WACO (August 29, 2009)—Rep. Chet Edwards, D-Waco, held the second of three face-to-face town hall meetings Saturday in Waco on the controversial and complex health care reform bill now before the U.S. House, telling the crowd of about 1,200, “Doing nothing is not a long-term option.”
“I consider health care to be one of the most important issues any Congress will face,” Edwards said, promising to spend “countless hours” analyzing the legislation and to listen to views of residents of the district “from all walks of life.”
Edwards initially planned only to hold a district-wide telephone town hall meeting, but reconsidered the decision not to schedule personal appearances in the face of mounting criticism and with assurances from groups opposed to the reform bill that they would not disrupt the meetings.
The first of the town halls was Wednesday at the Brazos Center in Bryan, where it appeared most of the 1,200 residents in attendance opposed the measure.
The third of the face-to-face meetings is from 6 p.m. to 8 p.m. Friday in the Cleburne High School auditorium, which holds 1,800.
Early in the session Saturday, Edwards again dismissed the claim the bill provides for so-called death panels to make decisions about whether health care should be withheld, but the question came up several times during the two-hour meeting Saturday, anyway.
“Let’s put to rest the death panels,” Edwards said, “the absolute myth that there is going to be a group of government bureaucrats saying that you’re 70 years old, you’re no longer working and you’re somehow no longer productive citizens.”
“Government doesn’t have that right or that responsibility and that is not in the bill,” he said.
The question of whether coverage should be mandated in public or private plans for abortion also came up.
Edwards said the bill now before the House would preserve the restrictions of the Hyde Amendment, which says federal dollars may pay for abortions only in cases of rape or incest or when the life or health of the mother is endangered.
He said he would oppose any effort to drop those restrictions from the measure.
Among the first questions Edwards was asked Saturday was whether the terms and requirements of the sweeping bill would apply to members of Congress.
“I will not vote for a bill that exempts members of Congress from the provisions of this law,” Edwards responded.
Another resident wanted to know how the bill would affect those who have health insurance and are satisfied with the coverage and the care they’re now receiving.
In a response that produced boos from some members of the audience, Edwards said the bill “would in no way prohibit you from keeping your coverage or choosing your doctor.”
“Whether you like the answer or not, it’s a fact,” he added.
Edwards said he has not made up his mind on whether the bill should include a government health insurance option, but said the goal of the measure should be to foster competition among insurance companies to drive down costs.
He said he would vote against the government option, however, if it were clear that it’s a backdoor to a single-payer system and he said he would not support any taxpayer subsidy for either a government-created or cooperative health insurance provider.
Another questioner wanted to know, “Where do we find it in the Constitution where government is responsible for our health care.”
“Article 1, Section 8 as well as the Interstate Commerce Clause allows the government to be involved,” Edwards said, adding that he doesn’t “want government running and controlling our whole health care system.”
He was greeted with loud applause when he asked the audience if members would support getting rid of Medicare and Medicaid, but made it clear he disagrees with those that think those programs should be dissolved.
“I will not vote to privatize or get rid of Social Security,” he said.
“I will not vote to privatize or get rid of Medicare,” he said.
Before those programs, Edwards said, seniors had the highest percentage of those living under the poverty level.
“Today in America,” he said, “seniors have the lowest percentage…largely due to Social Security and Medicare.”
The country now has a public-private partnership in healthcare, Edwards said in response to another question, and there’s not a hospital today that could keep its doors open without Medicare and Medicaid.
He said the plan ultimately must protect the quality of that partnership, allowing choice while holding down costs.
Edwards agreed with another questioner about tort reform, saying there must be an end to frivolous lawsuits and the defensive medicine that comes with them.
But he said tort law has been jurisdiction of the states, and letting Washington write tort law would be a double-edged sword.
Another questioner expressed concern that providing health insurance coverage to as many as 46 million people without a corresponding increase in the number of doctors would inevitably lead to rationing.
Edwards agreed that in the short-term there would be extra demands on family practice physicians, but said getting those now without insurance about of emergency rooms and into doctors’ offices would ultimately be more efficient and more economical.
In the long run, Edwards said, the bill would address the issue by increasing reimbursement rates for family physicians and by encouraging more medical students to go into family practice through school loan forgiveness and reduced school loan interest rates.
Edwards fielded several questions about the cost of the bill, both to taxpayers and businesses.
He said a Congressional Budget Office analysis released in July found that the combination of cost savings that reforms are expected to produced coupled with a tax surcharge on Americans earning more than $350,000 a year would be more than enough to cover the cost of the measure.
But he said he has some questions about the analysis and wants to be sure that the assumptions it makes about savings are realistic.
He told another questioner that the bill’s requirement that most employers provide health insurance to workers could be a cost to business, but said for those firms already providing coverage a failure to act to rein in cost increases could ultimately lead to bankruptcy.
He said the bill exempts small businesses with payrolls less than $500,000 a year from the requirement and said that companies employing 25 or fewer would be eligible for subsidies of as much as 50 percent to provide the insurance.
He said the bill also would level the playing field, giving smaller businesses the same buying power in the health insurance marketplace as big companies and protecting small firms from precipitous rate hikes should a worker develop a serious and expensive illness by broadening the risk pool.
But in the end, he said, “you can’t have it both ways” if the goal is to maintain the public-private partnership through an employer-based health care system.
There are no easy answers in the process, but he said it would be irresponsible “to kick the can down the road and just do nothing.”
The district-wide telephone town hall meeting was held on Aug.20.
About 200,000 residents of the congressional district received automated calls inviting them to participate and about 20,000 actually did.
During the 90-minute call, Edwards outlined the five key principles of the bill.
1) Health insurance reform
The bill would bar insurance companies from denying coverage for those with preexisting conditions and from charging exorbitant rates to those with preexisting conditions. It would ensure that those who lose their jobs can continue their coverage through an insurance exchange that would also allow small businesses and individuals to obtain coverage at competitive rates, as large businesses are able to do now. The bill would bar insurance companies from penalizing small businesses because a few employees had major illnesses or serious injuries. And the bill would prohibit annual and lifetime caps.
2) Personal responsibility
All Americans would be required to buy health care insurance, much as they’re required now to buy automobile insurance in order to buy and license a car. Tax credits would be provided to low and middle-income families.
3) Employer responsibility
All businesses would be required to provide health care insurance with exemptions for companies with payrolls less than $500,000 a year.
Companies with 25 or fewer employees would receive subsidies of as much as 50 percent.
4) Cost containment
If we do nothing, Edwards said, by 2016, Texas families will pay $24,000 a year for health insurance, which is 51 percent of the average family income in the state. Cost containment measures in the bill include a push away from emergency room care and toward primary care physicians; an emphasis on preventive care including such things as mammograms and colonoscopies; A reduction of what Edwards said is an $1,800-a-year “hidden tax” that insured Texans pay in the form of higher premiums to offset the cost of care to those without insurance; drug company concessions to drop Medicare Part B drug expenses by 50 percent; more Medicare insight, and insurance reforms.
5) Budget neutrality
The reforms would be paid for without increasing the federal deficit. Half of the cost would be paid by cost savings, Edwards said, and the other half by a health tax surcharge on Americans with incomes of more than $350,000 a year. Edwards said the nonpartisan Congressional Budget Office concluded the bill would create a $7 billion surplus over 10 years.