Enhancing Obamacare in the COVID era: A Q&A with Rep. Frank Pallone
Last Friday, the Trump Administration filed a brief with the Supreme Court asking it to torpedo Obamacare, wipe out coverage for 23 million Americans, and strip protections from 130 million more with pre-existing conditions.
It’s a curious thing to do during a global pandemic that has already killed 130,000 Americans, so the Democrats in the House used the occasion to draw a vivid contrast and turbocharge Obamacare by passing the Patient Protection and Affordable Care Enhancement Act.
While it will never be taken up in the Senate, the bill is a statement of how Democrats plan to strengthen our landmark healthcare law if they regain control in Washington: It lowers costs for coverage and drugs, expands Medicaid coverage for millions, and reverses some of the damage done by the current administration by cracking down on so-called junk plans.
Rep. Frank Pallone (D-6th Dist.), the Chairman of the House Energy and Commerce Committee who was one of the key authors on the original ACA, spoke with Dave D’Alessandro of the Star-Ledger Editorial Board about The Enhancement Act Tuesday:
Q. We just had 26 million Americans lose jobs and their employee-based insurance in March and April. So this would seem to be a good time to bolster Medicaid and the ACA exchanges.
Pallone: Absolutely. The main way the ACA expanded insurance was by providing subsidies to pay for premiums and by expanding Medicaid, but a lot of states (14, down from 19) did not expand Medicaid. So we’re trying to create an incentive by going back to a 100-percent federal match there. The problem now is, not only are people losing their insurance when they lose their jobs, their premiums are also going up. The value of this bill is that it reduces the cost of your health insurance as well as the cost of prescription drugs. The CBO estimated that it would result in a 10 percent decrease in premium costs, and up to a 55 percent reduction in drug prices.
Q. The Enhancement Act improves the existing ACA in a number of ways, but bringing down drug costs has to be your top bullet.
Pallone: Right. The original ACA didn’t address drug prices, but HR-3, which passed the House at the end of last year, says that the federal government has to negotiate drug prices. There was a report last week from Patients For Affordable Drugs that said 245 of the most expensive drugs increased 23 percent since January. And, 75 percent of the price increase is related to fighting Covid. Now, all these things are a problem anyway – increasingly, drug costs are a larger and larger part of people’s health expenses. But this has also been aggravated a great deal by Covid.
Q. You said you’ll pay for the other two key provisions — Medicaid expansion in the red holdout states and lowering premiums — with the savings from lower drug prices. The Senate is unlikely to take up this bill, but is there any hope for bipartisan support just on prescription drugs?
Pallone: The only way that happens is if the president pushes Mitch McConnell and Senate Republicans to do it. Remember, he has said several times over the last few years that he wanted to do something about prices, but he doesn’t exercise any pressure on McConnell and the GOP. So my hope is that we get closer to the election and he realizes this is a commitment he’s made since he was a candidate, and he tells McConnell, “Look, you have to do this.”
Q. Some regard the Enhancement Act as a tack to center, maybe since it is not as ambitious as Joe Biden’s proposal, in that it doesn’t include a public option. What’s the thinking there?
Pallone: Well, I’ve always been in favor of a public option. And the only reason we didn’t include it in the last bill is that the Senate wouldn’t support it. But I would like to see a public option, and hopefully that’s something we can do when Biden is elected president and we have a Democratic Senate and House.
Q. The current president isn’t open to much — he’s trying to eliminate the ACA by asking the Supreme Court to rule the individual mandate unconstitutional. Surprised?
Pallone: Obviously he wants to repeal the whole ACA, but beyond that, the Administration’s sabotage is really having a negative impact as well. Because if you buy one of these short-term junk plans that were expanded by the Trump Administration, like many states are offering now, you don’t have an essential benefits package and you’ll face discrimination if you have a preexisting condition. The Energy and Commerce Committee just released a report on junk plans over the last year, and they’re a threat to health and financial well-being – they repeatedly deny claims, they rescind coverage if the enrollee has a prior condition, they discriminate against women, and much more. So people are still buying this lousy coverage and can’t get basic services, after the ACA had required plans to cover a standard package of services.
Q. If president’s agenda is to erase anything with the term “Obama” attached to it, what’s the motivation of your Republican colleagues in Congress?
Pallone: There are many on the Republican side that just believe the federal government shouldn’t help people pay for their health insurance. They don’t remember that before the ACA, they were selling plans for $50 a month that didn’t include hospitalization. If you don’t have hospitalization, you don’t have insurance.
Q. What has our handling of the Coronavirus taught you about the state of the American health care system?
Pallone: This will sound political, but you have to put it at the feet of the president. Because there was no reason why he couldn’t have coordinated everything – medical supplies, testing, vaccine research — and there was nothing but reluctance on his part to get involved and a lot of hospitals and health care systems couldn’t get the equipment they needed. This is why our country has one of the highest number of cases and fatalities. We had (government whistleblower) Dr. Rick Bright testify before our committee, and he said we’ll have the same problem with the vaccine, because there is no coordination at the federal level.
Q. Covid has also exposed massive gaps in coverage, and health professionals are reporting extremely costly ailments that come with Covid – kidney failure, heart damage, etc. How will people ever deal with that financial burden?
Pallone: Right, in the same way we provide free testing — with no copays or deductibles in the CARES Act — the HEROES Act includes free treatment, drugs, and the eventual vaccine. But that hasn’t been taken up in the Senate. And that’s important, because separate and apart from health insurance in general, we really should provide all those things for free without out-of-pocket expenses. Look, people are going to have horrific bills — it’s happening, it’s going to continue to happen, and there’s no reason not to say treatment should be free and the government will supplement where necessary for the people who are uninsured. So yes, we’re going to continue to push for that.