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Column: Improve, Don’t Ditch, Obamacare



To the Valley News
Saturday, July 15, 2017

Seven years ago, the Affordable Care Act initiated monumental change in our health care system. Health insurers are no longer allowed to discriminate against individuals with pre-existing conditions, providers are now required to cover important services such as mental health and substance misuse treatment, and young adults can stay on their parents’ plans until age 26.

Additionally, expanded Medicaid coverage has provided quality health care to tens of thousands of Granite Staters and Vermonters alike and has been an important tool in our fight against the heroin and opioid epidemic. More than 100,000 individuals in New Hampshire and over 90,000 in Vermont now have access to health care because of the Affordable Care Act. More people are receiving preventative care, which has reduced the strain on our emergency rooms and the overall cost of health care.

We know, however, that the ACA isn’t working for some Americans. Premiums have risen for some businesses and individuals, and many parts of the country do not have sufficient competition in the individual marketplace. No major legislation is perfect when first enacted, but that doesn’t mean the ACA should be repealed. Think of Social Security and Medicare, both of which have been amended and improved over time.

Clearly, the health care proposal put forward by Republican leaders will not achieve our goals of expanding access, lowering costs and improving quality of care. It’s no wonder a recent poll found only 12 percent of Americans support the Senate Republican’s legislation. Their bill would increase premiums, particularly for Americans 50 and older, and would jeopardize access to health insurance for as many as 7 million veterans. In addition, it threatens coverage for pre-existing conditions and mental health, and ends the Medicaid expansion. It is wrong for New Hampshire, wrong for Vermont and wrong for our country. We’re encouraged that every day thousands of people across the United States are letting their lawmakers know that this isn’t the solution.  

A partisan bill is not the answer. We’re hopeful that its failure will lead to a genuine bipartisan compromise that is necessary to improve the Affordable Care Act. We approach the health care debate with the belief that, by working together, we can make significant improvements to our health care delivery system. 

For the last several months we have been working closely with several like-minded Democratic colleagues to develop a plan to stabilize and strengthen the Affordable Care Act. Our group has received input from expert health care economists, insurers, care providers, consumers, small business owners our Republican colleagues and others in the medical field to develop a plan to stabilize the individual marketplace, promote competition and bring down costs. 

Last week we unveiled our proposal and are hopeful our plan will serve as the starting point for finding bipartisan common ground in Congress on health care reform.

Our proposal has many elements, including a “reinsurance” program to help stabilize insurance costs and bring down premiums, and expand premium assistance based on age and geography as well as income. We also propose allowing older Americans to buy into Medicare.

We hope it will provide the framework for further discussions on improving our health care system. For example, in 2003, Congress created the Medicare Part D drug program, which prohibited the federal government from negotiating lower drug prices. It was a huge giveaway to the pharmaceutical companies. Problems like this need to be fixed. We would like to come together to fix these issues, but we must first ensure Americans have access to stable and affordable insurance markets.

The health and well-being of the American people isn’t an issue that falls along party lines. No one, Republican or Democrat, wants to see a health care system in which Americans fall through the cracks. But a single-minded focus by Republican leaders on repealing the Affordable Care Act has led to inaction and inadequate policy proposals. No party has a monopoly on good ideas. Solutions need to come from genuine collaboration. Our initiative is just the beginning. We’re hopeful that once the dust settles on this nearly decade-long divisive debate, our plan will serve as the building blocks for finally ensuring that all Americans have the peace of mind that comes with access to quality and affordable health care coverage.

Annie Kuster, a Democrat, represents New Hampshire’s 2nd District in the U.S. House. Peter Welch, a Democrat, represents Vermont in the House.