United Methodist Legislators Disagree on Reform Details

October 16, 2009

A UMNS Report
By Tom Gillem

As the debate over reforming the nation's health care system rages in Washington, the 53 United Methodists who are members of Congress are listening to their constituents and deciding the best path to follow.
But their feelings about the various reform proposals in both the House and Senate tend to echo the positions of their particular political party. All think some reform is needed, but how to make it happen is the issue.
Michigan Democrat Debbie Stabenow, one of nine United Methodists in the Senate, says the need for health insurance reform is imperative.
"We know America cannot continue on this road where health insurance premiums skyrocketed 128 percent, while wages have risen only 38 percent," she says. "The costs of health insurance premiums are growing rapidly, and too many families do not have access to affordable coverage that they deserve."
Stabenow, a member of the Senate Finance Committee, says health care reform legislation should "keep what works and fix what is broken."
"I would like to see the system reformed to provide a public health insurance choice and competition so that all families and individuals have access to affordable health care," she says. "I am very hopeful that we can get it done this year."
Across the aisle, Sen. Pat Roberts, a Kansas Republican, agrees reform is needed, but disagrees on the specifics of the legislation.
"I believe we need reform but not just any reform - the right reform that allows those who like their health plans to keep them while enabling those in need to get better coverage," Roberts says.
'We need reform to ensure that patients aren't turned away for pre-existing conditions," he says. "We need to ensure reforms don't interfere with the doctor-patient relationship or ration care. We also need to make sure that reform isn't paid for on the backs of our seniors through Medicare cuts."
Roberts, a member of both the Senate finance and health committees, says Republican senators have been largely shut out of the process of writing the current Senate proposals.
"If we are going to have comprehensive health care reform that ensures Americans access to quality, affordable care, it should be considered on a bipartisan basis," Roberts says. "It is better to have thoughtful, step-by-step reform than rushing to get something at any cost."
His Kansas constituents are suspicious of the health care reform proposals, he says.
"Many of them worry they could lose their care, and most are concerned that the proposals will do nothing to slow the ever-growing costs of care," he says. "And finally, they are worried about the costs to the taxpayer and future generations of Americans."
'Do no harm'
In the House, where there are 44 United Methodists, Rep. Bill Posey, R-Fla., also says he believes reforms are needed, "but first and foremost, we must do no harm to the 80 percent of those who currently have health insurance and want to keep the coverage that they now have. … Our focus should be to help those that lack insurance to find affordable coverage. We don't need to throw the proverbial baby out with the bathwater, or turn the world upside-down to do that."
Health care reform legislation will have no support from House Republicans unless the Democratic leadership stops trying to push it through without GOP input, Posey says.
"You have to be willing to respect the opinion of the other side, and the current House leadership has failed to do that," he says. "Even on the issue of illegals. You know, the president represented that the bill says illegals are ineligible, but twice they (the Democrats) defeated on party lines amendments from the Republicans to put in a check to make sure you were a legal citizen before you enrolled. There are a lot of people who perceive this as just a step where you give illegals medical rights and then you give them voting rights, then what's next?"
He says Republicans believe providing a tax credit of $2,500 for an individual or $5,500 for a family "would be the cheapest way for the government to solve the (health care) problem - to let them solve the problem themselves with money they are allowed to keep in their pockets for that purpose."
In addition, Republicans feel people who do not have group insurance should be able to pool coverage through alumni associations or other affinity groups, which would increase competition among private plans and bring prices down, Posey says.
Town hall meetings
Democratic Rep. Betty Sutton says she hosted and attended many meetings in her northern Ohio district during the August recess to talk about health care reform with constituents.
"Unfortunately, I have also heard a good deal of misinformation and inaccurate interpretations of the proposals and have attempted to provide information to correct the record," she says. "For example, rumors about death panels and government access to bank accounts have had to be repeatedly dispelled."
The opinions of her constituents differ greatly on the pending proposals, with some favoring a single-payer system and others wanting to "inject choice and competition into the system by providing consumers with the potential to choose a public option."
"Some constituents have also indicated that they want me to vote no, regardless of what any health reform bill contains," she says. "Many supporters have encouraged me to fight for a public option, while some opposed have issued 'demands' that I vote no regardless of the contents proposed."
Sutton says she believes all Americans should have access to affordable quality health care.
"We should inject competition in health care reform. The way we achieve this is by creating a public option to compete with private insurers as one choice that consumers could purchase if they so desire," the Ohio congresswoman says.
Any health care reform legislation should also end pre-existing conditions and both lifetime and annual caps and stop "the overpayment that private insurers are getting through Medicare advantage."
Democratic Rep. Rick Larsen says he was called a liar by some people attending one of his town hall meetings in Washington state even before the meeting began.
"Some of the town hall disruptions, I think, are to the detriment of the folks who are looking for information to help them better understand the legislation," he says. "Those are the people that we need to talk to because they have concerns about health care and they have concerns about the bill and want to understand the direction that Congress is heading so they can understand the kinds of changes that may take place."
After hearing the opinions expressed at the town hall meetings, Larsen says he feels reform is needed because the status quo is not acceptable.
"I challenged people in town halls to tell me what they thought was acceptable, if they did not want reform, and tell me what they thought was unacceptable, if they wanted reform. And honestly, the folks who opposed health care reform couldn't come up with any," he says. "Generally, I didn't hear any specific reasons why they opposed health care reform except that they oppose health care reform."
Spreading the cost
Larsen says he will support the public option as long as it is not permanently tied to Medicare reimbursement rates, which he feels unfairly impacts Washington and 16 other states that receive lower rates because they provide seniors with health care at relatively lower costs and better health outcomes.
Reform legislation should include insurance market reforms that end discrimination in coverage based on age, gender and pre-existing conditions, "but we can only do that cost effectively if we couple it with an individual insurance mandate, so you can spread any cost among a wider group of people," he says. People who make so little income that they cannot buy health insurance on their own must be supported, he says.
"I think if we're going to expand coverage, we're going to have to, as a country, step up for those who can't currently afford health insurance," he says. "There is certainly a good economic reason to do that because we're all carrying that cost right now when those folks go to the emergency room. But there's a good moral reason to do that, as well."