Rep. Newhouse Responds to My Letter Urging a 'No' Vote on the American Health Care Act

Dear Dr. Badalamente,

          Thank you for contacting my office regarding your thoughts on the American Health Care Act.  It is important to hear from constituents as I work in Congress representing the people of Washington’s 4th District.  I sincerely appreciate you reaching out and sharing your views on this important issue.
          I strongly believe Congress must act to improve our health care system and ensure all Americans have access to quality care.  The Affordable Care Act (ACA) has failed far too many Americans, and this trend continues with fewer and fewer plans available to families across the country as insurers continue to flee the market, limiting options and increasing costs.  Right here in our state, the health insurance market continues to collapse.  The Office of the Insurance Commissioner (OIC) recently announced drastic reductions of choices in the 2018 marketplace, resulting in less than half the number of individual health plans Washingtonians can now buy in and outside the state’s insurance exchange.  Currently, 13 insurers offer 154 plans in Washington state.  In 2018, that number will be cut down to just 71 plans offered by 11 insurers.  These changes will impact tens of thousands of patients in our state.  Chelan, Ferry, Pend Oreille, and San Juan counties will all have only one insurer offering coverage plans on the exchange—that is no choice at all.  Douglas County, right here in Washington’s 4th Congressional District, will also only have one option.  Even more devastating, Grays Harbor and Klickitat counties will have no options at all; zero insurers are offering insurance plans in these counties, both in and outside of the ACA exchange.  This year alone, premiums rose 13.1 percent in our state.  If Congress does not address this issue, premiums, deductibles, and other health care costs will continue to rise and choices for coverage will continue to diminish.  Too many families are being afflicted with skyrocketing costs and limited access to care, which is why I remain committed to providing relief for the American people and to fixing our broken health care system.
          As you may know, the U.S. House of Representatives passed H.R. 1628, the American Health Care Act (AHCA), on May 4, 2017, by a vote of 217-213.  The legislation is now being considered by the U.S. Senate.  I released the following statement upon passage of H.R. 1628 in the House:
 

“For years, I have been hearing from Central Washington families who lost insurance that they wanted to keep and are now paying more for health care due to the Affordable Care Act.  Their stories of paying higher prices for insurance and higher deductibles with limited insurance options have been the reason I have voted in the past to repeal Obamacare along with its mandate and bureaucratic regulations.  I strongly believe that every American deserves access to affordable health care, and the status quo under the ACA is not working.  Because of my wife Carol’s health, I have largely remained by her side and was unable to be in D.C. for the vote on the AHCA.  I am pleased the process to improve our health care system will continue with action by the Senate and further negotiations with the House.  I will continue to work with my colleagues to keep my promise to reverse the burdens created by Obamacare and restore patient-centered health care.”

          I believe all Americans deserve access to quality, affordable health care.  We owe it to the American people to replace the ACA with an alternative that reduces costs and ensures patients have access to quality care of their choice.  The AHCA eliminates the federally dictated individual and employer mandates established by the ACA, which have driven many consumers from the marketplace or forced them to buy costly plans that don’t fit their individual needs.  I fundamentally believe the federal government should not be mandating Americans to purchase a one-size-fits-all health plan, but rather should encourage Americans to purchase the health plan they deem best fits their needs or those of their family.  The bill also dismantles the vast array of burdensome taxes set down by the ACA.  Instead, the AHCA will help Americans access affordable, quality health care by providing tax credits for low- and middle-income individuals and families so they can purchase insurance in the private market.  The bill also establishes a Patient and State Stability Fund that provides $138 billion to states to design programs that meet the unique needs of their patient populations while helping low- and middle-income Americans afford quality health care coverage.  Additionally, the AHCA enhances and expands Health Savings Accounts so Americans can plan and save for their future health care needs.  By eliminating burdensome taxes and lifting the mandates currently weighing on the shoulders of millions Americans, I believe we can spur a robust market for individuals and families to access the best care they need, cut out-pocket costs like premiums and deductibles, promote access to health care services, and lower costs for Americans.
          There has been an extensive amount of misreporting about the AHCA, particularly regarding the update to the bill known as the MacArthur amendment.  To reduce insurance premiums, the MacArthur amendment provides states with the option to apply for limited waivers from certain federal insurance regulations that increase premiums.  This new flexibility will allow states to design insurance frameworks that are best for their unique populations, providing better care and lowering costs for patients.  States that apply for these waivers must have established a risk-sharing program with the purpose of lowering premiums and other out of pocket costs for patients in the program.  To be clear, under the AHCA and the MacArthur Amendment, insurance companies are prohibited from denying or not renewing coverage due to an individual’s pre-existing condition.  Insurance companies are also banned from rescinding coverage based on a pre-existing condition.  And, insurance companies are banned from excluding benefits based on a pre-existing condition.
          The waiver only applies to the individual insurance market, where approximately seven percent of the country purchases coverage.  It does not apply to the 93 percent of Americans with employer-provided coverage or a government coverage program, such as Medicare, Medicaid, Tricare, and Department of Veterans Affairs (VA) benefits.  In the rare circumstance when a person who purchases health care in the individual market may be affected by a waiver and charged a higher premium, it would be due to that individual not maintaining continuous insurance coverage.  Under no circumstance could they be denied coverage for a pre-existing condition.  Additionally, higher premiums could only be charged to these individuals for a period of one year.  The $138 billion Patient and State Stability Fund includes $100 billion for states to establish these high-risk pools, cut out-of-pocket costs, promote participation in private health insurance markets, increase the number of options available through the market, and develop other innovative risk-sharing programs.  $15 billion is made available to establish a federal risk-sharing program to serve as a secondary buffer for high-cost individuals.  An additional $15 billion is made available specifically to cover costs associated with maternity and newborn care, mental health care, and substance abuse disorders.  Finally, $8 billion is specifically targeted to reduce the premiums and out-of-pocket costs of those citizens with pre-existing conditions who find themselves in the unlikely situation outlined above.
          I was disappointed to see the many outlandish and appalling claims being made about the AHCA, including the dangerous assertion that rape and sexual assault are classified as pre-existing conditions that could prevent an individual from accessing insurance coverage.  This is a patent lie, as no one can be denied coverage, and I am glad the Washington Post rated it false with “Four Pinocchios”: http://wapo.st/2sjrmUl.  Various other claims have been debunked or fact-checked as false, including baseless and irresponsible assertions that seven million veterans will lose their health insurance tax credit, that 129 million people with pre-existing conditions could be denied coverage, and that the AHCA goes “back to the day when insurance companies could deny coverage to those with pre-existing conditions.”  Honest public debate should rightly take place in our country when comprehensive reforms are being discussed and considered—but such debates must be made on the facts, not on fear-mongering hyperbole.
          Again, I believe we can do better for Americans struggling with high health care costs, and I will continue to advocate for a system that benefits all Washingtonians and all Americans.  We can protect the most vulnerable amongst us without sacrificing the livelihoods of many in the middle class.  We can strengthen the safety net for those who need it most, aid those transitioning out of the safety net by supporting them with tax credits to purchase affordable care that fits their needs, and make it easier for middle class families to access and acquire the care they desire.
          Over the past several months, I have been meeting and speaking with constituents from all sides of the health care debate, including doctors, nurses, hospital and health district administrators, insurers, patients, and constituents—all who have a variety of perspectives and helpful input.  It is vital we continue to have a dialogue in order to find common ground and solve these problems together.  My door has been, and will always be, open to hear from patients, providers, experts, physicians, and all people of the 4th Congressional District as we continue to have this national debate.  I remain committed to reforming our health care system to ensure current and future generations have access to the care they need, and I greatly appreciate the input of engaged citizens like you. 

          I hope you will continue to be in contact as Congress debates the many issues of importance to the country. I also encourage you to connect with me on Facebook and Twitter and to sign up for my e-newsletter for the latest updates on my work to represent Central Washington’s views in our nation’s capital.

          Thank you again for taking the time to share your concerns with me—I am always glad to hear from constituents of the 4^th District. It is an honor and privilege to serve you in Congress.
Sincerely,

Dan Newhouse
Member of Congress
________________________________________ http://www.politifact.com/truth-o-meter/article/2017/mar/22/republican-health-care-bill-cheat-sheet/

Republicans Finagling Passage of AHCA

The Republican-led House passed the American Health Care Act (AHCA) May 4, without waiting for the Congressional Budget Office (CBO) assessment of the plan. Last week, May 24th, the CBO and the staff of the Joint Committee on Taxation (JCT) provided their assessment, which was required before the bill could be sent to the Senate for consideration. The CBO results were bad, just as republicans anticipated. Nevertheless, they plan to go ahead with their pledge to repeal and replace the Affordable Care Act (ACA). Why? Because it plays to their base, and because it’s another brick in the Obama legacy wall they are intent on tearing down. They need bricks, lots of bricks, to build "The Wall."

Republican debates and machinations on the health care bill have been held behind closed doors. Members have no doubt been threatened with severe repercussions should they leak anything to the Press (after all, one Texas republican recently threatened to shoot a colleague in the head over an altercation on immigration). What has emerged however, is that Senate Leader Mitch McConnell and his cohorts are attempting to have the AHCA considered under special budget rules designed to protect it from Democratic defeat.

The Senate parliamentarian, Elizabeth MacDonough and her staff will decide whether Republicans can use the budget reconciliation process to pass the AHCA in the Senate. Under the budget reconciliation process, Republicans would only need 50 "yes" votes from GOP members to pass the healthcare bill, assuming no Democrats vote for the bill and Vice President Mike Pence casts a tie-breaking vote — both good assumptions.

Republicans are promoting the AHCA’s estimated $119 billion reduction of the U.S. deficit over ten years, $11.9b per year. For perspective, that’s 1.4% of the 2018 U.S. military budget. The reduction comes through steep reductions in Medicaid and the replacement of current subsidies with less-generous tax credits.

Among other things, the republican plan would leave some 23 million people without health insurance. People age 50 to 64 would be hit particularly hard, especially those with lower incomes. According to the CBO, premiums for a 64-year-old earning $26,500 a year would increase by a whopping $14,400 in 2026. In addition, people with preexisting conditions may not even be able to purchase health insurance because the prices would be prohibitively high.

One republican lawmaker, Rep Raul Labrador, R-Idaho, recently claimed in a heated town hall meeting that, “Nobody dies because they don’t have access to health care.” Of course we know through tragic experience that isn’t true — and studies have validated that experience. People do die because they lack access to health care. Usually, the people who die are the elderly, sick, and disabled. Who knows, killing off people who drive up health care costs may be the republicans’ nefarious plan — all that talk about “death panels” gave them the idea.

Homeless in Los Angeles

So, what to do?

Well, there are some republicans who appear troubled by the cruelty of this bill. There are others, of course, for whom any federal government subsidized healthcare is anathema. Forget them. Focus on the former, they include: Dean Heller (Nev), Patrick Toomey (PA), Orrin Hatch (Utah), Bill Cassidy (La), and John Hoeven (N.D.). Jeff Flake, and John McCain, both of Arizona (Flake is up for reelection in 2018), Susan Collins (ME). Use your social media smarts to email, tweet (they all have Twitter accounts), and post of their Facebook pages. Call their offices. Use your Facebook to identify your FB friends who reside in the state of one of these swing senate votes and urge them to contact their representatives. Just DO WHAT YOU CAN DO!

And continue to bombard Rep Dan Newhouse with calls, emails, postcards, tweets, Facebook comments, and requests for face-to-face meetings. Real life anecdotes work best.

Please share what you're doing on our various group Facebook pages.

Stronger together!

Why Are Republicans Pushing a Vote on AHCA Without a CBO Analysis?

Read my lips!

via GIPHY

Republicans Determined to Pass AHCA, But Hurdles Grow

Michigan Representative Fred Upton (R-St. Joseph), a respected moderate Republican lawmaker came out against the latest iteration of the GOP American Health Care Act (AHCA), throwing another hurdle in the way of Paul Ryan's all out push to get the measure passed. Upton said the AHCA in its latest iteration would undermine insurance protections the Affordable Care Act (ACA), the current law, gives people with pre-existing illnesses, a view disputed by supporters of the legislation.

The Detroit Free Press writes,

"Under Obama’s 2010 law, insurers may not charge seriously ill customers higher premiums than healthy ones. The latest revised GOP bill bars insurers from limiting access to coverage for people with pre-existing conditions. But states can obtain federal waivers letting insurers raise premiums on people with pre-existing illnesses, though only if the customer has let their coverage lapse during the previous year. The state must also have a high-risk pool or another mechanism to help such people afford a policy. Supporters of the GOP legislation say it protects people with pre-existing conditions and that the exclusion would affect only a small proportion of them. Opponents say it diminishes their protections by letting insurers charge unaffordable prices. They also say high-risk pools have a mixed record of effectiveness, often because the government money provided to finance them proves inadequate."

Speaker Ryan and other GOP House leaders are working with reluctant members to try pushing the AHCA measure through before the end of this week.

For 4th CD voters, Rep Dan Newhouse may be contacted via form email, or telephone ((202) 225-5816).

Please don't harangue Rep. Newhouse about his wife's illness. Just say your piece about why you oppose GOP efforts to repeal the ACA and replace it with an inferior measure.

The GOP American Health Care Act is Outrageous

From Indivisible Washington

Republicans are rushing to get their outrageous American Health Care Act (AHCA) through before the upcoming April recess, ignoring the normal legislative process, because they don’t want to face you, their constituents. They are moving forward even though we now know, from estimates from the nonpartisan Congressional Budget Office, that TrumpCare will lead to at least 24 million Americans losing their coverage, higher premiums for consumers, and a $600 billion tax break on the wealthy and corporations.

Members of Congress need to know that you reject TrumpCare. The bill the House will be voting on this Thursday would harm millions of Americans. It gives wealthy Americans, insurance companies, drug companies, and other corporations tax breaks. These tax cuts are paid for on the backs of poor and middle class Americans by dramatically scaling back the subsidies that low- and moderate-income families use to purchase affordable health care as well by gutting the Medicaid program.1 The changes to Medicaid financing would not only end Medicaid expansion but also jeopardize states’ long-term financing of the program and their ability to provide coverage to other populations who depend on the program—for example, children, the elderly, and the disabled.

Call your representative in the House and tell them to vote NO on TrumpCare. Tell them you oppose any plan that does not preserve the coverage gains and quality of care under the ACA. First, Do No Harm. Reject TrumpCare.

TrumpCare Details: The CBO score is in and (surprise, surprise!) TrumpCare is even worse than we feared

• 24 million Americans would lose coverage over the next 10 years—14 million in the first year alone
• 2 million Americans with employer-sponsored coverage would lose it by 2020; 7 million would lose it over 10 years
• Higher premiums, higher deductibles, and more out-of-pocket costs
• Insurance premiums would skyrocket by 20% by 2019
• $880 billion in cuts to Medicaid funding while giving rich Americans and corporations a $592 billion tax cut

Call NOW and tell your members of Congress that you oppose the AHCA. Go here to see scripts you can use, if you'd like. Then go to the Indivisible Facebook page and post your experience.

I just finished talking with "Andrew" in Rep Dan Newhouse's office (202-225-516). He was very pleasant and promised to pass on my comments.

And keep sending in those postcards!

Statement by Derek Kilmer (D-WA6)

The debate about repealing the Affordable Care Act is neither disconnected nor distant – it’s about people. Real people who will suffer real consequences if the Republican repeal plan were to pass. 

• It’s about the breast cancer survivor in Gig Harbor who told me that she's only here because of treatment she received through the Medicaid expansion. 
• It’s about the mom in Tacoma who was able to make sure that her daughter's bi-polar disorder was treated by keeping her on the family's insurance plan until she was 26. 
• It’s about all of the seniors I represent that will face premium costs up to 5 times more than younger individuals under the repeal plan.
• It’s about the 24 million Americans expected to lose their insurance under the Trumpcare plan and for every person who will see their insurance premiums rise – on average 10-15 percent.
• It’s about women. One in every five women in our country have gotten care from Planned Parenthood, and they may lose access to mammograms, cancer screenings, and primary care if this bill passes.
• It’s about the 1.3 million people who have received treatment for mental health and substance abuse disorders who may lose access to those vital services under this bill.
• And it’s about the people who will lose access to preventive services from our public health departments because this misguided bill completely eliminates the Center for Disease Control’s Prevention and Public Health Fund.

It’s for all of these people that I will vote no.
There is still plenty we need to do to improve our healthcare system. There are positive changes that can be made to the Affordable Care Act. In fact, I've proposed changes to the law to improve rural health care, enhance affordability for small businesses, and strengthen primary care. 

But Trumpcare doesn't represent progress. Asking people to pay more for less heath care coverage is a move backward.  

Please know that I will keep fighting the fight for the folks I represent. As always, I’m honored to represent you.
- Derek