Arizona Physician

Arizona Physician

Congressional Corner: U.S. Congresswoman Kyrsten Sinema

As I travel around Arizona, I hear almost daily from families, seniors, and businesses about the uncertainty surrounding health care. Unfortunately, partisan gridlock in Washington currently prevents an honest, fact-based discussion from occurring.

The Affordable Care Act (ACA) has been a mixed bag for Arizonans.

On the upside, kids can stay on their parents’ plans until they’re 26, Medicaid expansion provides coverage to millions of hardworking low-income individuals who were previously uninsured, and individuals with pre-existing conditions can buy insurance at more reasonable rates.

Uncompensated care has decreased, allowing greater stability and investment in health care for Arizonans in both urban and rural areas. Medical reimbursements and payments are now more closely aligned with health outcomes.

On the downside, too many people are struggling to find affordable coverage and provider networks that provide adequate choices. Costs continue to rise and options for Arizonans in the individual market are insufficient and expensive. Our exchange isn’t working well.

Instability in health markets creates uncertainty and pain for both families and businesses. Burdensome regulations create unnecessarily challenges for small and large medical practices alike.

Thoughtful fixes must be made, but a full repeal of the ACA without a reasonable replacement would be devastating for many Arizona families and for our state’s economy.

The first attempt by this Congress to repeal and replace the ACA, the American Health Care Act (AHCA), was not reasonable and actually made the law worse for Arizona.

After studying the text and analysis of the AHCA, I could not support it. It would have added financial burdens to our state’s economy. It would have denied coverage and made health care more expensive for too many Arizonans.

Health care reform should control costs and improve quality and access to care for hardworking Arizona families.

Under this plan, too many Arizonans, especially older Arizonans, would lose coverage or face higher premiums or deductibles with less financial support for plans that cover less. The bill’s Medicaid repeal would cost Arizona at least $5.6 billion in health care funding and put a $1.475 billion coverage hole in our state’s budget over the next six years.

This would result in fewer working Arizonans, children, and seniors getting affordable coverage and increased costs for Arizona hospitals, families, and taxpayers.

On March 24, 2017, Speaker Paul Ryan pulled the AHCA from consideration because it was opposed by both conservative and moderate Republicans, and because no attempt was made to work with Democrats to find common ground and effective solutions to the health care challenges we face together.

Today, Republican members of the House have vastly different ideas of what health reform should look like, and outreach to Democrats remains nonexistent. It is unclear if Republicans in the House can coalesce around one bill, and it is even less clear whether the Senate would take up any bill that may come out of the House.

For healthcare reform to last, both sides must put partisanship aside and have a serious debate about America’s healthcare system – so we can keep what’s working and fix what isn’t.

There are actions Congress and the federal government can take to stabilize the market. First, the administration should make clear that cost-sharing reduction payments will remain in effect so Arizonans can afford the plans on offer. Second, Congress should examine allowing older Americans in the individual market to buy into Medicare Advantage plans, and provide effective financial or plan design incentives to encourage more eligible young people to enroll in individual market plans. Third, Arizona should explore waiver authority under the ACA to create a high-risk reinsurance program that better manages the risks and costs within the individual market.

Each of these ideas, and many others, if considered in an open, honest, and transparent way, would lower premiums, increase stability, expand options, and could receive bipartisan support.

We have had some important success. In 2015, my legislation, the PACE Act, introduced with Congressman Brett Guthrie (KY-02), to protect small and mid-size businesses from increased regulations and potential health premium increases was signed into law. We introduced and passed the PACE Act to maintain the current definition of the small group market and ensure stability for employers and employees. Our bill was signed into law before the scheduled change, allowing employees to keep their health insurance plans.

Another area where we have bipartisan support is our work to repeal the Health Insurance Tax (HIT) – a burdensome tax that increases the cost of health insurance for seniors, families, employers, and employees. I introduced this legislation in the House last Congress, and we successfully won a one-year delay. I introduced our bill again this year with Congresswoman Kristi Noem (SD-AL), and we have received strong support from both sides of the aisle.

I have sponsored legislation called the “Lower Drug Costs through Competition Act” to increase competition in the prescription drug market by encouraging the development of generics. I support increasing Graduate Medical Education slots and reducing the crushing medical debt deterring individuals from entering medicine or practicing in underserved areas across our state.  I will also continue to advocate for simplifying the frequently counterproductive reporting requirements that keep providers from spending more time with patients, and let doctors and patients make decisions that are in the best interest of patients.

As other proposals come before Congress, I will support reforms that expand consumer choice, increase the quality of care and access to care, control costs, and strengthen the doctor-patient relationship.

There is absolutely no reason that so many conversations in Washington have a partisan overtone. We know that that there are never just two perspectives, there are dozens. I will continue to focus on where we agree, and on finding new, effective ways to solve problems.

This approach is more important now than ever before – especially as we address serious challenges like making health care affordable and accessible for Americans.

 

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