I thought for my first blog post, it might be interesting to share some recent correspondence I have had with Lamar Smith (or more likely, someone in his office) about the Affordable Care Act. It started with his Newsletter of January 13th, when he posted this:
Repealing and Replacing Obamacare
The American people have spoken and today in the House of Representatives we took a major step in repealing the Affordable Care Act (see #3 below) – through the seldom-used budget reconciliation process. This process ensures that a simple majority – 51 votes – in the Senate can pass a bill, as opposed to the 60 votes traditionally needed to advance legislation. This process allows the House and Senate to repeal and replace the ACA in an expeditious manner and put a patient-centered health policy in place.
Senator Michael Enzi of Wyoming put it well: “The Obamacare bridge is collapsing, and we’re sending in a rescue team. Then we’ll build new bridges to better health care, and finally, when these new bridges are finished, we’ll close the old bridge.”
Well, that sounded like maybe Enzi, at least, was under the impression that Congress was going to put together a replacement before repealing, so I thought I would write Lamar Smith and urge him not to repeal the ACA before the replacement was ready. I felt obliged to point out that the American people had, indeed, “spoken,” and that almost 3 million more of us had spoken in favor of Hillary Clinton. I also mentioned that recent polls indicated that only about 26% of Americans favored a full repeal of the ACA. And I must admit that I also asked him, “what would Jesus do?” which I thought might well end our conversation. To my surprise, however, I got a fairly lengthy response, which I will append at the bottom of this post. Here is the letter I just sent him this morning:
January 27, 2017
Dear Congressman Smith,
Thank you for your recent reply to my letter requesting that you not vote to repeal the Affordable Care Act without first coming up with a replacement. In your reply, you say that your “priority is affordable, accessible and quality health care coverage for every one of [your] constituents,” and that “Congress is working on a new plan to improve health care for Americans that lowers health care costs, expands access to care and eliminates unfair mandates and penalties.” I heartily approve of this priority, but I am concerned that the Republican-controlled Congress will not be able to agree upon a replacement plan that will meet your stated goal of ensuring “that [I] and [my] family do not lose access to affordable and quality coverage.” After all, the Republicans have not been able to come up with such a plan for the past six years, so why should anyone believe that things will be different now? The uncertainty that Congress can come together on this kind of complex and controversial legislation is precisely why it so important that the ACA not be repealed without a viable replacement plan being ready to implement. It would be truly catastrophic if Congress went ahead and repealed the ACA, potentially causing millions of people to lose their insurance, and then was unable to agree upon a replacement.
While it is true that the ACA has had some problems, it has also had some undeniable successes. According to the Center for Disease Control’s latest report, approximately 28.4 million Americans were uninsured in the first half of 2016, while approximately 48.6 million were uninsured in 2010, at the time the ACA was enacted. That’s 20 million more people with insurance! Some of them could not have obtained insurance before, perhaps because they had a pre-existing condition, or simply couldn’t afford it. I am relieved to hear that you plan to support retaining the ACA’s mandate concerning pre-existing conditions, but let us not overlook the fact that just because people may have “access to affordable and quality coverage,” it does not mean they can actually afford it.
Finally, I would like to take issue with some specific things that you stated in your letter. First, you claim that “more than five million Americans received cancellation notices for the health care plans they were promised they could keep.” According to a report published by FactCheck.org, “the claim that ‘millions’ lost their insurance or their doctor is a longstanding GOP talking point based on the fact that many with individual market plans received cancellation notices in 2013, when their plans no longer met minimum benefit standards required under the ACA. But that talking point is misleading — those specific plans were discontinued; policyholders weren’t denied coverage.” Second, you state that “Americans are seeing their premiums and deductibles go up, not down.” True, but it is disingenuous to blame rising premiums on the ACA, when according to some objective analysts, premiums would have gone up faster without it. Here is some information about this that I found on HealthInsurance.org:
“Three years before the ACA took effect, health insurance premiums were increasing by 10 percent to 12 percent each year, and the rate of the uninsured was growing.
Today, even as news about big premium increases for 2017 raises concerns about the Affordable Care Act’s long-term health, an analysis released last week in the journal Health Affairs seeks to put things in perspective. The upshot: Things could be worse.
It turns out that the average premiums in the individual market actually dropped when the ACA was implemented.
‘Average premiums for the second-lowest cost silver-level (SLS) marketplace plan in 2014, which serves as a benchmark for ACA subsidies, were between 10 and 21 percent lower than average individual market premiums in 2013, before the ACA…,’ write researchers from the Brookings Institute.”
It is easy and tempting to blame everything wrong with our current healthcare system on Obama and the ACA, and I know that doing so excites some of your most conservative constituents, but until the Republicans can actually come up with a viable alternative, it would be irresponsible and reckless to simply repeal it.
January 19, 2017
Dear Mr. Pinkston,
Thank you for your recent letter regarding the Affordable Care Act, also known as Obamacare. I appreciate hearing from you.
Obamacare is not working for Americans as it was promised. In 2009, President Obama assured Americans that, “If you like your health care plan, you can keep it.” But this has not been the case for the more than five million Americans who received cancellation notices for the health care plans they were promised they could keep. He also failed to mention its 21 different taxes on Americans and businesses at a cost of over one trillion dollars. Across the country, Americans are seeing their premiums and deductibles go up, not down, even though President Obama promised premiums would decline by $2,500 per family.
In 2015 alone, about eight million Americans opted to pay the mandate penalties totaling $1.7 billion. The penalty will rise to $700 per person in 2017. The number of Americans opting to forego health insurance and pay a penalty because of the cost demonstrates Obamacare’s failure. Additionally, two of largest health care insurers stopped offering plans through Obamacare in Texas and dozens of other states. This massive blow has left many Texans and Americans with only one health care option. And this will be the case for over 1,000 counties across the country. For these reasons and more, I support repealing and replacing the Affordable Care Act.
My priority is affordable, accessible and quality health care coverage for every one of my constituents. We are on the precipice of change and Congress is working on a new plan to improve health care for Americans that lowers health care costs, expands access to care and eliminates unfair mandates and penalties. My goal throughout a repeal and replace process will be to ensure that you and your family do not lose access to affordable and quality coverage.
Preliminary discussions have indicated that replacement legislation will maintain policies for pre-existing conditions and an allowance for young adults to stay on a parent’s health plan until age 26. I support these provisions.
The gravity of our health care situation is one that requires immediate attention, which is why the House and Senate have already passed reconciliation legislation to set in motion new heath care policy. Please know I will consider your opinions and concerns on the issue, in addition to how any health care changes may affect you and your family.
For more information about federal issues, or to send me an email, please visit the 21st District’s website, http://lamarsmith.house.gov.
Member of Congress