issue at its core. While the Affordable Care Act was far from perfect, particularly in the individual market, this bill stands to nly make those problems worse {want to thank you for allowing me to engage with you on this vital issue, both in Washington last month and in phone calls over the past few weeks, ‘As lected officials, itis incumbent on us to filly understand the benefits and consequences of the legislative proposals that we consider every day. The AHCA is a glaring example of «proposal ‘that needs further consideration and opportunity for public input. We must remove ourselves from the partisan politics that drive the health care debate today and consider how this proposal will impact ‘people's lives, With that sid, below are my top-line concerns: + lestips coverage from more than 180,000 Pennsylvanians with mental lines snd substance use disorders who have gained coverage dus to Medicaid expansion andthe Marketplaces: + Itcharges older Pensylvanians an “age ax” of up to five times what younger Pennsylvanians wll pay. For low-income seniors cue receivng income-based tax eres, this wil be especially devastating + Peonsyvana's uninsured rte, curenly a its lowest ever at 6.4%, wl skyrocket under this proposal ‘Nationally, those newly uninsured individuals will eek $88 bilin in aditional ‘uncompensated caren 2019 alone, $24.6 bilion ofthat amount fem hospitals As federal Tunding for uncompensated care will isrease only lig, stats and local governments will Inve consider picking up the tb. In Pemnsylvania, our eurent budget sation wll make that impossible, which will shi the buden onto hospital and other sey net providers ‘This unprecedented strain onthe safety net sytem simply cannot be absorbed, meaning people's healthcare needs wil go emily unmet and hospitals already surviving a the ‘margins financially may have to clos. ‘The Honorable Tim Murphy March 22,2017 Page Two ‘= Iedissolves the Prevention and Public Health Fund after October 2018, which will strip more than $22 million each yea fom our state and local health departments, These cuts mean children and adults will go without vaccines, underserved women will go without access to lifesaving breast and cervicel cancer sereenings, and efforts to prevent chronic diseases ike diabetes, heart disease, and obesity will be severely hampered While our departments of Human Services and Insurance are working diligently to fully ‘understand the Financial impacts ofthis proposal, ov rough estimate is thatthe changes to Medicaid and the per capita proposal put forward in this act will cost Pennsylvania somewhere in the neighborhood of $2.5 o $3 billion each year. These costs, when considered in conjunetion with our current $3 billion structural deficit, are far from inconsequential. We will be forced to either significantly scale back the heal care programs we currently offer to vulnerable residents, such as seniors and individuals wth isbiltes, or wil be forced to weigh decisions about who to cover against other eitial state funding obligations, including education, infrastructure, and the environment, Regardless of who picks up the remaining tab from the lack of federal funds, this levislation will no doubs jeopardize health outcomes and frankly, people's lives, as our state immediately begins reeling from the implications of such abil | have shared projected district level impacts with cach of your offices and will continue to provide any information you need to make informed decisions about the people that live in our ‘communities [ask again that you consider this an open invitation to work together on crafting & solution that works forthe people of Pennsylvania Please vote no on the AHA when it comes tothe House Floor for a vote this week. Thank _you for your onsideraton. Sincerely, oa fp ‘TOM WOLF Governor "haps ep med harvard edits fal esnerpreation 200A 20Tablet20SMI- SUDD20162016%20v2 pa "pw arb og ta!dtau ies publcation 869162001046 impact-o-helt-

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