Think Tank

Repeal & Replace Watch

California’s Republican Congress Members Face Quandary Over Health Bill

With the House expected to vote Thursday on the American Health Care Act, the GOP leadership’s first swipe at repealing the nation’s landmark health care law, California’s 14 congressional Republicans find themselves in a delicate position. Seven of them represent districts that voted for Hillary Clinton, and many of their constituents could lose coverage under the GOP health plan.

Since the Republican bill was introduced earlier this month, California Republicans have been largely silent or noncommital about it, especially in the face of strong opposition from some constituents.

In the meantime, a Congressional Budget Office report suggested that that up to 24 million Americans could lose their insurance coverage under the bill by 2026. A recent analysis by Covered California, the state’s insurance exchange, found that many Californians could be priced out of exchange coverage because of an average 40 percent drop in subsidies by 2020, as reported by the CBO.

And the state released an analysis of the bill Wednesday estimating that California would lose more than $24 billion annually in federal funding for Medicaid by 2027. More than 13 million low-income Californians depend on Medicaid (called Medi-Cal in California).

The Trump Administration and House leaders, who see the Medicaid program as a far-too-costly entitlement program, have been pressing fellow Republicans to support the legislation. Its prospects were still uncertain late Wednesday.

In recent days, California Healthline contacted all 14 Republican House members in California. Five responded, all through staffers, with a written statement. Others who did not respond had expressed their views though earlier statements or other news outlets.

For example, Rep. Tom McClintock, R-Elk Grove, said on the House floor Tuesday that he would support the bill after certain changes, the Los Angeles Times reported He had previously sent mixed signals on his position after facing anti-repeal protesters at a raucous town hall earlier this year.

Rep. Darrell Issa, R-Vista, who narrowly won re-election in November, said last week that he “is not prepared” to vote for the AHCA as it stands. “I think we can do better,” he said on Fox News, citing affordability concerns. Issa’s press office did not respond to several attempts by California Healthline to get an updated statement from the Southern California congressman, who is believed to be a top Democratic target in 2018.

Contacted by California Healthline this month in regards to a story about Medi-Cal, Rep Devin Nunes, R-Tulare, described the program as “a broken healthcare system that’s been completely mismanaged by the state of California.”

“The problems have particularly affected residents of the Central Valley, where specialized doctors are so scarce that vast numbers of Valley residents have to go to Los Angeles or the Bay Area for specialized treatment,” his statement read. “Under the American Health Care Act, all citizens will have the ability to get coverage if they want it. My expectation is that healthcare for Valley residents will dramatically improve.”

Nunes’ staff did not respond to further inquiries.

Below are statements from the five House Republicans who responded to inquiries from California Healthline:

If It's Broken — And It Is — Fix It

Our healthcare system was broken before Obamacare, but Obamacare made it even worse.

Possession of an insurance card does not necessarily equate to access to quality healthcare, a reality my constituents grapple with every day. That’s why we need to find a better solution.

Our healthcare system is incredibly complex and any potential reforms must be thoughtfully considered. As I continue to review the recent proposal from House Republicans, ensuring my constituents have access to affordable, quality healthcare will remain my top priority.

GOP Bill Will Empower Americans With Choice

Obamacare continues to collapse under its own weight. Premiums are skyrocketing. Insurers are pulling out of the marketplace, leaving some counties with no providers at all and others with only one choice.

This report by the CBO confirms that this first phase of health care reform, the American Health Care Act, uses conservative and free-market principles that will empower Americans with access, choice, and affordability. After 10 years, premiums will be 10 percent lower than under Obamacare even while we reduce the deficit by $337 billion and make Medicaid solvent with an $880 billion reduction in spending.

The next phases of our plan — from administrative actions taken by Health and Human Services Secretary Tom Price to scheduling votes on additional legislation outside of the reconciliation process — will only further reduce costs and increase access to health care.

Unlike Obamacare, our plan does not force people to buy insurance plans they may not want or even need. The fundamental premise of the American Health Care Act is that people should be free and able to buy quality health care that suits their needs.

Great In Theory But What About In Practice?

In reviewing this bill, it seems to address many of my constituents’ concerns, including protecting coverage for pre-existing conditions, allowing individuals up to age 26 to remain on their parents’ insurance and keeping the ban on lifetime coverage limits.

However, I have questions about how it will affect constituents upon implementation, namely those covered under the Affordable Care Act’s Medicaid expansion, and tax credits for working families.

The Central Valley, along with many other rural areas, has a huge lack-of-access issue. California is currently the 48th-lowest state for reimbursement rates to doctors who accept Medicaid patients, which means we have fewer doctors willing to serve our community than we would otherwise. In order to attract more doctors to our community and improve their ability to treat the sick, we must improve reimbursement rates as well as increase residency positions in underserved areas.

This bill is the first of several steps toward a more affordable and patient-centered healthcare system for America, and I will make sure that my constituents’ voices are heard in Washington. I encourage everyone to continue informing me with comments and concerns now that we have text available for review.

System Is On Life Support And We Need To Act

With premiums rising, deductibles increasing and health care choices decreasing, American families know all too well that Obamacare is collapsing. That’s exactly why I promised the voters in my district that I would take action and work to repeal and replace Obamacare with patient-centered health care solutions that actually reduce costs and expand choices.

The simple fact is our health care system is on life support and whoever won last year’s election was going to need to resuscitate it.

The introduction of the American Health Care Act is an important step towards the fulfillment of that promise. The bill empowers families and doctors with health care decisions, rather than giving Washington bureaucrats the power to impose one-size-fits-all regulations. Not everyone requires the same type of health plan, so the bill gives Americans more affordable options and the ability to find the right plan for them.

It’s important to note that the House plan will continue to protect American families by ensuring people with pre-existing conditions are not denied heath care policies and allowing the coverage of dependents until they are 26 years old.

The American Health Care Act will also help patients and our economy by repealing Obamacare taxes on prescription drugs, over-the-counter medications, health-insurance premiums and medical devices.

Repealing and replacing Obamacare is not an easy task, but the American people don’t want to hear excuses — they want health care policies that actually work. I look forward to working with my colleagues throughout the legislative process to send a bill to President Trump’s desk that saves our health care system.

This Is Just The First Step

The new plan presented by Republicans to repeal and replace the Affordable Care Act is a good start for the discussion.

This is only the first part in a three-pronged process to provide better and more affordable health care options for Americans.

While we will still suffer through the effects of the ACA’s momentum for a few more years, this proposal is intended to significantly lower premiums and to lower the deficit by $337 billion. We cannot sustain the current projection that we are on, and the Republican plan intends to provide much-needed relief and freedom of choice to millions of Americans.