美国国家公共电台 NPR Veterans Helped By Obamacare Worry About Republican Repeal Efforts（在线收听）

STEVE INSKEEP, HOST:

As Republican senators take some extra days to consider a health care bill, they may consider this. The measure, which has been delayed because of a lack of votes, takes money out of Medicaid, often described as the health program for the poor. It's become the health program for many of the working poor as well. And turns out, it's also the health program for many veterans. Stephanie O'Neill reports.

STEPHANIE O'NEILL, BYLINE: Air Force veteran Billy Ramos of Southern California gets his medical coverage for himself and for his family from Medicaid, the government insurance program for low-income people. It's coverage he counts on, especially because of his work as a self-employed heating and air conditioning contractor.

BILLY RAMOS: If I were to get hurt on the job or something, I'd have to go run to the doctor's. And if I don't have any coverage, they're going to charge me an arm and a leg. And, you know, I have to work five times as hard just to make the payment on one bill.

O'NEILL: Medicaid coverage has become especially important to Ramos, as a routine checkup in blood tests this year showed that he's infected with hepatitis C. In California, Medicaid covers his costly treatment.

RAMOS: Right now, I'm just grateful that I do have it. If they take it away, I don't know what I'm going to end up doing.

O'NEILL: The Senate health plan, which proposes deep cuts in federal spending on Medicaid, has some veterans and advocates worried. Will Fischer, a Marine who served in Iraq, is with votevets.org, a political action group that opposes the Republican health plan.

WILL FISCHER: If it were to be passed into law, Medicaid would be gutted. And as a result, hundreds of thousands of veterans would lose health insurance.

O'NEILL: It's too early to know just how many veterans would lose coverage as a result of the Medicaid reductions. First, states would have to make some tough decisions, whether to make up the lost federal funding or to limit benefits or to restrict who would get coverage. But Dan Caldwell thinks the concerns are overblown. He's a Marine who served in Iraq and is now policy director for the group Concerned Veterans for America.

DAN CALDWELL: The people who are saying that this is going to harm millions of veterans are not being entirely truthful because they're leaving out the fact that many of these veterans qualify for VA health care or, in some cases, already are using VA health care.

ANDREA CALLOW: About a half million veterans today are enrolled in both programs, says Andrea Callow with the nonprofit group Families USA. Callow is an author of a recent report that shows 1 in 10 U.S. veterans is enrolled in Medicaid.

CALLOW: Oftentimes, veterans will use their Medicaid coverage to get primary care. If, for example, they live in an area that doesn't have a VA facility, they can use their Medicaid coverage to see a doctor in their area.

O'NEILL: Whether a particular veteran qualifies for coverage through the VA depends on a host of variables that Callow says leaves many with only Medicaid as an option. But Caldwell says, rather than fighting to preserve Medicaid access, veterans would be better served by efforts to reform the care the VA provides to those who qualify.

CALDWELL: We believe that giving veterans more health care choice and restructuring the VA so they can act more like a private health care system will ultimately lead to veterans who use the VA receiving better health care.

O'NEILL: The Urban Institute found that the first two years of the Affordable Care Act saw a nearly 40 percent drop in the number of uninsured veterans under the age of 65. That was due in large part to Medicaid expansion under the law. For NPR News, I'm Stephanie O'Neill.

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INSKEEP: And this story is part of a reporting partnership with NPR News and Kaiser Health News.

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