Obamacare repeal would cost state, Health chief warns

DOVER — Delaware could face challenges as a result of two looming health care issues: About 10,000 people could lose Medicaid coverage and some students could fail to gain access to medical school programs.

Changes to the Affordable Care Act as promised by President-elect Donald Trump would have “a significant budgetary impact” on Delaware, Department of Health and Social Services Secretary Rita Landgraf said Tuesday.

The state is also facing the end of two programs that help some Delawareans get into medical school and supporters claim that would create a shortage of physicians in Delaware.

Ms. Landgraf, appearing before budget officials, detailed the agency’s request for $42 million more on top of the amount it is already earmarked this year. The additional request, made for the fiscal year starting July 1, 2017, would bring the total to $1.23 billion.

About 29 percent of the state budget currently goes to DHSS, with $770 million being spent this year on Medicaid.

Fall colors welcome visitors to Legislative Hall, Dover, where budget meetings began Tuesday. (Delaware State News/Andrew West)

Fall colors welcome visitors to Legislative Hall, Dover, where budget meetings began Tuesday. (Delaware State News/Andrew West)

Ms. Landgraf said the state would be responsible for additional costs in the neighborhood of $100 million if Congress repeals the Affordable Care Act, also known as Obamacare.

“Curtailment or elimination of other provisions of the ACA may raise barriers to ongoing innovation or transformation,” she said.

The state could erase that deficit by restricting eligibility — undoing a prior Medicaid expansion and effectively removing coverage for about 10,000 people.

Meanwhile, more than 10 speakers testified against ending funding for two arrangements that make it easier for Delawareans to get into medical school and, advocates say, help ensure they move back to the First State after graduation.

The Delaware Institute of Medical Education and Research and the Delaware Institute for Dental Education and Research are receiving about $1.8 million this year in special funding. That came about after the Joint Finance Committee removed the money from the regular budget in June, misunderstanding what the funding was for.

Delaware is one of five states with no medical school.

Rita Landgraf

Rita Landgraf

DIMER, which began in 1969, reserves 20 spots at Sidney Kimmel Medical College of Thomas Jefferson University of Philadelphia and five at Philadelphia College of Osteopathic Medicine for Delaware students. DIDER sets aside five slots at Temple University Kornberg School of Dentistry.

According to Delaware Healthcare Association President and CEO Wayne Smith more than a quarter of the physicians in Delaware went through DIMER.
Withholding funding “would be a calamity,” Mr. Smith said, telling budget officials Delawareans seeking medical degrees will move far away for their education and not return to the state after becoming doctors if the program ends.

Others agreed.

“It’s you young people and your children who are going to be affected if these pipeline programs shut off,” Delaware League of Women Voters health care chairwoman Joann Hasse said.

Support for DIMER and DIDER could still be included in the governor’s January recommended budget.

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