Philly's likely future DA on cutting Medicaid: 'If you want more crime, it's exactly what you would do'

Lawrence Krasner during the Democratic primary for district attorney.

We’re all familiar with the Declaration of Independence, which asserts that each of us has certain unalienable rights, among them “Life, Liberty and the pursuit of Happiness.”

In the name of health-care reform, politicians in Washington and Harrisburg threaten the first and most foundational of these individual rights: life itself. Their legislative agenda — curtailing important Obamacare protections and cutting back on Medicaid — threatens the lives of tens of thousands of Philadelphians.

It also jeopardizes public safety. When people are faced with chronic health problems or a life-threatening situation involving a family member, and have no options or support, they will act in desperation. When people are unable to afford treatment for behavioral health issues because they lack insurance, the criminal justice system often becomes the only societal structure that intervenes.

Under the American Health Care Act passed by the House of Representatives in May, 1.3 million Pennsylvanians would lose health insurance and 3,250 would die prematurely for lack of it, according to a statement from Marc Stier, director of the Pennsylvania Budget and Policy Center. Meanwhile, the U.S. Senate’s proposed Better Care Reconciliation Act would eliminate federal funding for the Medicaid expansion and impose caps on traditional Medicaid. That would cost Pennsylvania more than $30 billion in federal funding between 2020 and 2026 alone, says a Manatt Health / Robert Wood Johnson Foundation analysis.

As recently amended, the Senate bill would increase premiums and deductibles for millions of moderate-income people who buy health insurance through the ACA marketplaces; weaken consumer protections for people with preexisting conditions; and eliminate the individual mandate, which helps ensure a balanced insurance risk pool. It would block Planned Parenthood from receiving Medicaid funding for a year. And it would have a profoundly negative impact on our city’s world-class health-care providers.

Let’s look specifically at the impact these Medicaid cuts would have. Medicaid is not just a source of health care for millions of Americans, which allows them to remain productive and to take care of other family members. It is also the source of drug treatment and mental health services for the most vulnerable members of our population, including people reentering society from incarceration.

The Medicaid expansion of the Affordable Care Act enables 160,000 more Philadelphians to receive mental health or substance-abuse treatment. According to the Mayor’s Office, almost 40,000 of them are using these services. Statewide, 140,000 people have used the Medicaid expansion for addiction treatment since 2015, the Wolf administration estimates. And nationwide, Medicaid expenditures on opioid-blocking medications such as naltrexone, which many low-income people rely on to kick their addiction, increased tenfold in 2016, according to an Urban Institute report. The demand for such treatment shows no signs of slowing down.

Cut off that funding and you cut off a lifeline for people trying to avoid the kind of behavior that can land them in the criminal justice system. If you want more crime, it’s exactly what you would do.

The same short-sighted and mean-spirited policymaking is happening in the Pennsylvania General Assembly. The Republican-controlled House of Representatives recently amended and passed Bill 59, its own attack on Medicaid and the people who rely on it — primarily children, seniors, and people with disabilities.

Unconscionable bills like these are designed not to provide health care, but to deprive people of it. They would give hundreds of billions in tax breaks to the wealthiest Americans and protect the interests of big insurance and big pharma at the expense of the most vulnerable among us. They jeopardize our health, our well-being, and our lives. They would make us less safe.

As a citizen of Philadelphia and a candidate for district attorney, I stand with you to defend the safety, the health, and the well-being — indeed, the very lives — of the people of our city and state. We must do more than resist; we must resist and then build a more just society.

Larry Krasner is the Democratic candidate for Philadelphia district attorney. You can reach him at @Krasner4DA on Twitter.

Readers respond

As lawmakers on both sides of the aisle consider next steps in the health care debate, what provision would you like to see as part of any reform? How would such a provision impact you or your family? Send responses no longer than 300 words to opinion@philly.com.