Blog

Emails, letters, social media comments, and phone calls have poured into my office over the past weeks, as the House debated and then passed the American Health Care Act. Some of them express support. Some express anger and frustration. The majority include questions and concerns. 

With that in mind, I wanted to take a few moments to directly address concerns I’ve heard and answer some of the most common questions I have received:

“You owe your constituents an explanation for your “yes” vote on AHCA. As a physician, how could you?” – James, via Twitter
Without action, one third of counties across America will be left with only one company offering insurance on the Affordable Care Act exchanges. Higher premiums and higher deductibles continue to be the reality for too many families -- just last week, the Washington Post reported the largest insurer in the Mid-Atlantic region saying the ACA marketplaces “were in the early stages of a death spiral” as the company announced its request for “massive, double-digit premium increases for next year.” Recent analysis for 2017 found that “the percentage increase in average premium for each category of Obamacare nationwide is in the double-digits” while “deductibles among bronze and silver plans… are still considerably beyond what the average family has saved for medical bills.”

Faced with this fiscal reality, and the fact that insurers are increasingly leaving the market altogether, action was imperative. We need to lower costs, so Americans aren’t stuck paying for a fine instead of coverage, or for insurance they can’t afford to use. While the Affordable Care Act helped some Americans, too many are being hurt -- as a doctor, I could not vote to keep this status quo. The AHCA rolls back $1 trillion in ACA tax hikes, repeals the individual and employer mandates, and puts free market-based policies in place to begin lowering costs and increasing choices, while providing protections for the most vulnerable. We may have different ideas about the best solutions, but we cannot leave this many Americans without choices and without care.

“Have you read the legislation for the AHCA and what is your justification for voting in favor of it?” – Adomas, via Twitter
As always, I read the legislation and carefully weighed the amendments before supporting it. Additionally, I connected with over 25,000 constituents through telephone town halls to get their thoughts, and conducted multiple meetings, listening sessions, and roundtables to hear the perspectives of local medical professionals, hospital staff, and district employers. Ultimately, I supported the House healthcare bill because I believe it helps jumpstart the process of finding free-market based solutions to America’s healthcare crisis. I share my thoughts in a little more depth in my video, here.

“Since you're so fair minded, I assume you'll be behind this effort to hold congressmen to the same standard of coverage you just agreed to for the rest of us Americans?” – Mindy, via Facebook
Yes -- the House also passed H.R. 2192, with my support. This legislation ensures lawmakers and their staff aren’t exempt from the AHCA. Under the Affordable Care Act, Members of Congress were in the program while the President and other government officials were exempt. I believe all of Washington should live under the same rules as the rest of America.

“This bill turns the preexisting condition to letting states allow denying that coverage and provides layers that don't support the actual needs of preexisting conditions.” – Jerald, via Facebook
Actually, this bill prohibits insurers from denying coverage based on pre-existing conditions -- period. No state may obtain a waiver for things like pre-existing condition protection or prohibitions on gender discrimination. While the bill gives states the option to tailor insurance frameworks for their residents, the process is very strict. A state must explain how the waiver will lower premiums, increase enrollment, stabilize the market, and/or increase options for their residents. Before getting the waiver, states are required to create separate “high-risk pools” that are subsidized to ensure coverage for pre-existing conditions remains affordable, without spiking costs for everyone.
 
“Why did you vote for this tax break for the ultra-wealthy thinly disguised as a healthcare plan?” – Vince, via Twitter
All Americans benefit from rolling back Obamacare’s $1 trillion tax hikes, as we get rid of increased taxes on health insurance and products that raise costs for consumers. A full list of the tax hikes being repealed can be found here.

“How can you support something that says sexual assault is a pre-existing condition?” – Whitney, via Facebook
 The Washington Post recently fact-checked this claim against the House bill, reporting: “The notion that AHCA classifies rape or sexual assault as a preexisting condition, or that survivors would be denied coverage, is false.” Providing care for victims of violence, particularly those who have suffered sexual violence, must always be a priority.
 
“Hey Brad, why did you vote to GUT Medicaid?” – Doug, via Twitter
This bill does not “gut” Medicaid. Instead, its goal is to refocus the program on those who need it most, while ensuring the rug isn’t pulled out from under anyone. I believe Medicaid serves as a critical safety net -- I also believe we can do better. The program now has three times as many people and costs three times as much as it did under President Clinton. The goal of the bill’s reforms is to give states flexibility to better address the unique needs of their residents, with the opportunity to increase access to real care. It will also encourage more efficient spending in the Medicaid program.

“Trumpcare will make mental health conditions worse. How do you respond?” – Annie, via Twitter
Protecting the most vulnerable is an obligation – that’s why this bill, as amended, includes $15 billion specifically toward mental health and substance abuse disorders.
 
“Sir, I am one of your constituents. I totally disagree with your reasoning.” – Pattie, via Facebook
Ultimately, disagreements will always exist over the best solutions to address America’s healthcare crisis, and some of those disagreements – like the ideological clash between a government-centric versus free market-based system -- may be too fundamental to fully resolve. However, I would invite those with concerns over the bill to bring forward their ideas to make it better. Share your ideas and feedback by contacting one of my offices, sending me an email, requesting an in-person meeting, or signing up for one of my regularly scheduled, live telephone town halls. Let’s continue to debate and hone the solutions it provides as the process moves forward.

This bill is just the first step. I look forward to continuing to hear from you as we work towards a patient-centered system that gives Americans their freedom back, protects the vulnerable, and provides more choices for better care.

Read online, here: https://goo.gl/DWN2zR